CHEST Guidelines-Race-Specific-Spirometry-Equations-Do-Not-Improve-

Race-Specific-Spirometry-Equations-Do-Not-Improve-

Pdf Summary

The study examines the impact of using race-specific spirometry equations versus race-neutral or race-free equations in assessing lung function and its relevance to diagnosing lung disease in diverse racial groups. Current spirometry equations typically adjust for race, predicting lower lung function in some racial groups, particularly among Black individuals. However, the necessity and benefit of these race adjustments have been increasingly questioned. <br /><br />This research used data from healthy nonsmokers and individuals who smoke from the National Health and Nutrition Examination Survey (NHANES) and COPDGene cohorts. The study created and compared race-specific, race-neutral, and race-free spirometry prediction models. These models were assessed for their effectiveness in explaining chest CT phenotypes, dyspnea, and the GOLD (Global Initiative for Chronic Obstructive Lung Disease) classification.<br /><br />The results showed no advantage of race-specific equations over race-neutral or race-free equations. The race-neutral models reclassified up to 19% of Black smokers into more severe GOLD categories, potentially improving the diagnosis of pulmonary conditions. Essentially, race-specific equations might mask lung damage in races predisposed to respiratory issues, exacerbating health disparities.<br /><br />The study supports discontinuing race-specific spirometry reference equations, especially in clinical settings, indicating that they offer no clinical advantages and may perpetuate disparities. Previous studies similarly found no prognostic benefit from race-specific models and highlighted the genetic and environmental factors contributing to lung health disparities. The study calls for reconsidering how these models are used in medical evaluations to reduce racial health inequities effectively.

Keywords

spirometry

race-specific equations

race-neutral models

lung function

health disparities

COPDGene

NHANES

GOLD classification

pulmonary conditions

racial health inequities