CHEST Guidelines-The-Race-to-Abandon-Ethnicity-in-Interpreting-Pulm

The-Race-to-Abandon-Ethnicity-in-Interpreting-Pulm

Pdf Summary

The article discusses the ongoing debate around using race or ethnicity in interpreting pulmonary function tests (PFTs). Historically, spirometry values have been differentiated by race, largely originating from outdated notions holding Black individuals as naturally possessing lower lung function—a perspective tied to slavery and racial bias in the 1800s. However, today it's acknowledged that race and ethnicity are sociocultural constructs with limited ties to genetic ancestry.<br /><br />The use of race-specific reference values for diagnosing respiratory diseases like COPD has been questioned because these categories are often arbitrary, lack standardization, and don't effectively account for genetic or cultural intermixing. Race-specific lung function reference values have historically classified lung function as lower in certain racial groups compared to others, potentially leading to misdiagnosed or undiagnosed cases based on these biased standards.<br /><br />The research by Non et al. challenges the need for race-specific equations in lung function interpretation, instead proposing race-neutral equations that account for factors such as age, sex, and height across all population groups. Their study found no significant benefit in using race-specific equations for predicting adverse health outcomes such as emphysema and breathlessness.<br /><br />These findings prompt the need for updated guidelines in respiratory medicine that remove race as a factor in interpreting lung function, which could improve early disease detection and treatment in underrepresented groups. The emphasis should now be on developing multiethnic reference equations that better predict outcomes without relying on racial or ethnic categories. Researchers are investigating new methods, such as using metrics like ulna length, to improve the accuracy of PFTs across diverse populations. The ultimate goal is to ensure health equity and improve diagnostic and prognostic tools in respiratory health without the crutch of race-based distinctions.

Keywords

pulmonary function tests

race-neutral equations

spirometry values

respiratory diseases

health equity

genetic ancestry

multiethnic reference

diagnostic tools

race-based distinctions

lung function