Race-Neutral Equations Examined for Interpreting Lung Function Tests

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Use of race-neutral reference equation results in increase in number of Black people with respiratory impairment, severity of impairment.

HealthDay News — Use of race-neutral reference equations to interpret pulmonary function tests (PFTs) results in an increase in the number of Black individuals with respiratory impairments and an increase in impairment severity, according to a study published online June 1 in JAMA Network Open.

Alexander T. Moffett, MD, from the University of Pennsylvania in Philadelphia, and colleagues compared the PFT interpretations produced with race-neutral and race-specific equations developed by the Global Lung Function Initiative.

PFTs were interpreted from 2722 Black and 5709 White individuals. The researchers found that replacing the race-specific reference equations with race-neutral reference equations was associated with an increase in the prevalence of restriction (26.8 to 37.5%) and of a nonspecific pattern of impairment (3.2 to 6.5%) among Black individuals, while no significant change was seen in the prevalence of obstruction. Among White individuals, replacing the equations was associated with a decrease in the prevalence of restriction (22.6 to 18.0%) and in the prevalence of a nonspecific pattern of impairment (8.7 to 4.0%) and was associated with no significant change in the percentage with obstruction (23.9 to 25.1%). Compared with race-specific equations, the race-neutral equations were associated with an increase and a decrease in severity in 22.8 and 19.3% of Black and White individuals, respectively.

“These findings indicate that the choice of race-specific or race-neutral reference equations were associated with PFT interpretation and that the use of race-specific reference equations may play an important role in promoting racial disparities in the diagnosis and evaluation of respiratory disease,” the authors write.

Two authors disclosed ties to the pharmaceutical industry.

Abstract/Full Text

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