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Researchers Compare Race-Based, Race-Neutral Lung Function Equations

Similarly accurate prediction seen for respiratory outcomes, but occupational eligibility and disability compensation differed

By Elana Gotkine HealthDay Reporter

TUESDAY, May 21, 2024 (HealthDay News) — The use of race-based and race-neutral equations for lung-function testing generate similarly accurate predictions of respiratory outcomes, but differ in terms of disease classifications, occupational eligibility, and disability outcomes, according to a study published online May 19 in the New England Journal of Medicine to coincide with the American Thoracic Society 2024 International Conference, held from May 17 to 22 in San Diego.

James A. Diao, M.Phil., from Harvard Medical School in Boston, and colleagues used longitudinal data from 369,077 individuals to compare the race-based 2012 Global Lung Function Initiative (GLI-2012) equations to race-neutral equations introduced in 2022 (GLI-Global).

Among 249 million persons in the United States between age 6 and 79 years who could produce high-quality spirometric results, the researchers found that GLI-Global equation use may reclassify ventilatory impairment for 12.5 million persons, medical impairment ratings for 8.16 million, occupational eligibility for 2.28 million, chronic obstructive pulmonary disease grading for 2.05 million, and military disability compensation for 413,000. These potential changes differed according to race; classifications of nonobstructive ventilatory impairment may increase 141 percent and decrease 69 percent among Black and White persons, respectively, and annual disability payments may increase by more than $1 billion and decrease by $0.5 billion, respectively, among Black and White veterans. Similar discriminative accuracy was seen for GLI-2012 and GLI-Global equations with respect to respiratory symptoms, health care utilization, new-onset disease, death from any cause, death related to respiratory disease, and death among persons on a transplant waiting list.

“Our study showed that the use of race in lung-function testing has broad clinical, occupational, and financial implications for millions of patients,” the authors write.

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