FEV₁Q: a race-neutral approach to assessing lung function.

Area of Science:

• Pulmonary Medicine
• Spirometry Interpretation
• Mortality Prediction

Background:

• Forced expiratory volume in 1 second quotient (FEV1Q) offers a simplified spirometry interpretation by comparing lung function to a lower boundary.
• Current spirometry interpretation methods may not fully capture survival predictions.
• The impact of race on FEV1Q and its predictive accuracy requires further investigation.

Purpose of the Study:

• To evaluate the predictive accuracy of FEV1Q for survival compared to existing spirometry interpretation methods.
• To determine if race influences the effectiveness of FEV1Q in predicting mortality.
• To assess the race-neutrality of FEV1Q.

Main Methods:

• Utilized spirometry and mortality data from NHANES III and UNOS databases, including White and Black adults.
• Calculated FEV1Q using established formulas based on sex.
• Employed Cox proportional hazards models to analyze mortality risk associated with FEV1Q, adjusting for covariates and stratifying by race.

Main Results:

• FEV1Q demonstrated a significant association with increased mortality risk across both NHANES III and UNOS cohorts.
• No significant differences in lower boundary FEV1 values were observed between Black and White individuals.
• FEV1Q exhibited superior discriminative power for mortality prediction compared to other FEV1-based approaches in both racial groups.

Conclusions:

• FEV1Q serves as an intuitive, simple, and race-neutral method for interpreting FEV1.
• FEV1Q offers improved survival prediction compared to current spirometry interpretation alternatives.
• The findings support the use of FEV1Q as a reliable tool for assessing lung function and predicting outcomes across diverse populations.