Perspectives on Using Race in Pulmonary Function Testing: A National Survey Fellows and Program Directors

Area of Science:

• Pulmonary Medicine
• Medical Ethics
• Health Equity

Background:

• Pulmonary function tests (PFTs) traditionally relied on race-specific prediction equations.
• Recent American Thoracic Society guidelines advocate for race-neutral spirometry prediction equations.
• Limited research exists on pulmonologists' views regarding race in spirometry.

Purpose of the Study:

• To investigate academic pulmonary and critical care providers' beliefs on using race in spirometry prediction equations.
• To understand provider perspectives on the impact of race in pulmonary function testing.
• To assess potential barriers to adopting new race-neutral guidelines.

Main Methods:

• A nationwide survey of academic pulmonary and critical care providers was conducted.
• 151 open-ended responses were collected and analyzed using thematic content analysis.
• Inductive and deductive coding methods were employed to categorize responses.

Main Results:

• Provider opinions on incorporating race in spirometry prediction equations were balanced, with support, opposition, and uncertainty.
• Respondents showed varied understanding of race's definition and its physiological relevance.
• A lack of consensus was observed among participants.

Conclusions:

• No consensus exists among pulmonary providers regarding the use of race in spirometry.
• Persistent beliefs about the biological implications of race may hinder the adoption of new race-neutral guidelines.
• Provider opinions are crucial for the successful implementation of updated PFT guidelines.