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Current Practices and Preferences Regarding Race and Spirometry Interpretation: A National Survey
J Henry Brems1,2, Aparna Balasubramanian1, Kadija Ferryman2
1Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, MD.
Most academic pulmonologists prefer race-neutral spirometry equations for improved equity and accuracy. While many have adopted these, further research and education are needed for full implementation of the Global Lung Function Initiative (GLI) guidelines.
Area of Science:
- Pulmonary Medicine
- Clinical Diagnostics
- Health Equity
Background:
- The American Thoracic Society recommends race-neutral spirometry equations.
- Clinician adoption and opinions on these recommendations are not well understood.
Purpose of the Study:
- To assess current practices and opinions of pulmonologists regarding race-specific versus race-neutral spirometry reference equations.
- To identify preferred race-neutral alternatives and perceived benefits/drawbacks.
Main Methods:
- A national survey of pulmonologists was conducted.
- Data were analyzed using descriptive and thematic analyses.
Main Results:
- 54% of respondents reported their lab uses race-neutral equations.
- 64% recommended race-neutral equations, with GLI-Global/GLI-Other being the preferred alternative.
- Key advantages cited were improved equity and accuracy; disadvantages included potential misclassification and loss of precision.
Conclusions:
- Most academic pulmonologists favor race-neutral spirometry equations.
- Transition to race-neutral approaches is underway, but implementation gaps for GLI-Global persist, highlighting the need for continued research and education.
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