Related Experiment Video
Updated: Aug 5, 2026
Conducting Respiratory Oscillometry in an Outpatient Setting
Published on: April 8, 2022
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.
Background:
The American Thoracic Society recently recommended the use of race-neutral rather than race-specific equations for spirometry interpretation. The uptake of and clinicians' opinions about these practices remain unclear.
Research Question:
What are clinicians' current practices and opinions around race-specific vs race-neutral reference equations?
Study Design And Methods:
We conducted a national survey of pulmonologists identified through the American Lung Association and Pulmonary Fibrosis Foundation. Participants completed an electronic survey about their opinions and practices related to race in spirometry reference equations. Descriptive and thematic analyses were conducted.
Results:
We received and analyzed 66 responses (29% response rate). Respondents had a median age of 48 years (interquartile range, 41-55), and 63 (95%) worked in an academic setting. A total of 34 respondents (54%) reported that their pulmonary function testing laboratory is already using a race-neutral equation. Most (n = 42, 64%) recommended that race-neutral equations should be used for spirometry interpretation, and 6 (9%) recommended race-specific equations alone should be used. When considering alternatives to race-specific equations, the use of Global Lung Function Initiative (GLI)-Global or GLI-Other as a single race-neutral equation was the most preferred alternative (n = 47, 71%). The most cited advantages of race-neutral equations were (1) improving equity, fairness, and bias (48%); and (2) improving accuracy and classification of disease (40%). The most cited disadvantages were (1) misclassification of respiratory disease (25%) and (2) loss of precision of lung function estimates (13%).
Interpretation:
Our results show that most academic pulmonologists would prefer to use a race-neutral rather than race-specific equation for spirometry interpretation. Although most have already transitioned to a race-neutral approach, significant gaps in implementing GLI-Global remain and indicate needs for ongoing research and education.
Related Concept Videos
01:25Pulmonary Function Tests
Pulmonary Function Tests are crucial diagnostic tools for assessing respiratory function, particularly in patients with chronic respiratory disorders. They comprehensively evaluate lung volumes, ventilatory function, breathing mechanics, diffusion, and gas exchange. These tests help diagnose pulmonary diseases and play a significant role in monitoring disease progression, evaluating disability, and assessing response to therapy.
PFTs involve using a spirometer, a...
01:30Assessment of Airway, Skin Color, and Use of Accessory Muscles
Introduction
The initial evaluation of a patient's respiratory system...
01:28Physical Assessment of the Respiratory Tract I: Health History
Subjective Data
Subjective data provides vital information about the patient's health history and symptoms. This data is typically collected through interviews in which patients describe their experiences, symptoms, and concerns.
Health history and key...
01:23Assessment of Respiration
Subjective Assessment: Nurses interview the patient to gather information directly during the subjective assessment. It includes questions about the individual's medical history, medications, and symptoms, focusing on past respiratory conditions like asthma or COPD,...
01:27Chronic Obstructive Pulmonary Disease-IV: Assessement and Diagnostic Studies
Medical History
01:30Respiratory System Abnormal Finding I: Inspection and Percussion
Inspection Findings
During an inspection, several findings may suggest the presence of respiratory distress or disease. Pursed-lip breathing, where exhalation is slowed by...