特定种族的螺旋测量方程可能会高估黑人儿童和青少年的喘控制
Allison J Burbank1,2,3, Claire E Atkinson4, Andre E Espaillat5
1Division of Allergy & Immunology, Department of Pediatrics, University of North Carolina School of Medicine, Chapel Hill, NC, USA. Allison_Burbank@med.unc.edu.
Respiratory research
|August 17, 2023
概括
使用种族特异性精神测量可能会错误地标记黑人儿童的喘控制,可能会掩盖疾病的严重程度. 种族中立方程更好地识别不受控制的喘,突出显示肺部护理方面的差异.
科学领域:
- 肺部医学 肺部医学
- 儿童喘研究 儿童喘研究
- 健康差异 在健康上的差异
背景情况:
- 有证据表明,基于种族的螺旋测量方程低估了黑人群体的疾病,可能导致差异.
- 根据种族调整的螺旋计对喘特异性后果的数据有限.
研究的目的:
- 调查种族特异性与种族中立性螺旋计对儿童喘控制评估的影响.
- 将螺旋计结果与黑人和白人儿童的喘控制指标进行比较.
主要方法:
- 从两个观测性喘研究中对163名儿童的二次分析.
- 进行比较前支气管扩展剂百分比预测1秒内强迫呼气体积 (ppFEV1) 使用种族特定 (GLI-非洲裔美国人/高加索人) 和种族中立 (GLI-全球) 方程.
- 评估了ppFEV1与喘控制测试TM (ACT) 成绩的对齐.
主要成果:
- 平均ppFEV1在种族特异性方程 (95.4%) 与种族中立 (90.4%) 相比,在整体队列中显著高.
- 在患有非控制性喘的黑人儿童中 (ACT ≤19),40%的ppFEV1<80%与种族中立的螺旋计相比20%与种族特定.
- 种族中性螺旋测量显示,与特定种族 (87%) 相比,控制喘 (ACT > 19) 的黑人儿童的ppFEV1≥80% (67%) 更多.
- 儿童被重新分类为ppFEV1 ≤80%,具有种族中性方程,显示出更大的气道阻塞 (较低的FEV1/FVC).
结论:
- 种族特定的螺旋计参考方程可能导致黑人儿童未能控制喘的诊断不足.
- 这可能会增加错误分类喘严重程度和影响治疗决策的风险.
- 种族中立螺旋测量可以在不同儿科群体中更准确地评估喘控制.
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