慢性阻塞性肺病的早期证据被种族特定的预测方程所掩盖
Elizabeth A Regan1, Melissa E Lowe2, Barry J Make3
1Department of Medicine.
American journal of respiratory and critical care medicine
|August 23, 2023
概括
特定种族的螺旋测量方程可能低估了非裔美国人的慢性阻塞性肺病 (COPD) 严重程度,可能会推迟诊断和治疗. 这项研究强调了COPD护理的差异,原因是过时的诊断工具.
科学领域:
- 肺病学和呼吸系统医学
- 医学诊断 医学诊断 医学诊断
- 健康差距 研究 研究 研究 研究
背景情况:
- 早期发现慢性阻塞性肺病 (COPD) 对患者的管理和治疗的发展至关重要.
- 目前的COPD严重程度分类依赖于特定种族的螺旋测量方程,这可能会使某些人群处于不利地位.
- 由于使用这些种族特定方程,COPD诊断和护理的差异可能会出现.
研究的目的:
- 研究种族特异性螺旋测量方程对非裔美国人 (AA) 与非西班牙裔白人个体中COPD的诊断和分期的影响.
- 在不同的螺旋测量预测方程中比较COPD的表现.
主要方法:
- 对COPDGene队列的横截面分析,比较非西班牙裔白人 (n=6,766) 和AA (n=3,366) 参与者.
- 使用特定种族,多民族和"种族逆转"预测方程 (NHANES,GLI) 进行了螺旋计分类的比较.
- 评估呼吸道症状,6分钟步行距离,CT成像,恶化和生活质量 (圣乔治呼吸道问卷).
主要成果:
- 不同的预测方程导致COPD分类变化,种族逆转方程将AA参与者分为更严重的阶段.
- 使用NHANES种族特定方程,AA参与者在GOLD阶段1-4年龄较小,有较少的包年,但表现出更多的恶化和更糟糕的临床结果.
- 种族反向方程将43%的AA参与者从GOLD阶段0重新分类到维护比率受损螺旋计.
结论:
- 种族特定的螺旋测量方程似乎低估了非洲裔美国人的COPD严重程度.
- 这些低估在COPD早期阶段 (GOLD阶段1和2) 特别明显.
- 使用潜在的不公平的特定种族方程可能会导致AA人群中慢性慢性肺炎的延迟检测和低于最佳的治疗.
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