肺功能测试在COPD的诊断和管理中的种族调整:一个范围审查
Sean Richard Davidson1, Muhammed Y Idris2,3, Christopher S Awad2
1Pulmonary and Critical Care Medicine Division, Department of Medicine, Morehouse School of Medicine, Atlanta, GA, USA.
概括
基于种族的肺功能测试可能会加剧COPD非洲裔美国人的健康不平等. 从肺功能方程中消除种族可能会提高诊断准确度,并减少对疾病严重程度的低估.
科学领域:
- 肺部医学 肺部医学
- 健康 公平 卫生 公平
- 临床算法 临床算法
背景情况:
- 在临床算法中自我认同的种族可以延续健康不平等.
- 肺功能测试 (PFTs) 历史上使用了基于种族的参考方程.
- 这种做法引起了人们对诊断准确性和公平护理的担忧.
研究的目的:
- 审查有关基于种族的PFT预测方程对患有COPD的非洲裔美国人的影响的文献.
- 评估这些方程如何影响诊断,严重程度分类和临床结果.
主要方法:
- 进行了对英语出版物的范围审查.
- 搜索包括PubMed/Medline,Embase,Scopus和科学网络 (2022年9月,更新至2023年12月).这些搜索包括PubMed/Medline,Embase,Scopus和科学网络 (2022年9月,更新至2023年12月).
- 研究的重点是针对成年COPD患者的种族特定与种族中立算法,特别是包括非洲裔美国人.
主要成果:
- 从PFT方程中删除种族对非裔美国人和白人肺功能严重性评估产生了差异性影响.
- 种族中立的算法导致了非洲裔美国患者重症的重新分类.
- 当不使用种族特定值时,症状和客观发现的调整得到改善.
结论:
- 有限的证据支持使用基于种族的PFT预测方程.
- 基于种族的方程可能会阻碍非洲裔美国人患有COPD的准确诊断和严重程度分类.
- 消除基于种族的值可以减少对该人口中COPD严重程度的低估.
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