种族调整在肺功能方程中的影响
James A Diao1, Yixuan He1, Rohan Khazanchi1
1From the Department of Biomedical Informatics, Harvard Medical School (J.A.D., P.R., L.M.-K., C.J.P., M.F., A.K.M.), the Computational Health Informatics Program, Boston Children's Hospital (J.A.D., A.K.M.), the Analytic and Translational Genetics Unit (Y.H., A.R.M.) and the Division of Pulmonary and Critical Care Medicine, Department of Medicine (M.F.), Massachusetts General Hospital, Harvard Internal Medicine-Pediatrics Combined Residency Program, Brigham and Women's Hospital, Boston Children's Hospital, and Boston Medical Center (R.K.), the François-Xavier Bagnoud Center for Health and Human Rights, Harvard University (R.K.), the Department of Medicine (M.J.N.T.) and the Channing Division of Network Medicine and the Division of Pulmonary and Critical Care Medicine, Department of Medicine (M.H.C., E.K.S.), Brigham and Women's Hospital, and the Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, Beth Israel Deaconess Medical Center (S.L.), Boston, and the Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge (Y.H., A.R.M.) - all in Massachusetts; the Departments of Pediatrics (J.I.W.), Medicine (J.R.E., E.G.B.), and Bioengineering and Therapeutic Sciences (J.R.E., E.G.B.), University of California, San Francisco, San Francisco; the Department of Computer Science, Cornell University, Ithaca (E.P.), and the Department of Population Health Sciences, Weill Cornell Medical College (E.P.), and the Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, City University of New York (L.N.B.), New York - all in New York; the Department of Engineering Science, University of Oxford, Oxford, United Kingdom (L.M.-K.); and the Medical Scientist Training Program, University of Illinois at Chicago, Chicago (A.Y.).
种族中立的肺功能方程可能会重新分类数百万,影响疾病分类和残疾补偿在不同种族群体之间有所不同. 虽然对呼吸系统结果的预测准确性仍然相似,但这种转变影响了数百万人,特别是黑人和白人.
科学领域:
- 肺部医学 肺部医学
- 健康 公平 卫生 公平
- 生物统计学 生物统计学
背景情况:
- 在肺功能测试中不鼓励基于种族的调整.
- 采用种族中立方程的含义需要全面量化.
研究的目的:
- 为了比较基于种族 (GLI-2012) 和种族中立 (GLI-Global) 肺功能方程的影响.
- 在临床,职业和财务结果方面评估重新分类.
- 评估个人肺部分配分数和预测准确度.
主要方法:
- 利用了来自多项大型健康研究的369,077名参与者的纵向数据.
- 将2012年全球肺功能倡议 (GLI-2012) 基于种族的方程与2022年种族中立 (GLI-Global) 方程进行比较.
- 评估结果包括临床,职业和财务重新分类,以及预测一致性统计.
主要成果:
- 种族中立方程可以重新分类1250万美国人的呼吸系统损伤.
- 观察到显著的种族差异:非阻塞性障碍分类在黑人中增加了141%,在白人中下降了69%.
- 预计黑人退伍军人每年的残疾支付将增加超过10亿美元,而白人退伍军人将减少50亿美元.
- 两组方程都显示了呼吸道结果的差异性准确性相似.
结论:
- 基于种族和种族中立的肺功能方程产生了类似的呼吸结果预测.
- 然而,种族中立方程显著改变了疾病分类,职业资格和数百万人的残疾赔偿.
- 这些影响主要是基于种族而异,突出了公平考虑.
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