Effect of Race and Ethnicity on Pulmonary Function Testing Interpretation: An American College of Chest Physicians (CHEST), American Association for Respiratory Care (AARC), American Thoracic Society (ATS), and Canadian Thoracic Society (CTS) Evidence Review and Research Statement

Darcy D. Marciniuk, Ellen A. Becker, David A. Kaminsky, Meredith C. McCormack, Sanja Stanojevic, Nirav R. Bhakta, Christian Bime, Vikram Comondore, Clayton T. Cowl, Sharon Dell, Jeffrey Haynes, Fred Jaffe, Carl Mottram, Nneka Sederstrom, Mary Townsend, Jonathan M. Iaccarino

Research output: Contribution to journalArticlepeer-review

8 Scopus citations

Abstract

Background: Calls have been made to discontinue the routine use of race and ethnicity in medicine. Specific to respiratory medicine, the use of race- and ethnicity-specific reference equations for the interpretation of pulmonary function test (PFT) results has been questioned. Research Questions: Three key questions were addressed: (1) What is the current evidence supporting the use of race- and ethnicity-specific reference equations for the interpretation of PFTs? (2) What are the potential clinical implications of the use or nonuse of race and ethnicity in interpreting PFT results? and (3) What research gaps and questions must be addressed and answered to understand better the effect of race and ethnicity on PFT results interpretation and potential clinical and occupational health implications? Study Design and Methods: A joint multisociety (American College of Chest Physicians, American Association for Respiratory Care, American Thoracic Society, and Canadian Thoracic Society) expert panel was formed to undertake a comprehensive evidence review and to develop a statement with recommendations to address the research questions. Results: Several assumptions and gaps, both in the published literature and in our evolving understanding of lung health, were identified. It seems that many past perceptions and practices regarding the effect of race and ethnicity on PFT results interpretation are based on limited scientific evidence and measures that lack reliability. Interpretation: A need exists for more and better research that will inform our field about these many uncertainties and will serve as a foundation for future recommendations in this area. The identified shortcomings should not be discounted or dismissed because they may enable flawed conclusions, unintended consequences, or both. Addressing the identified research gaps and needs would allow a better—a more informed—understanding of the effects of race and ethnicity on PFT results interpretation.

Original languageEnglish (US)
Pages (from-to)461-475
Number of pages15
JournalCHEST
Volume164
Issue number2
DOIs
StatePublished - Aug 2023
Externally publishedYes

Keywords

  • ethnicity
  • interpretation
  • pulmonary function testing
  • race
  • research

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine
  • Cardiology and Cardiovascular Medicine

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