Impact of Spirometry Race-Correction on Preadolescent Black and White Children.
Asthma
Pulmonary diseases
Race-correction
Racial disparities
Spirometry
Structural racism
Journal
The journal of allergy and clinical immunology. In practice
ISSN: 2213-2201
Titre abrégé: J Allergy Clin Immunol Pract
Pays: United States
ID NLM: 101597220
Informations de publication
Date de publication:
10 2023
10 2023
Historique:
received:
28
06
2022
revised:
24
05
2023
accepted:
30
05
2023
pmc-release:
01
10
2024
medline:
9
10
2023
pubmed:
11
6
2023
entrez:
10
6
2023
Statut:
ppublish
Résumé
Race-correction for Black patients is standard practice in spirometry testing. History suggests that these corrections are at least partially a result of racist assumptions regarding lung anatomy among Black individuals, which can potentially lead to less frequent diagnoses of pulmonary diseases in this population. To evaluate the impact of race-correction in spirometry testing among Black and White preadolescents, and examine the frequency of current asthma symptoms in Black children who were differentially classified depending on whether race-corrected or race-uncorrected reference equations were deployed. Data from Black and White children who completed a clinical examination at age 10 years from a Detroit-based unselected birth cohort were analyzed. Global Lung Initiative 2012 reference equations were applied to spirometry data using both race-corrected and race-uncorrected (ie, population-average) equations. Abnormal results were defined as values less than the fifth percentile. Asthma symptoms were assessed concurrently using the International Study of Asthma and Allergies in Childhood questionnaire, while asthma control was assessed using the Asthma Control Test. The impact of race-correction on forced expiratory volume in 1 second (FEV Race-correction had an extensive impact on spirometry classification in Black children, and differentially classified children had a higher rate of asthma symptoms than children consistently classified as normal. Spirometry reference equations should be reevaluated to be aligned with current scientific perspectives on the use of race in medicine.
Sections du résumé
BACKGROUND
Race-correction for Black patients is standard practice in spirometry testing. History suggests that these corrections are at least partially a result of racist assumptions regarding lung anatomy among Black individuals, which can potentially lead to less frequent diagnoses of pulmonary diseases in this population.
OBJECTIVE
To evaluate the impact of race-correction in spirometry testing among Black and White preadolescents, and examine the frequency of current asthma symptoms in Black children who were differentially classified depending on whether race-corrected or race-uncorrected reference equations were deployed.
METHODS
Data from Black and White children who completed a clinical examination at age 10 years from a Detroit-based unselected birth cohort were analyzed. Global Lung Initiative 2012 reference equations were applied to spirometry data using both race-corrected and race-uncorrected (ie, population-average) equations. Abnormal results were defined as values less than the fifth percentile. Asthma symptoms were assessed concurrently using the International Study of Asthma and Allergies in Childhood questionnaire, while asthma control was assessed using the Asthma Control Test.
RESULTS
The impact of race-correction on forced expiratory volume in 1 second (FEV
CONCLUSIONS
Race-correction had an extensive impact on spirometry classification in Black children, and differentially classified children had a higher rate of asthma symptoms than children consistently classified as normal. Spirometry reference equations should be reevaluated to be aligned with current scientific perspectives on the use of race in medicine.
Identifiants
pubmed: 37301437
pii: S2213-2198(23)00644-X
doi: 10.1016/j.jaip.2023.05.045
pmc: PMC10592501
mid: NIHMS1909207
pii:
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
3097-3106Subventions
Organisme : NIAID NIH HHS
ID : R56 AI050681
Pays : United States
Organisme : NIAID NIH HHS
ID : R01 AI110450
Pays : United States
Organisme : NHLBI NIH HHS
ID : R01 HL113010
Pays : United States
Organisme : NIAID NIH HHS
ID : P01 AI089473
Pays : United States
Organisme : NIAID NIH HHS
ID : R01 AI050681
Pays : United States
Informations de copyright
Copyright © 2023 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.
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