Journal article
Reconsidering the Utility of Race-Specific Lung Function Prediction Equations
American journal of respiratory and critical care medicine, Vol.205(7), pp.819-829
04/01/2022
DOI: 10.1164/rccm.202105-1246OC
PMCID: PMC9836221
PMID: 34913855
Abstract
African American individuals have worse outcomes in chronic obstructive pulmonary disease (COPD).
To assess whether race-specific approaches for estimating lung function contribute to racial inequities by failing to recognize pathological decrements and considering them normal.
In a cohort with and at risk for COPD, we assessed whether lung function prediction equations applied in a race-specific versus universal manner better modeled the relationship between FEV
, FVC, and other COPD outcomes, including the COPD Assessment Test, St. George's Respiratory Questionnaire, computed tomography percent emphysema, airway wall thickness, and 6-minute-walk test. We related these outcomes to differences in FEV
using multiple linear regression and compared predictive performance between fitted models using root mean squared error and Alpaydin's paired
test.
Using race-specific equations, African American individuals were calculated to have better lung function than non-Hispanic White individuals (FEV
, 76.8% vs. 71.8% predicted;
= 0.02). Using universally applied equations, African American individuals were calculated to have worse lung function. Using Hankinson's Non-Hispanic White equation, FEV
was 64.7% versus 71.8% (
< 0.001). Using the Global Lung Initiative's Other race equation, FEV
was 70.0% versus 77.9% (
< 0.001). Prediction errors from linear regression were less for universally applied equations compared with race-specific equations when examining FEV
% predicted with the COPD Assessment Test (
< 0.01), St. George's Respiratory Questionnaire (
< 0.01), and airway wall thickness (
< 0.01). Although African American participants had greater adversity (
< 0.001), less adversity was only associated with better FEV
in non-Hispanic White participants (
for interaction = 0.041).
Race-specific equations may underestimate COPD severity in African American individuals.Clinical trial registered with www.clinicaltrials.gov (NCT01969344).
Details
- Title: Subtitle
- Reconsidering the Utility of Race-Specific Lung Function Prediction Equations
- Creators
- Aaron D Baugh - University of California, San FranciscoStephen Shiboski - University of California, San FranciscoNadia N Hansel - Johns Hopkins UniversityVictor Ortega - Wake Forest UniversityIgor Barjakteravic - University of California SystemR Graham Barr - Columbia UniversityRussell Bowler - National Jewish HealthAlejandro P Comellas - University of IowaChristopher B Cooper - Ronald Reagan UCLA Medical CenterDavid Couper - University of North Carolina at Chapel HillGerard Criner - Temple University HospitalJeffrey L Curtis - University of Michigan–Ann ArborMark Dransfield - University of Alabama at BirminghamChinedu Ejike - Johns Hopkins UniversityMeiLan K Han - University of Michigan–Ann ArborEric Hoffman - University of IowaJamuna Krishnan - Cornell UniversityJerry A Krishnan - University of Illinois at ChicagoDavid Mannino - GlaxoSmithKlineRobert Paine IIITrisha Parekh - University of Alabama at BirminghamStephen Peters - Wake Forest UniversityNirupama Putcha - Johns Hopkins MedicineStephen Rennard - University of Nebraska at OmahaNeeta Thakur - University of California, San FranciscoPrescott G Woodruff - University of California, San Francisco
- Resource Type
- Journal article
- Publication Details
- American journal of respiratory and critical care medicine, Vol.205(7), pp.819-829
- DOI
- 10.1164/rccm.202105-1246OC
- PMID
- 34913855
- PMCID
- PMC9836221
- ISSN
- 1073-449X
- eISSN
- 1535-4970
- Grant note
- HHSN268200900017C / NHLBI NIH HHS K24HL137013 / NHLBI NIH HHS HHSN268200900019C / NHLBI NIH HHS HHSN268200900020C / NHLBI NIH HHS U24 HL141762 / NHLBI NIH HHS HHSN268200900015C / NHLBI NIH HHS HHSN268200900013C / NHLBI NIH HHS U01HL137880 / NHLBI NIH HHS HHSN268200900016C / NHLBI NIH HHS HHSN268200900018C / NHLBI NIH HHS HL137013 / NHLBI NIH HHS HHSN268200900014C / NHLBI NIH HHS F32HL158160 / NHLBI NIH HHS K23HL125551 / NHLBI NIH HHS P30 DK054759 / NIDDK NIH HHS
- Language
- English
- Date published
- 04/01/2022
- Academic Unit
- Roy J. Carver Department of Biomedical Engineering; Radiology; Pulmonary, Critical Care, and Occupational Medicine; ICTS; Internal Medicine
- Record Identifier
- 9984318724702771
Metrics
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