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‘Race Correction’ May Lead to Underdiagnosis of Lung Disease

Removing race correction in PFT results leads to higher prevalence, severity of lung disease diagnoses in Black patients

TUESDAY, May 25, 2021 (HealthDay News) — Removing race correction from the interpretation of pulmonary function tests results in higher prevalence and severity of lung disease among Black individuals, according to a study presented at the American Thoracic Society 2021 International Conference, held virtually from May 14 to 19.

Alexander Moffett, M.D., from the University of Pennsylvania Perelman School of Medicine in Philadelphia, and colleagues used American Thoracic Society guidelines to interpret 14,080 pulmonary function tests performed at the University of Pennsylvania Health System (2010 to 2020) among patients self-identifying as Black or African American. Interpretations were compared using the reference values for spirometry developed by the Global Lung Function Initiative, with and without race correction.

The researchers found that the removal of Black race correction led to a diagnosis of obstruction for an additional 414 patients, increasing the prevalence of obstructive lung disease from 22.1 to 23.9 percent. An additional 665 patients were diagnosed with restriction after the removal of race correction, increasing the prevalence of restrictive lung disease from 8.8 to 13.5 percent. For patients with an existing diagnosis of obstructive, restrictive, or mixed defect, removing race correction led to an increase in the severity of disease for 48.6 percent of patients. Overall, the investigators observed an increase in the percentage of patients with any pulmonary defect — from 59.5 to 81.7 percent — with the removal of race correction.

“The use of race correction in clinical algorithms may mask and, thus, reinforce the effects of structural racism, including known disparities in care processes and outcomes for Black patients with lung diseases,” Moffett said in a statement. “Black patients are both undiagnosed and underdiagnosed.”

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