{
  "abstract": "Pulmonary Function Testing (PFT) interpretation compares actual measurements with predicted values derived from a global dataset of healthy non-smokers. While race and ethnicity have historically informed these interpretations, their use is increasingly questioned due to their potential to perpetuate health disparities. To standardise PFT interpretation, the Global Lung Function Initiative (GLI) developed race-specific reference equations (2012), but limitations were recognised. In 2022, GLI introduced race-neutral equations. This study evaluates the impact of transitioning from race-specific to race-neutral equations on PFT interpretations in a local patient sample.A retrospective service evaluation using PFT data from 5716 patients aged 18–95. Datasets were reanalysed using GLI global 2022 race-neutral and compared to the existing GLI 2012 race-specific reference equations. Results were stratified by self-reported ethnicity (White, Black, and Other/Mixed) to assess clinical implications.The mean difference in FEV1 Z-scores between race-specific and race-neutral reference equations was -0.31 [LOA: 0.08; -0.71] in the white cohort, 0.53 (LOA: 0.93; 0.13) in the black cohort, and -0.06 (LOA: 0.36; -0.49) in the Other/Mixed cohort. Race-neutral equations predicted lower FEV1 Z-scores in Black individuals than race-specific equations, whereas in White individuals, they predicted slightly higher FEV1 Z-scores. Minimal differences were observed in the Other/Mixed cohort.Race-neutral equations increased the prevalence of lung function impairment by 1.9% in the White cohort, 11% in the Black cohort, and 0.65% in the Other/Mixed cohort. Applying race-neutral equations increased obstruction prevalence by 3.5% in the White cohort, with minimal changes in the Black and Other/Mixed cohorts. Restriction prevalence increased by 10.9% in the Black cohort but decreased by 4.6% and 3.2% in the White and Other/Mixed cohorts, respectively. Obstruction severity changed in 9.2% of White, 8% of Black, and 7.8% of Other/Mixed individuals. Overall, 8.1% of patients had interpretation changes from race-specific to race-neutral equations. (Figure 1)The adoption of GLI Global 2022 race-neutral reference equations will significantly impact spirometry interpretation, particularly in Black individuals. Clear communication with clinical teams is essential to ensure awareness of these changes and their implications. While the shift to race-neutral equations represents progress, further research, especially in non-white cohorts, is needed to fully evaluate its clinical impact.Abstract P15 Figure 1",
  "authors": [
    {
      "affiliations": [
        "Manchester University NHS Foundation Trust, Manchester, UK",
        "Manchester Metropolitan University, Manchester, UK"
      ],
      "name": "Rhys Tudge"
    }
  ],
  "title": "P15 Reinterpreting pulmonary function tests: clinical impacts of shifting from race-specific to race-neutral equations",
  "uid": "63e6bc33-2025-5a59-a866-36b02d72ca54"
}