{
  "abstract": "Introduction The Global Lung Initiative (GLI) 2012 reference equations have been the preferred method for assessing percent predicated (%pred) and Z score values locally, however the recent GLI 2022 race-neutral values for spirometry have been endorsed by many professional bodies, including the ARTP. There has been limited studies assessing the implications of these new equations for patients with Interstitial Lung Disease (ILD). This study aimed to explore the local impact of using race-neutral values in ILD.Methods A retrospective service evaluation was performed from 1st January 2015 to 1st January 2025 (CARMS-24250). This utilised data from our local multidisciplinary team outcomes and lung function data. Predicted values for forced vital capacity (FVC) were calculated for %pred and Z scores using both GLI 2012 (Caucasian/Other) and GLI 2022 race neutral values. Agreement between predicted values calculated using both equations were assessed with Bland-Altman analysis. The impact on severity classifications, using American Thoracic Society/ European Respiratory Society (ATS / ERS) 2005 (%pred) and 2022 (Z score) interpretive guidelines was also assessed. Differences in severity re-classification were analysed with McNemar’s tests, with p accepted at < 0.05.Results Bland-Altman (race specific – race neutral) showed that transitioning from GLI 2012 to GLI 2022 led to a bias of -3.97 (95% CI -8.74 to 0.79) for Caucasians and 1.33 (95% CI -1.39 to 4.04) in non-Caucasians. Movement towards GLI 2022 led to significantly higher frequency of ‘normal’ classification across both %pred (χ 2 = 30.1, p<0.001*) and Z score criteria (χ2 = 51.3, p<0.001*, See figure 1).Conclusions Patients with ILD previously described as Caucasian using GLI 2012 values are disproportionately affected by GLI 2022 values. A higher frequency of false negative results will be seen in this group from spirometry, in the context of meaningful disease.Abstract P15 Figure 1Reclassification of FVC criteria based on movement to race-neutral reference values",
  "authors": [
    {
      "affiliations": [
        "Birmingham Heartlands Hospital, University Hospitals Birmingham, Birmingham, United Kingdom"
      ],
      "name": "Megan Walton"
    },
    {
      "affiliations": [
        "Birmingham Heartlands Hospital, University Hospitals Birmingham, Birmingham, United Kingdom"
      ],
      "name": "Samuel Wallbanks"
    },
    {
      "affiliations": [
        "Birmingham Heartlands Hospital, University Hospitals Birmingham, Birmingham, United Kingdom"
      ],
      "name": "Christopher Huntley"
    },
    {
      "affiliations": [
        "Birmingham Heartlands Hospital, University Hospitals Birmingham, Birmingham, United Kingdom"
      ],
      "name": "Gareth Walters"
    }
  ],
  "title": "P15 Neutral ground? The clinical impact of race-neutral spirometry in interstitial lung disease",
  "uid": "e34d65c1-a547-509f-ae4a-c0b39ec223a7"
}