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Strategies to Classify Lung Function: It’s Not Black and White

Year: 2023

Type: article

Abstract: From labeling a desire for freedom from slavery as "drapetomania" (1) to justifying housing segregation a public health measure against tuberculosis (2), past medical standards have stoked public racism.Because race has been used as a social identity to justify exploitation, attempts at race-based medicine are especially susceptible to this dynamic.Characterizing race as a determinant of lung function has been discussed as another example of racism (3).But as millions have found resilience and meaning in racial identity, we believe that discussing racial differences in lung function is not inherently racist but can advance both science and equity.For example, a comparative study of the pre-European contact Congolese traditions that suffuse the Missa Luba and the distinctly European ones that inform the Sanctus in J.S. Bach's B-minor Mass (https://www.youtube.com/ watch?v=9NbtQP7F_G8) enriches both our knowledge of music theory and our appreciation of Catholic ritual.The American Thoracic Society's (ATS) recent position paper on the use of race in spirometry puts two major views into sharp relief.The ATS statement suggests that normal ranges for lung function should be "race neutral" (4).On the other hand, other experts prefer the prior, "race-specific" approaches as being more precise (5).For example, in a recent analysis of clinical data, race-neutral prediction equations reclassified 7.5% of White people who were (

Source: American Journal of Respiratory and Critical Care Medicine

DOI: 10.1164/rccm.202305-0807vp

Authors: Aaron Baugh, Russell G. Buhr, Andrew Bush, Marilyn Foreman, David M. Mannino