CHEST releases evidence review calling for more research on the effect of race and ethnicity on pulmonary function testing
March 27, 2023
Glenview, Illinois –
Recently published in the journal CHEST®, the American
College of Chest Physicians® (CHEST), the American Association
of Respiratory Care (AARC), the American Thoracic Society (ATS) and the
Canadian Thoracic Society (CTS) collaboratively wrote an
evidence review and research statement on the effect of race and ethnicity on pulmonary function testing (PFT). The statement calls for additional research, noting 10 gaps in research
relating to race, ethnicity and PFTs.
The collaborative statement addressed 3 key questions:
- What is the current evidence supporting the use of
race/ethnicity-specific reference equations for the interpretation of PFTs?
- What are the potential clinical implications of the use or non-use of
race/ethnicity in interpreting PFT results?
- What research gaps and questions must be addressed and answered to
better understand the effect of race/ethnicity on PFT interpretation and
potential clinical and occupational health implications?
In addressing the key questions, the statement shares 10 important research
gaps:
- Use clear, practical and standardized definitions of terms such as race
and ethnicity for research intentions.
- Establish guidance for how and when, or if at all, race and ethnicity
should be used in studies assessing lung function.
- Assess, derive and incorporate precise measures and study methods into
interpretation of pulmonary function.
- Generate consistent and robust investigations using validated
instruments for assessing the effects of social determinants of health on
lung health outcomes.
- Research studies assessing differences in lung function between
populations should include measures of standardized clinical relevance and
outcomes.
- Develop a more thorough understanding and inclusive definition of
“normal” lung function.
- A definition and understanding of a “gray zone” is required—either
borderline normal or borderline abnormal—that appreciates the reality of
more than a binary interpretation of test results.
- Evaluate and develop updated, equitable guidelines relating to PFTs for
assessing employability, impairment and disability and occupational health
and safety.
- Construct and standardize research study designs that allow for
meaningful comparisons, and with a data set of accepted and commonly
utilized comparisons.
- Research funding and efforts must be [re]directed to appropriately
address the many and significant identified research gaps related to the
complex relationship between race/ethnicity and lung function.
“Pulmonary function testing is essential to the field of
pulmonary/respiratory medicine,” says Darcy Marciniuk, MD, FRCPC, Master
FCCP, lead author on the statement. “This comprehensive multisociety
evidence review and research statement will help to inform and highlight
key research questions that will advance our understanding of PFTs in order
to provide the very best clinical care for our patients, as well as ensure
respiratory health and safety in occupational and work-related settings.”
The entire statement can be accessed through the
CHEST journal website.
About the American College of Chest Physicians
The American College of Chest Physicians® (CHEST) is the global
leader in the prevention, diagnosis and treatment of chest diseases. Its
mission is to champion advanced clinical practice, education, communication
and research in chest medicine. It serves as an essential connection to
clinical knowledge and resources for its 19,000+ members from around the
world who provide patient care in pulmonary, critical care and sleep
medicine. For information about the American College of Chest Physicians,
and its flagship journal CHEST®, visit chestnet.org.
About the American Association of Respiratory Care
The American Association for Respiratory Care (AARC), founded in 1947, is
the nation’s oldest and largest professional association dedicated to
respiratory therapists and health care providers involved in
cardiopulmonary care. The AARC strengthens the profession, providing
excellence in leadership and education, advancing the art and science of
respiratory therapy, and advocating for respiratory therapists, their
patients and caregivers. Fostering a diverse and inclusive membership
community worldwide, AARC is a not-for-profit organization headquartered in
Irving, TX. Learn more about us at
www.aarc.org.
About the American Thoracic Society
Founded in 1905, the American Thoracic Society is the world's leading
medical society dedicated to accelerating the advancement of global
respiratory health through multidisciplinary collaboration, education, and
advocacy. Core activities of the Society’s more than 16,000 members are
focused on leading scientific discoveries, advancing professional
development, impacting global health, and transforming patient care. Key
areas of member focus include developing clinical practice guidelines,
hosting the annual International Conference, publishing four peer-reviewed journals,
advocating for improved respiratory health globally, and developing an
array of patient education and career development resources. Please visit
our website to learn more.
About the Canadian Thoracic Society
The Canadian Thoracic Society (CTS) is Canada’s national specialty society
for respirology that brings together specialists, researchers, educators
and healthcare professionals working in respiratory, critical care, and
sleep medicine. The CTS advocates lung health by enhancing the ability of
healthcare professionals through leadership, collaboration, research,
learning and advocacy, and providing the best respiratory practices in
Canada. To request further information and for media inquiries: cts-sct.ca / info@cts-sct.ca /
@CTS_SCT