Clinical Implications of Removing Race-Corrected Pulmonary Function Tests for African American Patients Requiring Surgery for Lung Cancer

Editorial Material Medicine, General & Internal

Clinical Algorithms, Antidiscrimination Laws, and Medical Device Regulation

Katherine E. Goodman et al.

JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION (2023)

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Editorial Material Medicine, General & Internal

Prevention of Bias and Discrimination in Clinical Practice Algorithms

Carmel Shachar et al.

JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION (2023)

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Article Critical Care Medicine

Race and Ethnicity in Pulmonary Function Test Interpretation An Official American Thoracic Society Statement

Nirav R. Bhakta et al.

Summary: The use of race and ethnicity in pulmonary function test (PFT) interpretation is being questioned due to concerns of perpetuating false fixed differences between races and masking the effects of differential exposures. The American Thoracic Society (ATS) recommended replacing race and ethnicity-specific reference equations with race-neutral average equations, accompanied by a broader re-evaluation of how PFTs are used in clinical, employment, and insurance decisions. Further research and education are also recommended to better understand the impact of this change and improve the evidence for PFT use.

AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE (2023)

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Editorial Material Medicine, General & Internal

Redressing the Harms of Race-Based Kidney Function Estimation

Dinushika Mohottige et al.

Summary: This Viewpoint highlights the need to urgently eliminate race-based medical practices and argues that they have unfairly contributed to racial disparities in clinical care and health outcomes.

JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION (2023)

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Article Critical Care Medicine

Reconsidering the Utility of Race-Specific Lung Function Prediction Equations

Aaron D. Baugh et al.

Summary: This study found that using race-specific approaches for estimating lung function may underestimate the severity of COPD in African American individuals.

AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE (2022)

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Article Critical Care Medicine

Race/Ethnicity, Spirometry Reference Equations, and Prediction of Incident Clinical Events The Multi-Ethnic Study of Atherosclerosis (MESA) Lung Study

Arielle Elmaleh-Sachs et al.

Summary: This study found no evidence that race/ethnicity-based spirometry reference equations improved the prediction of CLRD events and mortality compared with race/ethnicity-neutral equations. The inclusion of race/ethnicity in spirometry reference equations should be reconsidered.

AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE (2022)

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Article Cardiac & Cardiovascular Systems

Demographic Landscape of Cardiothoracic Surgeons and Residents at United States Training Programs

Jacqueline K. Olive et al.

Summary: This study analyzed the demographics of trainees and faculty in cardiac thoracic surgery training programs in the United States and found increasing representation by gender and race/ethnicity. However, there is still a need to work towards equitable representation in order to benefit diverse patients.

ANNALS OF THORACIC SURGERY (2022)

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Article Critical Care Medicine

Addressing Race in Pulmonary Function Testing by Aligning Intent and Evidence With Practice and Perception

Nirav R. Bhakta et al.

Summary: The practice of using race or ethnicity in medicine to explain differences between individuals is being questioned due to its potential contribution to biased medical care, research, and perpetuation of health disparities and structural racism. This article focuses on the interpretation of pulmonary function test (PFT) results and highlights the need to examine the perspectives of practicing pulmonologists and physiologists. It discusses the limitations of current PFT measurement and interpretation practices and proposes changes in interpretation strategies and future research to address health disparities.

CHEST (2022)

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Editorial Material Surgery

The End of Race Correction in Spirometry for Pulmonary Function Testing and Surgical Implications

Sidra N. Bonner et al.

ANNALS OF SURGERY (2022)

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Editorial Material Medicine, General & Internal

Race-Free Estimation of Kidney Function Clearing the Path Toward Kidney Health Equity

L. Ebony Boulware et al.

JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION (2022)

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Article Medicine, General & Internal

Association of Estimated GFR Calculated Using Race-Free Equations With Kidney Failure and Mortality by Black vs Non-Black Race

Orlando M. Gutierrez et al.

Summary: This retrospective analysis compared the racial differences in risk of KFRT and mortality between Black and non-Black participants with kidney disease. The study found that the eGFR equation that included both creatinine and cystatin C without considering race demonstrated racial differences in risk across the range of eGFR. The eGFRcr-cys equation may be preferable for assessing racial differences in the risk of KFRT and mortality associated with low eGFR.

JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION (2022)

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Article Respiratory System

Longitudinal changes in pulmonary function and patient-reported outcomes after lung cancer surgery

Sumin Shin et al.

Summary: Pulmonary function and patient-reported outcomes (PROs) notably decline immediately after lung cancer surgery and gradually improve thereafter, except for dyspnea and lack of energy.

RESPIRATORY RESEARCH (2022)

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Review Critical Care Medicine

Race Correction and Spirometry Why History Matters

Lundy Braun

Summary: This essay explores the history of racialization of the spirometer in pulmonary medicine, focusing on how race correction became normative and how researchers explained differences between races. Over the past two centuries, the concept of innate racial differences has hardened, with few questioning the conceptual underpinnings of race correction in medicine.

CHEST (2021)

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Article Cardiac & Cardiovascular Systems

Women and Minorities Underrepresented in Academic Cardiothoracic Surgery: It's Time for Next Steps

Katherine A. Ortmeyer et al.

Summary: Women and racial and ethnic minorities are significantly underrepresented among trainees and faculty in academic cardiothoracic surgery compared with surgery and medicine overall, demonstrating a need for concerted action.

ANNALS OF THORACIC SURGERY (2021)

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Article Urology & Nephrology

A Unifying Approach for GFR Estimation: Recommendations of the NKF-ASN Task Force on Reassessing the Inclusion of Race in Diagnosing Kidney Disease

Cynthia Delgado et al.

Summary: A Task Force developed recommendations for reassessing inclusion of race in GFR estimation in the United States. The recommendations include immediate implementation of a creatinine equation refit without the race variable and increasing the use of cystatin C, as well as encouraging research on new filtration markers and interventions to eliminate racial and ethnic disparities.

JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY (2021)

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Article Cardiac & Cardiovascular Systems

Definition and assessment of high risk in patients considered for lobectomy for stage I non-small cell lung cancer: The American Association for Thoracic Surgery expert panel consensus document

Arjun Pennathur et al.

Summary: Lobectomy is a standard treatment for stage I non-small cell lung cancer, but a significant proportion of patients may be at high risk for complications, including mortality. The expert panel identified important risk factors for assessing high risk patients, such as the need for supplemental oxygen, low diffusion capacity, frailty, and overall daily activity assessment. Age was determined to be less important in risk assessment relative to other factors, and a minimally invasive approach is increasingly critical in older populations to mitigate risk.

JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY (2021)

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Article Respiratory System