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Race-specific spirometry equations may overestimate asthma control in Black children and adolescents.

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  • معلومة اضافية
    • المصدر:
      Publisher: BioMed Central Ltd Country of Publication: England NLM ID: 101090633 Publication Model: Electronic Cited Medium: Internet ISSN: 1465-993X (Electronic) Linking ISSN: 14659921 NLM ISO Abbreviation: Respir Res Subsets: MEDLINE
    • بيانات النشر:
      Publication: 2001- : London : BioMed Central Ltd.
      Original Publication: London : Current Science Ltd., c2000-
    • الموضوع:
      Airway Obstruction*/diagnosis ; Airway Obstruction*/epidemiology ; Airway Obstruction*/ethnology ; Asthma*/diagnosis ; Asthma*/epidemiology ; Asthma*/ethnology ; Asthma*/therapy; Adolescent ; Child ; Humans ; Black or African American ; Cost of Illness ; Spirometry/standards ; Observational Studies as Topic ; White
    • نبذة مختصرة :
      Background: A growing body of evidence suggests that use of race terms in spirometry reference equations underestimates disease burden in Black populations, which may lead to disparities in pulmonary disease outcomes. Data on asthma-specific health consequences of using race-adjusted spirometry are lacking.
      Methods: We performed a secondary analysis of 163 children from two observational asthma studies to determine the frequencies of participants with ppFEV1 < 80% (consistent with uncontrolled asthma) or ppFEV1 ≥ 80% using race-specific (GLI-African American or Caucasian) vs. race-neutral (GLI-Global) spirometry and their alignment with indicators of asthma control (Asthma Control Test™, ACT). Comparisons of mean ppFEV1 values were conducted using Wilcoxon matched-pairs signed-rank tests. Two group comparisons were conducted using Wilcoxon rank-sum tests.
      Results: Data from 163 children (100 Black, 63 White) were analyzed. Mean ppFEV 1 was 95.4% (SD 15.8) using race-specific spirometry and 90.4% (16.3) using race-neutral spirometry (p < 0.0001). Among 54 Black children with uncontrolled asthma (ACT ≤ 19), 20% had ppFEV1 < 80% using race-specific spirometry compared to 40% using race-neutral spirometry. In Black children with controlled asthma (ACT > 19), 87% had ppFEV1 ≥ 80% using race-specific compared to 67% using race-neutral spirometry. Children whose ppFEV1 changed to ≤ 80% with race-neutral spirometry had lower FEV1/FVC compared to those whose ppFEV1 remained ≥ 80% [0.83 (0.07) vs. 0.77 (0.05), respectively; p = 0.04], suggesting greater airway obstruction. Minimal changes in alignment of ppFEV1 with ACT score were observed for White children.
      Conclusions: Use of race-specific reference equations in Black children may increase the risk of inappropriately labeling asthma as controlled.
      (© 2023. BioMed Central Ltd., part of Springer Nature.)
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    • Grant Information:
      P30 ES010126 United States ES NIEHS NIH HHS; 1K12TR004416-01 United States TR NCATS NIH HHS; T32 AI007062 United States AI NIAID NIH HHS; UM1 TR004406 United States TR NCATS NIH HHS; U19AR069522 United States AR NIAMS NIH HHS; R01 HL135235 United States HL NHLBI NIH HHS; R01HL135235 United States HL NHLBI NIH HHS; UL1TR002489 United States TR NCATS NIH HHS; U19 AR069522 United States AR NIAMS NIH HHS; K12 TR004416 United States TR NCATS NIH HHS
    • Contributed Indexing:
      Keywords: Asthma; Asthma Control Test™; Health disparities; Race; Spirometry
    • الموضوع:
      Date Created: 20230817 Date Completed: 20230907 Latest Revision: 20240119
    • الموضوع:
      20240119
    • الرقم المعرف:
      PMC10433634
    • الرقم المعرف:
      10.1186/s12931-023-02505-3
    • الرقم المعرف:
      37592259