New Study Reveals Significant Consequences of Race-Neutral Lung Function Testing on Patients, Hospitals, and Beyond


A recent analysis led by scientists at Harvard Medical School sheds light on the potential effects of eliminating race as a factor in estimating lung function. The study, to be published in the New England Journal of Medicine on May 19, reveals that removing race from lung function equations could result in a significant shift in disease categorization across various patient populations.

The research team, including senior author Raj Manrai, assistant professor of Biomedical informatics in the Blavatnik Institute at HMS, and first author James Diao, a fourth-year medical student at HMS and a researcher in the Manrai lab, found that this change would result in more Black individuals being classified with advanced lung disease, while white and Hispanic individuals would be reclassified as having less severe illnesses.

Historically, lung function tests have included race as a factor in estimating normal lung function. However, the team noted that this practice can mask disease severity for many individuals. The researchers aimed to quantify the implications of removing race from lung function estimates and the potential consequences for patients, hospitals, and policymakers.

The findings suggest that the use of race to define normal lung function and what constitutes impairment or disease has significant clinical, financial, and occupational implications. The study’s results indicate that race-neutral lung function equations could lead to changes in diagnoses, eligibility for disability compensation and veterans’ benefits, and job opportunities that require specific lung function levels.

Manrai and Diao previously conducted research on the implications of race-free kidney equations. Their current study builds upon this work, focusing on the pulmonary function testing domain. The researchers emphasized the importance of understanding the potential consequences of race-neutral lung function equations and preparing clinicians, hospitals, and policymakers for the shifts in disease burden and eligibilities that may result from this change.

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