{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T11:08:03Z","timestamp":1789384083953,"version":"build-2803163510"},"reference-count":26,"publisher":"European Respiratory Society (ERS)","issue":"5","license":[{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"NIH","award":["NIH T32 HL171029"],"award-info":[{"award-number":["NIH T32 HL171029"]}]}],"content-domain":{"domain":["publications.ersnet.org"],"crossmark-restriction":true},"short-container-title":["ERJ Open Res"],"accepted":{"date-parts":[[2026,4,12]]},"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Recent consensus guidelines endorsed using a Global Lung Function Initiative (GLI Global) race-neutral approach to interpret spirometry. This study aims to examine how spirometry results using GLI Global reference equations correlate with patient healthcare utilisation and outcomes in a real-world cohort of patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Pulmonary function tests (PFTs) were analysed\n                      <jats:italic>via<\/jats:italic>\n                      race-specific and GLI Global approaches, respectively, using a 2010\u20132020 retrospective cohort study of spirometry tests. An abnormally low result for either forced vital capacity (FVC) or forced expiratory volume in 1\u2005s (FEV\n                      <jats:sub>1<\/jats:sub>\n                      ) was defined as a z-score &lt;\u22121.645. The 1-year pulmonary medication prescription, outpatient visit, emergency department (ED) visit or hospitalisation, as well as all-cause mortality were evaluated.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Out of the total cohort of 6107 tests, 530 (9%) and 595 (10%) results were re-classified when switching from race-specific to race-neutral for FEV\n                      <jats:sub>1<\/jats:sub>\n                      and FVC, respectively. Compared with patients whose lung function was consistently in the normal range (the control group), Black patients who were re-classified with an abnormally low FEV\n                      <jats:sub>1<\/jats:sub>\n                      had higher healthcare utilisation including pulmonary medication prescriptions, ED visits and worse outcomes such as hospitalisation. White individuals whose FEV\n                      <jats:sub>1<\/jats:sub>\n                      was re-classified as normal also had worse outcomes including higher mortality than the consistently normal group. Similar results were obtained when analysing FVC.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      We conclude that both Black and White individuals whose FEV\n                      <jats:sub>1<\/jats:sub>\n                      and FVC were re-classified had worse outcomes compared with those who remained normal. Clinical context and judgment must be used when considering any lung function result near arbitrary thresholds of normal.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1183\/23120541.01485-2025","type":"journal-article","created":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T14:55:16Z","timestamp":1777647316000},"page":"01485-2025","update-policy":"https:\/\/doi.org\/10.1183\/ers-crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Race-neutral spirometry reclassification in self-identified Black and White 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