US Race-Neutral Lung Assessments to Have Profound Effects, Study Finds

A guideline for U.S. doctors to ignore race in assessing lung health will likely have profound effects beyond the intended improvements in medical care, such as increasing disability payments and disease diagnoses for Black patients while boosting their job disqualifications, a study found on Sunday.

Asian and Black patients will move forward on U.S. lung transplant waiting lists, with 4.3 fewer days of expected wait time, while Hispanic and white candidates will move back, having to wait 1.1 days longer on average, according to a report of the study in the New England Journal of Medicine.

U.S. diagnoses of nonobstructive lung disorders, such as chronic bronchitis, will likely jump 141% for Black patients and fall 69% for white patients, the researchers found in the report presented at the annual meeting in San Diego of the American Thoracic Society, the premier society for lung doctors.

Annual disability payments for Black military veterans will likely rise by more than $1 billion and fall by $500 million for white veterans, the researchers estimated.

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Traditional race-based equations for interpreting the results of spirometry, the most commonly used type of pulmonary function test, therefore grew from the idea that “normal” differs by race.

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These equations “offer an opportunity to move beyond crude proxies like race and the associated assumption that these differences in lung function are benign,” said Dr. Raj Manrai of Harvard Medical School in Boston, the senior author of the study.

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