Race-based pulmonary-function reference values

Where in the source: Title page; Reference Equations — General issues, pp. 948–949

Direct joint ATS/ERS task-force standard identifying the societies that issued the interpretive guidance.

Where in the source: Title and author group; Recommendations

Identifies the ERS Global Lung Function Initiative as the task force that assembled the multi-group equations and urged respiratory societies and device users to implement them.

Where in the source: Reference Values for Asian Americans; Recommendation

An official ATS standard showing that race- or ethnicity-specific equations and fallback correction factors remained endorsed in occupational spirometry in 2014.

Where in the source: Footnote on approval and endorsement

Records ATS approval in February 2023 and ERS endorsement in March 2023, establishing the institutional status of the reversal.

Where in the source: Reference Equations — General issues, p. 949

Specifies self-identification, selection of a group-specific equation and fallback adjustments of about 12%, 7% or 0.94 for named measurements and groups, with the selected factor recorded on the report.

Where in the source: Results; Conclusions; Recommendations

Encodes four named racial or geographic groups and an averaged “Other” category in continuous all-age reference equations intended for implementation in spirometry equipment.

Where in the source: Table 1; Comparison of measured values to a healthy population

Unequivocally rejects fixed race factors but still says either a similar ancestral grouping or a whole-population comparison may be appropriate, documenting a transitional position before the 2023 recommendation.

Where in the source: Reference Values for Asian Americans; Recommendation

Prefers population-specific equations but calls a factor an appropriate interim solution and recommends multiplying White FEV1 and FVC reference values by 0.88 for Asian populations in North America.

Where in the source: Reference Equations — General issues, pp. 949–950

Explains that reference choice affects classification against the lower limit of normal and warns that changing equations can alter interpretation, especially for results near an abnormality threshold.

Where in the source: Clinical Implications of Race-Specific Pulmonary Function Prediction Equations; Table 1

Shows how reference choice can cross thresholds used for insurance, ventilatory support, transplant referral and surgery, while discussing potential harms from either retaining or changing the equations.

Where in the source: Abstract, Results and Conclusions

Documents that changing equations alone altered physiological pattern and severity labels in opposite directions across the two studied groups and calls for further work on effects on diagnosis, referral and treatment.

Where in the source: Abstract; Lung-Transplant Priority; Discussion; Limitations

Finds similar discrimination for studied respiratory outcomes but major modeled differences in threshold-defined classifications, eligibility and payments; limitations include U.S.-only projections and applications a person might never face.

Where in the source: Table 1; Comparison of measured values to a healthy population

Contrasts the 2005 preference for group-specific equations with the update's rejection of fixed factors, uncertainty about genetic, social and environmental causes, and continued caution over the appropriate comparison population.

Where in the source: History and Methodology of Race-Specific Reference Equations; Key Conclusions and Recommendations

Distinguishes group-specific equations from fixed adjustments, explains GLI Global as a weighted race composite with wider uncertainty and notes that many world populations remain absent from the source data.

Where in the source: Abstract; Discussion

Documents the available race-neutral comparator adopted in 2023: a weighted reanalysis of the GLI 2012 data that omits race at application but has wider normal limits and does not represent every population or ideal individual health.

Where in the source: Overview; Key Conclusions and Recommendations; Conclusions

Recommends race-neutral average equations, identifies GLI Global for spirometry, rejects adjustment factors for lung volumes and diffusing capacity and calls for broader review of PFT-based decisions.

Where in the source: Page body, paragraphs on the new recommendation and continued research

The ATS public announcement presents the move to GLI Global as an institutional change, confirms ERS endorsement and emphasizes continuing research and reassessment of threshold-based decisions.

Where in the source: Abstract; Current Practices; Discussion and Limitations

Supports a partial rather than complete correction rating: just over half of this small, mostly academic respondent sample reported laboratory use of a race-neutral equation three years after the recommendation.