Beyond Race-Specific Spirometry Reference Equations: What Comes Next?
Beyond Race-Specific Spirometry Reference Equations: What Comes Next?
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超越特定种族肺活量测定参考方程：接下来会发生什么？
DOI：
10.1164/rccm.202305-0921le
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发表时间：
2024
影响因子：
24.7
通讯作者：
Wang,RichardJ
中科院分区：
文献类型：
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作者：
Wang,RichardJ
我谨祝贺巴克塔博士及其同事在最近一期《华尔街日报》上发表的具有里程碑意义的立场声明。这是将肺功能测试从错误和有害的观念中解脱出来的重要一步，这种观念认为，社会决定的类别之间存在先天的生物学差异，我们称之为“种族”。但正如作者所指出的，还需要做更多的工作。虽然立场声明花了相当大的努力来解释为什么使用种族特定的方程可能是有害的，但对随后的问题却很少注意：应该使用哪些非种族特定的方程？对于肺活量测定，作者推荐最近发表的全球肺功能倡议（GLI）全球参考方程(2)。我曾在其他地方指出，用于创建GLI全球参考方程的方法依赖于分配给任意种族类别的任意样本权重(3)。因此，全球呼吸量指数全球参考方程并不是解决问题的持久办法，可以明确地说，需要一种公平推导、广泛接受、非种族的单一参考标准，在比较和解释个人和群体的呼吸量测量时，可用于各种科学和医学目的。
I wish to congratulate Dr. Bhakta and colleagues on the landmark position statement in a recent issue of the Journal (1). This is a momentous step toward disentangling pulmonary function tests from erroneous and harmful notions of innate biological differences between the socially determined categories that we call “race.” But as the authors note, ever more work is needed. Although the position statement devotes considerable effort to explaining why the use of race-specific equations may be harmful, less attention is afforded the subsequent question: which non–race-specific equations should be used?For spirometry, the authors recommend the recently published Global Lung Function Initiative (GLI) Global reference equations (2). I have pointed out elsewhere that the method used to create the GLI Global reference equations rely on arbitrary sample weights assigned to arbitrary racial categories (3). As such, the GLI Global reference equations are not a durable solution to the problem, which might be articulated as the need for an equitably derived, widely accepted, non–race-specific single reference standard that may be used for diverse scientific and medical purposes when comparing and interpreting spirometric measurements for individuals and populations.