Addressing Race in Pulmonary Function Testing by Aligning Intent and Evidence With Practice and Perception.
Addressing Race in Pulmonary Function Testing by Aligning Intent and Evidence With Practice and Perception.
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DOI：
10.1016/j.chest.2021.08.053
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发表时间：
2022-01
期刊：
影响因子：
9.6
通讯作者：
Stanojevic S
中科院分区：
文献类型：
--
作者：
Bhakta NR;Kaminsky DA;Bime C;Thakur N;Hall GL;McCormack MC;Stanojevic S
在医学中使用种族或族裔来解释个人之间差异的做法受到质疑，因为它可能会导致有偏见的医疗保健和研究，使健康差距和结构性种族主义长期存在。一个常被引用的例子是在解释肺功能测试（PFT）结果时使用种族或民族，但在此讨论中缺少执业肺科医生和生理学家的观点。这种讨论对于日益多元文化的社区具有全球意义，其中代表正常肺功能的值的范围是不确定的。我们回顾了肺功能差异的潜在来源，包括那些可能被种族或民族捕获的差异，并证明了目前PFT测量和解释的实践在准确描述功能和健康结果之间关系的能力方面是不完善的。我们总结了反对使用种族特定方程的论点，以及解决有关从PFT结果的解释中删除种族的问题。此外，我们概述了知识差距和关键问题，需要回答改变目前的方法，包括种族或民族的PFT结果解释周到。最后，我们提出了解释策略和未来研究的变化，以减少健康差距。
The practice of using race or ethnicity in medicine to explain differences between individuals is being called into question because it may contribute to biased medical care and research that perpetuates health disparities and structural racism. A commonly cited example is the use of race or ethnicity in the interpretation of pulmonary function test (PFT) results, yet the perspectives of practicing pulmonologists and physiologists are missing from this discussion. This discussion has global relevance for increasingly multicultural communities in which the range of values that represent normal lung function is uncertain. We review the underlying sources of differences in lung function, including those that may be captured by race or ethnicity, and demonstrate how the current practice of PFT measurement and interpretation is imperfect in its ability to describe accurately the relationship between function and health outcomes. We summarize the arguments against using race-specific equations as well as address concerns about removing race from the interpretation of PFT results. Further, we outline knowledge gaps and critical questions that need to be answered to change the current approach of including race or ethnicity in PFT results interpretation thoughtfully. Finally, we propose changes in interpretation strategies and future research to reduce health disparities.
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