Race-Neutral Metrics More Accurately Predict Risk in COPD

GLI-Global differentiated all-cause mortality risk between normal spirometry and first grade of COPD in adjusted analyses
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FRIDAY, May 31, 2024 (HealthDay News) -- Race-neutral metrics more accurately predict the risk for death and exacerbations in chronic obstructive pulmonary disease (COPD), according to a study published online April 11 in the American Journal of Respiratory and Critical Care Medicine.

Enrico Schiavi, M.D., from the Università Cattolica del Sacro Cuore-Roma in Italy, and colleagues examined European Respiratory Society (ERS)/American Thoracic Society (ATS) airflow obstruction severity classification in the COPDGene Study (10,108 participants). The Global Initiative for Chronic Obstructive Lung Disease (GOLD) approach, using National Health and Nutrition Examination Survey III race-specific equations, was compared to the application of the Global Lung Initiative (GLI)-Global race-neutral equations.

The researchers found that individuals with milder disease had the lowest agreement between ERS/ATS with zGLI Global and the GOLD classification; race was a major determinant of redistribution. zGLI Global differentiated all-cause mortality risk between normal spirometry and first grade of COPD after adjustment for relevant covariates (hazard ratio, 1.23); in addition, a linear increase in exacerbation rates was seen with increasing disease severity in comparison to GOLD.

"The Brigham has already shifted to using race-neutral equations when interpreting pulmonary function tests, but not all labs across the U.S. have made these changes," senior author Craig Hersh, M.D., M.P.H., from Brigham and Women's Hospital in Boston, said in a statement. "Producing more data that replicates these results will allow us to continue to improve care for patients living with COPD."

The COPDGene study has been supported by the COPD Foundation through contributions made by pharmaceutical companies.

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