Pagef for updatesAMERICAN THORACIC SOCIETYDOCUMENTSRace and Ethnicity in Pulmonary Function Test InterpretationAn Official American Thoracic Society StatementNirav R.Bhakta,Christian Bime,David A.Kaminsky,Meredith C.McCormack,Neeta Thakur,Sanja Stanojevic,Aaron D.Baugh,Lundy Braun,Stephanie Lovinsky-Desir,Rosemary Adamson,Jonathan Witonsky,Robert A.Wise,Sean D.Levy,Robert Brown,Erick Forno,Robyn T.Cohen,Meshell Johnson,John Balmes,Yolanda Mageto,Cathryn T.Lee,Refiloe Masekela,Daniel J.Weiner,Charlie G.Irvin,Erik R.Swenson,Margaret Rosenfeld,Richard M.Schwartzstein,Anurag Agrawal,Enid Neptune,Juan P.Wisnivesky,Victor E.Ortega,and Peter Bumey;on behalf of the American Thoracic Society Committees on Pulmonary Function Testing and on Health Equityand DiversityTHIS OFFICIAL STATEMENT OF THE AMERICAN THORACIC SOCIETY WAS APPROVED FEBRUARY 2023THE ATS STATEMENT WAS ENDORSED BY THE EUROPEAN RESPIRATORY SOCIETY ON MARCH 1,2023Abstracta workshop in 2021 to evaluate the use of race and ethnicity inPFT interpretation.Review of evidence published since then thatCurrent American Thoracic Society (ATS)standards promote thechallenges current practice and continued discussion condudeduse of race and ethnicity-specific reference equations forwith a recommendation to replace race and ethnicity-specificpulmonary function test(PFT)interpretation.There is risingequations with race-neutral average reference equations,whichconcern that the use of race and ethnicity in PFT interpretationmust be accompanied with a broader re-evaluation of how PFTscontributes to a false view of fixed differences between races andare used to make clinical,employment,and insurance decisions.may mask the effects of differential exposures.This use of raceThere was also a call to engage key stakeholders not representedand ethnicity may contribute to health disparities by normingin this workshop and a statement of caution regarding thedifferences in pulmonary function.In the United States anduncertain effects and potential harms of this change.Otherglobally,race serves as a social construct that is based onrecommendations include continued research and education toappearance and reflects social values,structures,and practices.understand the impact of the change,to improve the evidence forClassification of people into racial and ethnic groups differsthe use of PFTs in general,and to identify modifiable risk factorsgeographically and temporally.These considerations challengefor reduced pulmonary function.the notion that racial and ethnic categories have biologicalmeaning and question the use of race in PFT interpretation.TheATS convened a diverse group of dlinicians and investigators forKeywords:race;ethnicity;interpretation;PFTOverviewexpected values calculated from race andbetween some racial and ethnic groups.Theethnicity-specific reference equations(1).recommendations have been challengedCurrent standards from the AmericanThese recommendations are based on thebecause race and ethnicity do not
