The use of race-based and race-neutral equations for lung-function testing generate similarly accurate predictions of respiratory outcomes, but differ in terms of disease classifications, occupational eligibility, and disability outcomes, according to a study in the New England Journal of Medicine. Researchers used longitudinal data from 369,077 people to compare the race-based 2012 Global Lung Function Initiative (GLI-2012) equations to race-neutral equations introduced in 2022 (GLI-Global). Among 249 million persons in the United States between 6 and 79 years of age who could produce high-quality spirometric results, the researchers found that GLI-Global equation use may reclassify ventilatory impairment for 12.5 million persons, medical impairment ratings for 8.16 million, occupational eligibility for 2.28 million, COPD grading for 2.05 million, and military disability compensation for 413,000. These potential changes differed according to race; classifications of non-obstructive ventilatory impairment may increase 141% and decrease 69% among Black and White persons, respectively, and annual disability payments may increase by more than $1 billion and decrease by $0.5 billion, respectively, among Black and White veterans.
