The Impact of "race corrections" in Spirometry: How Results Differ When Identifying as Caucasian or Non-Caucasian

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The Impact of "race corrections" in Spirometry: How Results Differ When Identifying as Caucasian or Non-Caucasian

The Impact of "race corrections" in Spirometry: How Results Differ When Identifying as Caucasian or Non-Caucasian

Naziha Ali

Schulich School of Medicine & Dentistry

FUNDER: Schulich-UWindsor Opportunities for Research Excellence Program (SWORP)

GRANT DURATION: 2025-2026

Related Programs:
Nucleus Cores:

Spirometers, which are instruments used to measure pulmonary function, often have built-in “race corrections” that assign different predicted values of lung volumes based on the patient’s race. These modifications have long been part of standard practice in the medical community. However, the scientific origin of “race corrections” in pulmonary function tests is strongly tied to slavery and racism(1,2). This history, combined with recent evidence suggesting that these modifications contribute to incorrect diagnoses in non-white patients, has led to new guidelines that instruct against the usage of “race corrections” in spirometry(3,4). Unfortunately, many clinicians are not aware of the biases inherent to these “race corrections”. Furthermore, replacing spirometry equipment is often cost-prohibitive. This study aims to demonstrate the magnitude of the impact that these “race corrections” have on spirometry results. The study will examine the data output by a standard spirometer when participants self-select their ethnicity. Each participant will also be output a second time as Caucasian, so that comparisons in the data can be made. Data will be analysed from approximately 400 university students whose spirometry results were collected by the Kinesiology department from 2016-2024. The two sets of data extracted for each participant will be statistically analysed to determine the differences. A literature review will also be conducted on the topic. Establishing the impact of these “race corrections” on spirometry results will help guide future investigations on this topic and potentially point to clinical implications for non-white patients undergoing pulmonary function tests.

Although the usage of “race corrections” has started to be removed from PFT guidelines, it has long been a standard in the medical community and is still a part of medical education. Furthermore, there is a lack of evidence delineating the exact impact of inputted race on spirometry results. The high expense of replacing spirometry equipment may additionally prevent medical professionals from transitioning away from using “race corrections” in spirometry. This study will help to develop the growing body of evidence that points towards a more racially inclusive and accurate method of pulmonary function testing. Ultimately, this will not only allow clinicians to provide more effective care, but will also help them to better understand the impact of racism on their medical practice.

CO-INVESTIGATORS

The University of Windsor

  • Dr. Adriana Duquette
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