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Societal discussions of racial and ethnic disparities became more prominent in 2020, which prompted reflection on how these disparities present in clinical practices.1,-,3 The most notable respiratory care practice involves reference equations used to predict normal values for pulmonary function testing (PFT). For over a hundred years,4 spirometry reference equations were tied to anthropometric measurements and race/ethnicity. Numerous studies documented differences in spirometry values among racial and ethnic groups;5,-,7 however, recently clinicians questioned the continued use of race and ethnic variables in reference equations.
In 2023, the American Thoracic Society issued a statement that was endorsed by the European Respiratory Society that recommends changing from race- and ethnicity-specific reference equations to race-neutral average equations.8 Implementing a change, especially one that challenges long-standing practices, requires a thoughtful approach. This month’s article by Banerjee et al9 provides seminal information about the beliefs pulmonary and critical care clinicians have about the role of race and ethnicity in prediction equations. Pulmonary function technologists and others can address these beliefs using the Theory of Planned Behavior,10 a well-researched …
Correspondence: Ellen A Becker PhD RRT RPFT AE-C FAARC, Rush University, 600 S. Paulina Street, Suite 746, Chicago, IL 60612. E-mail: Ellen_Becker{at}rush.edu
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