Atsushi Nakagomi, Masashige Saito, Toshiyuki Ojima, Takayuki Ueno, Masamichi Hanazato, Katsunori Kondo
Sociodemographic Heterogeneity in the Associations of Social Isolation With Mortality
JAMA network open
implications adopting raceneutral reference equations spirometry interpretation children remain unknown examine spirometry results patterns change transitioning global lung function initiative gli racespecific reference equations glir 2012 gli raceneutral reference equations glin 2023 crosssectional study spirometry tests conducted children aged 6 21 years 2012 2022 2 large academic pediatric institutions us data analyzed september 2023 march 2024 data participant characteristics raw test measurements collected forced expiratory volume 1 second fev1 forced vital capacity fvc fev1fvc z scores percent predicted calculated using glir glin addition test results categorized normal obstructive suspected restrictive mixed suspected dysanapsis uncategorized patterns based z scores calculated using glir glin spirometry result difference z scores percent predicted transitioning glir glin calculated proportion tests normal pattern individual spirometry patterns changed gli reference equation applied also examined data 24 630 children analyzed mean sd age 121 38 years 3848 black children 156 19 503 white children 792 1279 children races 52 following implementation glin fev1 fvc z scores decreased black children mean difference 0814 95 ci 0823 0806 p 001 0911 95 ci 0921 0902 p 001 respectively fev1 fvc z scores slightly increased 0073 95 ci 0069 0076 p 001 similar changes found using percent predicted black children number tests normal pattern decreased 2642 687 2383 619 21 20481 p 001 mostly due tests normal pattern transitioning suspected restrictive uncategorized pattern opposite albeit smaller changes spirometry results patterns seen white children adjusted models black children approximately 3fold higher odds white children changing spirometry pattern following implementation glin adjusted odds ratio 315 95 ci 286 348 p 001 pronounced differences spirometry results patterns found switching gli reference equations markedly differed race findings suggest implementation glin likely change treatment children chronic lung diseases prevalent underrepresented minorities asthma