CHESTPress ReleasesEvidence review calling for more research on the effect of race and ethnicity on pulmonary function testing

CHEST releases evidence review calling for more research on the effect of race and ethnicity on pulmonary function testing

Glenview, Illinois – Recently published in the journal CHEST®, the American College of Chest Physicians® (CHEST), the American Association of Respiratory Care (AARC), the American Thoracic Society (ATS) and the Canadian Thoracic Society (CTS) collaboratively wrote an evidence review and research statement on the effect of race and ethnicity on pulmonary function testing (PFT). The statement calls for additional research, noting 10 gaps in research relating to race, ethnicity and PFTs.

The collaborative statement addressed 3 key questions:

  1. What is the current evidence supporting the use of race/ethnicity-specific reference equations for the interpretation of PFTs?
  2. What are the potential clinical implications of the use or non-use of race/ethnicity in interpreting PFT results?
  3. What research gaps and questions must be addressed and answered to better understand the effect of race/ethnicity on PFT interpretation and potential clinical and occupational health implications?

In addressing the key questions, the statement shares 10 important research gaps:

  1. Use clear, practical and standardized definitions of terms such as race and ethnicity for research intentions.
  2. Establish guidance for how and when, or if at all, race and ethnicity should be used in studies assessing lung function.
  3. Assess, derive and incorporate precise measures and study methods into interpretation of pulmonary function.
  4. Generate consistent and robust investigations using validated instruments for assessing the effects of social determinants of health on lung health outcomes.
  5. Research studies assessing differences in lung function between populations should include measures of standardized clinical relevance and outcomes.
  6. Develop a more thorough understanding and inclusive definition of “normal” lung function.
  7. A definition and understanding of a “gray zone” is required—either borderline normal or borderline abnormal—that appreciates the reality of more than a binary interpretation of test results.
  8. Evaluate and develop updated, equitable guidelines relating to PFTs for assessing employability, impairment and disability and occupational health and safety.
  9. Construct and standardize research study designs that allow for meaningful comparisons, and with a data set of accepted and commonly utilized comparisons.
  10. Research funding and efforts must be [re]directed to appropriately address the many and significant identified research gaps related to the complex relationship between race/ethnicity and lung function.

“Pulmonary function testing is essential to the field of pulmonary/respiratory medicine,” says Darcy Marciniuk, MD, FRCPC, Master FCCP, lead author on the statement. “This comprehensive multisociety evidence review and research statement will help to inform and highlight key research questions that will advance our understanding of PFTs in order to provide the very best clinical care for our patients, as well as ensure respiratory health and safety in occupational and work-related settings.”

The entire statement can be accessed through the CHEST journal website.

About the American College of Chest Physicians

The American College of Chest Physicians® (CHEST) is the global leader in the prevention, diagnosis and treatment of chest diseases. Its mission is to champion advanced clinical practice, education, communication and research in chest medicine. It serves as an essential connection to clinical knowledge and resources for its 19,000+ members from around the world who provide patient care in pulmonary, critical care and sleep medicine. For information about the American College of Chest Physicians, and its flagship journal CHEST®, visit

About the American Association of Respiratory Care

The American Association for Respiratory Care (AARC), founded in 1947, is the nation’s oldest and largest professional association dedicated to respiratory therapists and health care providers involved in cardiopulmonary care. The AARC strengthens the profession, providing excellence in leadership and education, advancing the art and science of respiratory therapy, and advocating for respiratory therapists, their patients and caregivers. Fostering a diverse and inclusive membership community worldwide, AARC is a not-for-profit organization headquartered in Irving, TX. Learn more about us at

About the American Thoracic Society

Founded in 1905, the American Thoracic Society is the world's leading medical society dedicated to accelerating the advancement of global respiratory health through multidisciplinary collaboration, education, and advocacy. Core activities of the Society’s more than 16,000 members are focused on leading scientific discoveries, advancing professional development, impacting global health, and transforming patient care. Key areas of member focus include developing clinical practice guidelines, hosting the annual International Conference, publishing four peer-reviewed journals, advocating for improved respiratory health globally, and developing an array of patient education and career development resources. Please visit our website to learn more.

About the Canadian Thoracic Society

The Canadian Thoracic Society (CTS) is Canada’s national specialty society for respirology that brings together specialists, researchers, educators and healthcare professionals working in respiratory, critical care, and sleep medicine. The CTS advocates lung health by enhancing the ability of healthcare professionals through leadership, collaboration, research, learning and advocacy, and providing the best respiratory practices in Canada. To request further information and for media inquiries: / / @CTS_SCT