ArticleArthritis care & research2026
The Effect of Pulmonary Function Test Reference Equations on Classification of Restrictive Lung Disease Severity in Systemic Sclerosis.
Article in Arthritis care & research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
2 citing papers in PubMed.
- Review
- The Effect of Pulmonary Function Test Reference Equations on Classification of Restrictive Lung Disease Severity in Systemic Sclerosis.Arthritis care & research · 2026Article
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Authors and funding
10 authors.
Funding
Abstract
objectiveInterstitial lung disease (ILD) is a significant cause of morbidity and mortality in systemic sclerosis (SSc), particularly among Black patients. Pulmonary function tests (PFTs) are critical to screen for and monitor SSc-ILD. We examined whether race-specific and race-neutral PFT reference equations impact classification of restrictive lung disease (RLD) severity in Black and White patients with SSc.
methodsBaseline percent predicted forced vital capacity (ppFVC) was calculated for self-identified Black (n = 641) and White (n = 2,909) patients in the Johns Hopkins Scleroderma Center Research Registry using race-specific (Global Lung Function Initiative 2012 [GLI 2012] and National Health and Nutrition Examination Survey III) and race-neutral (GLI Global) equations. The percentage of Black and White individuals who switched RLD severity categories (normal [ppFVC ≥ 80%], mild [70% ≤ ppFVC < 80%], moderate [60% ≤ ppFVC < 70%], severe [50% ≤ ppFVC < 60%], or very severe [ppFVC < 50%]) with the use of race-neutral versus race-specific equations was calculated. The percentages of patients who would meet typical ppFVC thresholds for immunosuppression, clinical trial eligibility, and lung transplant referral were compared.
resultsBlack individuals had lower absolute FVC values than White individuals. Forty-seven percent (n = 303) of Black individuals were reclassified as having more severe RLD, and 17% (n = 487) of White individuals were reclassified as having less severe RLD when using the GLI Global versus GLI 2012 equations. Statistically greater proportions of Black individuals met ppFVC thresholds for immunosuppression, clinical trial eligibility, and lung transplant referral with race-neutral versus race-specific equations.
conclusionThe use of race-specific PFT reference equations may result in systematic misclassification of ILD severity with potential impact on health care delivery and clinical trial eligibility.
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