ArticleThe open respiratory medicine journal2026
Adopting Global Lung Function Initiative Reference Equations Alters Pulmonary Function Testing Interpretation in a Safety-Net Cohort.
Article in The open respiratory medicine journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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5 authors.
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Abstract
Introduction/Objective: Current American Thoracic Society/European Respiratory Society (ATS/ERS) guidelines recommend Global Lung Initiative (GLI) reference equations for spirometry, lung volumes, and diffusing capacity (DLCO). The impact of adopting these reference equations remains unclear and may differ by race. Methods: We conducted a cross-sectional study of Pulmonary Function Tests (PFT) performed at Grady Memorial Hospital in Atlanta, GA, from 2017 to 2024. PFT components and interpretive patterns were analyzed using current Grady reference equations, then compared with GLI, including race-neutral spirometry, and stratified by race. Results: There were 7877 eligible patients; 7034 (89%) were Black, 529 (7%) were White, and 314 (4%) were Hispanic. Black patients had increased frequency of abnormal FEV1 (37.4% to 52.1%, Discussion: In this health system with a predominantly Black patient population, transitioning our PFT reference equations to GLI increased detection of abnormalities and changed interpretive patterns, with greater effects in Black patients. Conclusion: The health-system impact of implementing GLI reference equations is highly context-dependent, influenced by demographics and prior reference equations.
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