ArticleAnnals of medicine2026
Race-neutral GLI-2022 interpretation in GOLD-positive COPD: reclassification in a Jordanian clinical cohort.
Article in Annals of medicine, 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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Abstract
backgroundDiagnostic interpretation of chronic obstructive pulmonary disease (COPD) depends on the reference equation used to define airflow obstruction. This study examined how often race-neutral Global Lung Initiative (GLI-2022) lower-limit-of-normal (LLN) interpretation reclassified clinically confirmed COPD patients meeting Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria as non-obstructed. GLI-2012 Caucasian, GLI-2012 Other/Mixed, and local Jordanian equations were secondary comparators.
methodsThis cross-sectional study included 845 patients aged ≥40 years with newly diagnosed, clinically confirmed COPD attending Jordan University Hospital, Amman, between August 2025 and March 2026. Diagnosis incorporated compatible symptoms, clinical history, post-bronchodilator FEV
resultsOf 845 clinically confirmed COPD patients, 224 (26.5%) did not meet the GLI-2022 LLN criterion for airflow obstruction, compared with 262 (31.0%) using GLI-2012 Caucasian, 174 (20.6%) using GLI-2012 Other/Mixed, and 13 (1.5%) using the Jordanian equation. GLI-2022 classified 621 patients as obstructed (73.5%; 95% CI 70.4-76.4), and all three paired comparisons with GLI-2022 were statistically significant (exact McNemar
conclusionOver a quarter of patients with clinically confirmed COPD in this cohort did not meet the GLI-2022 LLN criterion for airflow obstruction. GLI-2022 LLN-negative status should not be used in isolation to negate a COPD diagnosis established through guideline-based clinical assessment.
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