Race-Neutral Equations for Lung Function Improve Asthma Detection in Children

Mar 05, 2025

TUESDAY, March 4, 2025 (HealthDay News) — Using a race-neutral equation identifies more than twice as many Black children with asthma or asthma symptoms as having reduced lung function than race-specific equations, according to a study published online Feb. 28 in JAMA Network Open.

Wan Chi Chang, from the Cincinnati Children’s Hospital Medical Center, and colleagues compared the use of race-specific and race-neutral equations on subsequent asthma diagnosis in children. The analysis included 1,533 children participating in the Childhood Asthma Management Program (CAMP, 1991-2012), the Cincinnati Childhood Allergy and Air Pollution Study (CCAAPS, 2001-2010), and the Mechanisms of Progression from Atopic Dermatitis to Asthma (MPAACH, 2016-2024) cohorts.

The researchers found that the median percent predicted forced expiratory volume in 1 second (FEV₁) in Black children decreased by 11.9 percentage points (pp) in CAMP, 13.5 pp in CCAAPS, and 13.2 pp in MPAACH compared with the race-specific equation. The race-specific equation failed to detect reduced percent predicted FEV₁ in 12 of 22 Black children with asthma symptoms in CCAAPS (55 percent) and five of 15 Black children with asthma in MPAACH (41 percent). Children in CCAAPS with <90 percent predicted FEV₁ based on race-specific equations were eligible for postreversibility testing to objectively diagnose asthma, and when this asthma diagnostic algorithm was applied, 16 of 36 Black children in CCAAPS (44 percent) and six of 16 Black children in MPAACH (38 percent) became eligible for reversibility testing with a less than 90 percent predicted FEV₁ based on the race-neutral equation.

“These findings have significant clinical implications and further support the universal use of race-neutral equations to increase the likelihood of identifying reduced lung function and improving the detection of asthma, particularly in Black children, promoting health equity,” the authors write.

One author disclosed ties to the pharmaceutical industry.

Abstract/Full Text