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The American Thoracic Society Examining Race-Based Interpretation of Lung Function; Workshop Report in Progress

NEW YORK, NY – Oct. 3, 2022 – The American Thoracic Society recognizes race is a social construct, not a clinical or biologic construct, and is committed to reducing health disparities and addressing racism in clinical decision-making in medicine.

The ATS has set rigorous standards for the performance of lung function testing. Lung function testing provides airflow, lung size, and gas exchange measurements. These measurements are directly made, and the techniques are not influenced by race or ethnicity. 

Race and ethnicity have been included in the interpretation of the measured lung function values, along with an individual's age, sex, and height. The rationale for this has been based on observed differences in the lung function of healthy individuals that vary according to race and ethnicity. The ATS, and other leading organizations, have questioned this practice due to the potential to perpetuate race-based medicine. 

In response to emerging evidence, the ATS is now examining whether the interpretation of lung function should be race and ethnicity blind. The ATS requests patience as its dedicated volunteer physician-scientists consider the evidence in formulating their conclusions. Although we are united in our concern for this issue and its urgency, there are significant differences in expert opinions about how to address it. Multiple discussions are being held to reach consensus to produce a statement that addresses concerns and provides appropriate recommendations for a worldwide audience. This is a priority for the organization, and it is essential to all patients that the ATS get this right.

There are several related activities in progress. A workshop intended to begin the discussion about race and ethnicity in lung function interpretation was held, and the report is being prepared for consideration by ATS leadership. The workshop participants included individuals from various disciplines, including pulmonologists, sociologists, geneticists, and epidemiologists. The ATS is also collaborating with several other organizations to formulate a statement about race and ethnic considerations in the interpretation of lung function testing.

The society will continue to evaluate the topic of race and ethnicity in clinical decision-making on an ongoing basis and revise its guidance according to the best available science.