Transitioning From Race-Specific to Race-Neutral Reference Equations for Pulmonary Function Test Interpretation at a Large Safety Net Hospital System.

Wu, Amos; Nguyen, Tatyana; Do, Hyunji; Chen, Felicia; Marquez, Hector; Zolla, Jeff; Cohen, Robyn; Mattie, Karen et al. · Chest · 2026

case_series · Level IV

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Abstract

In April 2023, the American Thoracic Society (ATS) published an official ATS statement entitled "Race and Ethnicity in Pulmonary Function Test Interpretation" recommending the adoption of race-neutral reference equations for pulmonary function test results interpretation. However, lack of a clear roadmap to implement this recommendation effectively remains a challenge. This article outlines how our large safety net hospital systematically transitioned from race-specific to race-neutral reference equations. Our approach, guided by the Kotter change model, can serve as a framework for other institutions.

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