Aaron Baugh, MD, on Race-Specific Equations for Lung Function

Why It Matters

Eliminating race‑based lung function equations prevents underdiagnosis in minority patients and advances equitable respiratory care.

Key Takeaways

• Race-specific lung equations can mask true health disparities.
• Using race adjustments may underdiagnose respiratory disease in minorities.
• Scientific evidence shows genetic variation doesn’t align with social race.
• Shift toward race-neutral reference values improves diagnostic accuracy.
• Clinicians must reassess guidelines to ensure equitable pulmonary care.

Summary

Dr. Aaron Baugh, a pulmonology fellow, recounts his experience with race‑specific equations for interpreting spirometry during a fellowship retreat, initially viewing them as a step toward personalized care for minority patients.

He explains that early enthusiasm was based on the premise that physiological differences across racial groups warranted separate reference standards. However, emerging data reveal that these adjustments often stem from socioeconomic and environmental factors rather than innate biology, leading to systematic underestimation of lung impairment in Black and Hispanic patients.

Baugh admits, "we're often wrong," noting he was wrong about the study outcomes, his career direction, and the meaning for patients. He cites recent analyses showing race‑based corrections reduce the likelihood of diagnosing COPD and asthma in minorities, thereby delaying treatment.

The talk underscores a growing consensus to abandon race‑based spirometry in favor of race‑neutral or ancestry‑adjusted models, which promise more accurate diagnosis and equitable treatment. Clinicians and guideline committees must revise protocols to eliminate bias and improve health outcomes.

Original Description

Episode two of Intention to Treat explores how the spirometer, a medical device used to justify slavery, became a standard tool for doctors today. Listen wherever you get your podcasts.