Hidden Amongst Healthy: Normalization of Respiratory Pathology and Health Disparities by Reference Equations

Cole Bowerman, MSc
Michael G. DeGroote School of Medicine, McMaster University; Hamilton, ON

Session Description

Lung function thresholds to diagnose respiratory diseases are derived from Global Lung Function Initiative (GLI) reference populations that meet an oversimplified set of eligibility criteria including lifelong non-smoking, no respiratory symptoms, and no physician diagnosed respiratory disease. These limited criteria overlook important determinants of lung health, including air pollution, second hand smoke, and other factors which may differ by socioeconomic status (SES). We tested the hypothesis that lung pathology on CT would be common among GLI reference population-eligible adults and associated with lung function impairment, indices of SES, and mortality using data from the Multi-Ethnic Study of Atherosclerosis (MESA). We identified 31.8% of GLI eligible individuals in MESA with lung pathology on CT. These individuals had lower lung function, lower socioeconomic status, poor healthcare access, and higher mortality.

Learning Objectives

At the end of this presentation, attendees will be able to:

• Identify the limitations of currently used pulmonary function test reference equations
• Critically apply a patient’s results from pulmonary function test reference equations to their unique scenarios.

CanMEDS Roles: Health Advocate, Medical Expert, Scholar