Chair: Ms Rachel Ong-Salvador (Amsterdam, Netherlands)

Speakers: Dr Yet Hong Khor (Melbourne, Australia), Dr Darshali A. Vyas (Boston, United States)

Discussants: Mr Maximillian Thomas (Brighton, United Kingdom), Prof. Bruce Thompson (Parkville, Australia), Prof. Loretta Que (Durham, United States)

Fees: Free for ERS members / €10 for non-members
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Overview

With the endorsement of GLI (Global Lung Function Initiative) Global race-neutral spirometry equations, many national societies now recommend abandoning race-specific reference values. However, adoption remains inconsistent, and substantial debate persists regarding the clinical, ethical and scientific implications of race adjustment in lung function testing. Arguments against race-specific equations often cite race as a proxy for socioeconomic, nutritional and environmental factors, yet empirical evidence remains mixed.

This webinar addresses this critical educational gap by presenting two high-impact 2025 studies examining the real-world consequences of race-neutral versus race-specific GLI equations in different populations. By directly comparing findings from Asian and Black cohorts and discussing alternative normalisation strategies, the session aims to equip clinicians, physiologists and researchers with evidence-based insight to guide spirometry interpretation and policy decisions.

Race-neutral versus race-specific GLI reference equations on spirometry interpretation in the general population

Author & Speaker: Dr Yet Hong Khor
Study: Choi JY, Rhee CK, Jo YS, Khor YH et al. Scientific Reports. 2025 Jul 2;15(1):23569.
Summary:
This study examines the impact of using race-neutral versus race-specific GLI spirometry reference equations in an Asian general population. Findings illustrate how the choice of reference can influence interpretation of lung function, with implications for diagnosis, classification and disease-outcome assessment in diverse clinical settings.

Lung function trajectory using race-specific vs race-neutral GLI coefficients

Author & Speaker: Dr D.A. Vyas
Study: Vyas DA, Zhao S, Lai PS, Rodriguez-Lopez J, Schmidt EP, Brown R, et al. JAMA Network Open. 2025 Apr 1;8(4):e257304.
Summary:
This longitudinal cohort study evaluates how race-specific versus race-neutral GLI equations affect lung function trajectories over time, with noteworthy observations in Black patients and advocacy for alternative normalisation approaches. The work extends the debate beyond cross-sectional interpretation to long-term clinical impact.

Topics:

• Impact on lung function interpretation in Asian populations
• Longitudinal lung function trajectories in Black patients
• Ethical, clinical and methodological considerations of race adjustment
• Alternative approaches to spirometry normalisation
• Implications for clinical practice, research and guideline development

Format

One-hour webinar structured as follows:

• Opening remarks - Introduction by Chair Rachel Ong-Salvador (5 min)
• Presentation 1: Race-neutral versus race-specific GLI reference equations on spirometry interpretation in an Asian general population - Yet Hong Khor (15 min)
• Presentation 2: Lung function trajectory using race-specific versus race-neutral GLI coefficients - Darshali A. Vyas (15 min)
• Panel discussion - Panalists: Maximillian Thomas, Bruce Thompson, Loretta Que - engage both authors with targeted questions on study design, interpretation, ethical considerations, and clinical implications.
  Moderated by the Chair Rachel Ong-Salvador (15 min)
• Audience Q&A and Wrap-up - Moderated by Chair Rachel Ong-Salvador, summarising take-home messages, controversies, and future directions (10 min)

Learning outcomes

Following this webinar, participants will be able to:

• Compare race-neutral and race-specific reference standards and their effects on spirometry interpretation.
• Recognise population-specific differences revealed by recent 2025 evidence.
• Apply critical reasoning when choosing reference standards in practice.
• Discuss ethical and methodological considerations of race adjustment in lung function.
• Consider alternative approaches for spirometry normalisation and future research needs.

CME credit

An application for accreditation of this webinar has been made to the European Board for Accreditation in Pneumology (EBAP) for 1 CME credit per 1-hour attendance. If accredited, the CME credit will be granted upon attendance of at least 60 minutes during the live webinar only.

What is a webinar?

A webinar closely simulates a lecture-based teaching experience. The speaker can interact with the audience, just as in a classroom setting. During the webinar, you will be asked to share your opinion on issues related to the topic using interactive polls.

All participants will be able to hear the lecturer and see the slides throughout the presentation. As a participant you will be able to pose questions or discuss ideas with the other participants via the text chat facility and the speaker will respond to the questions via the microphone.

Login guidelines

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