Race-neutral metrics more accurately predict the risk for death and exacerbations in chronic obstructive pulmonary disease (COPD), according to a study published online in the American Journal of Respiratory and Critical Care Medicine. Study authors examined European Respiratory Society (ERS)/American Thoracic Society (ATS) airflow obstruction severity classification in the COPDGene Study (10,108 participants). The Global Initiative for Chronic Obstructive Lung Disease (GOLD) approach, using National Health and Nutrition Examination Survey III race-specific equations, was compared to the application of the Global Lung Initiative (GLI)-Global race-neutral equations. The researchers found that individuals with milder disease had the lowest agreement between ERS/ATS with zGLI Global and the GOLD classification; race was a major determinant of redistribution. zGLI Global differentiated all-cause mortality risk between normal spirometry and first grade of COPD after adjustment for relevant covariates (hazard ratio, 1.23); in addition, a linear increase in exacerbation rates was seen with increasing disease severity in comparison to GOLD.
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