What is the Global Lung Function Initiative and Its Purpose for Lung Function Testing?

The utilization of race-based normal values in medicine, particularly in regard to pulmonary function tests, is a topic that has become more prevalent in the field of pulmonology. This refers to the practice of using a patient’s self-reported race to adjust a standard ‘normal range’ for different medical tests.

One organization, known as the Global Lung Function Initiative (GLI), is bringing a conversation about this practice to light along with ​respirologists, physiologists, epidemiologists, and statisticians, with the aim of changing how lung function tests are ​interpreted.

During the January episode of the monthly respiratory health podcast series Lungcast, a discussion on this topic was featured between host Albert Rizzo, MD, chief medical officer of the American Lung Association (ALA), and 2 new speakers: Meredith McCormack, MD, a professor of medicine at Johns Hopkins School of Medicine and Loretta G. Que, MD, a professor of medicine at Duke University.

Both experts are known for their extensive work in the field of lung health. Que and McCormick were first asked about the GLI itself and its mission today.

“The global lung function initiative is an international collaboration of physicians, physiologists, researchers, and industry partners, and they formed a network in [around] 2008 with the purpose of trying to improve how lung function is reported and interpreted across all age groups around the world,” Que explained. “This network has become [close to] the largest resource of reference values for routine lung function testing assembled.”

Rizzo highlighted a set of significant publications released in 2023 on the effect of race and ethnicity on pulmonary function testing interpretation. He asked McCormack and Que to speak to the efforts that went into these publications and their recommendations, as well as the ways in which they interpret the move away from race-based predictive models for pulmonary functions progressing.

“I think one thing that's really important to note is those publications were published in 2023 but [there was a lot of] work that went into and the discussions began years prior to that,” McCormack said. “One aspect that I think is really important to note is the movement that we saw in the field of medicine in general, really reconsidering and questioning our practices related to how we think about race and medical algorithms, began years before. And one point to highlight is it was really sparked, in part, by the reflections of medical students and early career trainees.”

During the course of this Lungcast segment, both speakers highlighted the controversial use of race-based normal values in lung function testing.

For additional information on the GLI and on the changing conversation regarding race-based normal values in lung function testing, view the full interview segment above.

Lungcast is a monthly respiratory health podcast series which is hosted by Albert Rizzo, MD, the chief medical officer of the American Lung Association (ALA), and produced by the ALA and HCPLive.

Subscribe to Lungcast on Spotify here, or listen to the episode below.