Spirometric reference equations are typically stratified by race because of racial differences in lung function, particularly between black and white individuals, at least in part because of black individuals having a smaller thorax to leg length ratio, and thus smaller lung volumes for a given height, than white individuals. Use of race-based pulmonary function equations is especially problematic in biracial/multiracial individuals, who compose an increasing portion of the US population, as lung physiology may not simply be an average of their composite races; use of race in pulmonary function testing has recently been questioned. To our knowledge, no spirometric reference equations exist for biracial or multiracial individuals.
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