Uncovering the Gaps: Study Sheds Light on Racial Disparities in IPF Outcomes

Findings presented at the CHEST 2024 annual meeting earlier this year in Boston, Massachusetts, highlighted racial disparities in outcomes among patients hospitalized with idiopathic pulmonary fibrosis (IPF).¹ Using data from the National Inpatient Sample, it found that Black patients were less likely to be hospitalized with IPF, raising concerns about potential underdiagnosis or misclassification.

In part 2 of our interview with Cesar Davila-Chapa, MD, lead investigator and pulmonary and critical care co–chief fellow at the University of Nebraska Medical Center, he discussed surprising findings, the study's limitations, and potential future research directions.

This transcript has been lightly edited for clarity.

Transcript

Were there any surprising or particularly interesting findings?

I think the surprising thing that I mentioned is that Black patients are admitted at a younger age for IPF. I was surprised at the percentage, 90% were White who had the coding for IPF, but only 10% were Black. So, is that an issue with coding? Is that an issue of decreased suspicion?

I also saw that, as I mentioned earlier, female patients were more likely to be Black than White. Now, there is more incidence, more prevalence of connective tissue disease in the Black population.

What potential directions could this research take in the future?

I think the most important thing was that this is just a database study. It has its limitations, like coding, but I think having a prospective, multicenter study, showing IPF admissions, what their long-term outcomes are, whether it be inpatient or outpatient, and what their mortality is; IPF usually has a 5-year mortality. Then, raising awareness of what factors are different in both populations, that way we're more aware, will be important.

So, I think a prospective, multicenter study will be what we need. What would be more important is [analyzing] different areas of the US. Fortunately, I'm in the Midwest. I think our population is 80% White and the other 20% is a mix in Nebraska. I think it'd be important [to conduct] multicenter [studies] in various states.

Could you elaborate on your study's limitations?

So, this is a database study, and it's based on coding for IPF, with IPF as the primary diagnosis. Obviously, database studies have many limitations, and one of them, for this one at least, is the coding, if people are coding correctly. Was it the primary diagnosis? Was it more prevalent as a secondary diagnosis? I think that's one of the major limitations.

Reference

1. McCormick B. Racial, ethnic disparities persist in the treatment, hospitalization of patients with IPF. October 15, 2024. Accessed December 3, 2024. https://www.ajmc.com/view/racial-ethnic-disparities-persist-in-the-treatment-hospitalization-of-patients-with-ipf