How do you mitigate the risk of inadverdent under or over diagnosis of COPD in certain populations with transition to race-neutral spirometry reference equations?

Hi - I use the GOLD guidelines of fixed (rather than % predicted) FEV1/FVC ratio of < 0.7 to define obstruction for COPD. Most of the major studies in forming COPD treatment have used the fixed ratio. There is a risk of overdiagnosis in an older population with the fixed ratio, but in an older indiv...