If doctors and clinical educators rigorously analyze algorithms that include race correction, they can judge, with fresh eyes, whether the use of race or ethnicity is appropriate. In many cases, this appraisal will require further research into the complex interactions among ancestry, race, racism, socioeconomic status, and environment.

If doctors and clinical educators rigorously analyze algorithms that include race correction, they can judge, with fresh eyes, whether the use of race or ethnicity is appropriate. In many cases, this appraisal will require further research into the complex interactions among ancestry, race, racism, socioeconomic status, and environment. Much of the burden of this work falls on the researchers who propose race adjustment and on the institutions (e.g., professional societies, clinical laboratories) that endorse and implement clinical algorithms. But clinicians can be thoughtful and deliberate users. They can discern whether the correction is likely to relieve or exacerbate inequities. If the latter, then clinicians should examine whether the correction is warranted. Some tools, including eGFR and the VBAC calculator, have already been challenged; clinicians have advocated successfully for their institutions to remove the adjustment for race.43,44 Other algorithms may succumb to similar scrutiny.45 A full reckoning will require medical specialties to critically appraise their tools and revise them when indicated.

Darshali A. Vyas, Leo G. Eisenstein, and David S. Jones, “Hidden in Plain Sight — Reconsidering the Use of Race Correction in Clinical Algorithms,” The New England Journal of Medicine, Volume 2020, Number 383, 882. https://dx.doi.org/10.1056/NEJMms2004740.

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