Mixed Race Studies

Very Little Is Keeping Doctors From Using Racist Health Formulas

Wired
2021-10-08

Jyoti Madhusoodanan

Photo-Illustration: Sam Whitney; Getty Images

If nothing in medicine changes, it’s just a matter of time before yet another race-based risk calculator harms people of color.

RECENTLY, TWO LEADING medical associations recommended ending a decades-old practice among doctors: using race as one of the variables to estimate how well a person’s kidneys filter waste out of their bodies. Before, clinicians would look at the levels of a certain chemical in blood, then multiply it by a factor of approximately 1.15 if their patient was Black. Using race to estimate kidney function contributes to delays in dialysis, kidney transplants, and other life-saving care for people of color, especially Black patients.

To make the recent decision, 14 experts spent approximately a year evaluating dozens of alternative options, interviewing patients, and weighing the impact of keeping race in the equation. Their final recommendation ensures the corrected kidney equation is equally precise for everyone, regardless of race.

Yet other risk equations that include race are still being used—including ones that have been used to deny former NFL players’ payouts in a concussion settlement, ones that might contribute to underdiagnosing breast cancer in Black women, and ones that have miscalculated the lung function of Black and Asian patients. Ending the use of race-based multipliers in these and dozens of other calculators will take more than a task force in one medical specialty. It’ll need researchers to not just believe, but act on the knowledge that race is not biology, and for the biomedical research enterprise to implement clearer standards for how these calculators are used. Otherwise, it’s just a matter of time before another tool that wrongly uses race to make decisions about patients’ bodies trickles into clinical care…

Read the entire article here.

NKF and ASN Release New Way to Diagnose Kidney Diseases

National Kidney Foundation
2021-09-23

Both Organizations Recommend Race-Free Approach to Estimate GFR

Sept. 23, 2021, New York, NY – Today, the National Kidney Foundation (NKF) and the American Society of Nephrology (ASN) Task Force on Reassessing the Inclusion of Race in Diagnosing Kidney Diseases has released its final report, which outlines a new race-free approach to diagnose kidney disease. In the report, the NKF-ASN Task Force recommends the adoption of the new eGFR 2021 CKD EPI creatinine equation that estimates kidney function without a race variable. The task force also recommended increased use of cystatin C combined with serum (blood) creatinine, as a confirmatory assessment of GFR or kidney function. The final report, published today online in the American Journal of Kidney Diseases (AJKD) and the Journal of the American Society of Nephrology (JASN), was drafted with considerable input from hundreds of patients and family members, medical students and other trainees, clinicians, scientists, health professionals, and other stakeholders to achieve consensus for an unbiased and most reasonably accurate estimation of GFR so that laboratories, clinicians, patients and public health officials can make informed decisions to ensure equity and personalized care for patients with kidney diseases…

Read the entire press release here.