Promoting Equity In Clinical Decision Making: Dismantling Race-Based Medicine

https://www.healthaffairs.org/doi/10.1377/hlthaff.2023.00545 A new commentary published in Health Affairs recommends adopting a “race-aware,” as opposed to the current “race-based,” approach to the development and use of algorithms in healthcare to reduce disparities and advance a more equitable health system. The authors, including Arlene Bierman, M.D., M.S., AHRQ’s chief strategy officer, and Tina Hernandez-Boussard, Ph.D., M.P.H., M.S., a former member of AHRQ’s National Advisory Council, describe concerns about racial and ethnic biases built into algorithms that guide clinical decision-making. Algorithms that use race as a proxy for biological differences can lead to treatment patterns that are inappropriate, unjust and harmful, they assert. The authors conclude that increasing the diversity of clinical trial populations, broadening the focus of precision medicine, improving education about the complex factors shaping health outcomes, and developing new guidelines and policies to enable culturally responsive care are important next steps. Access the commentary, which is part of a special Health Affairs issue, Tackling Structural Racism In Health.