Hidden in plain sight — Reconsidering the use of race correction in clinical algorithms

Individual Author(s) / Organizational Author
Vyas, Darshali A.
Eisenstein, Leo G.
Jones, David S.
Publisher
Massachusetts Medical Society
Date
August 2020
Publication
The New England Journal of Medicine
Abstract / Description

Physicians still lack consensus on the meaning of race. When the Journal took up the topic in 2003 with a debate about the role of race in medicine, one side argued that racial and ethnic categories reflected underlying population genetics and could be clinically useful. Others held that any small benefit was outweighed by potential harms that arose from the long, rotten history of racism in medicine. Weighing the two sides, the accompanying Perspective article concluded that though the concept of race was “fraught with sensitivities and fueled by past abuses and the potential for future abuses,” race-based medicine still had potential: “it seems unwise to abandon the practice of recording race when we have barely begun to understand the architecture of the human genome.”

Our understanding of race and human genetics has advanced considerably since 2003, yet these insights have not led to clear guidelines on the use of race in medicine. The result is ongoing conflict between the latest insights from population genetics and the clinical implementation of race. For example, despite mounting evidence that race is not a reliable proxy for genetic difference, the belief that it is has become embedded, sometimes insidiously, within medical practice. (abbreviated author introduction) #P4HEsummit2022

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P4HE Authored
No