Every day, healthcare providers rely on clinical algorithms to assist them in making decisions about their patients. These algorithms take into account various factors such as blood pressure, age, weight, and surgical history. In some cases, a patient’s race is also considered in these algorithms.
Bioinformatician Shyam Visweswaran became interested in race-based tools in medicine after reading a notable paper published in the New England Journal of Medicine in 2020. This paper highlighted 13 common examples of race-based algorithms used in healthcare. Intrigued by this information, Visweswaran decided to delve deeper into the prevalence of such algorithms in the medical field. Unable to find a comprehensive resource on the subject, he took it upon himself to create one. Together with his colleagues, Visweswaran compiled a list of 48 clinical tools that incorporate race adjustments, with three additional tools added based on further research and reporting.
The release of this database in July 2023 shed light on the problematic nature of race-based algorithms in healthcare. These algorithms reinforce the flawed notion that race determines biological differences among individuals. Moreover, the database revealed the inconsistent and confusing use of race categories in these tools, with 49 distinct categories identified for race and ethnicity. This raises concerns about how patients of mixed ancestry are classified and how their treatment may be impacted as a result.
While the database is a significant step towards understanding the prevalence of race-based algorithms in healthcare, it is not exhaustive. It does not encompass the custom tools used by individual hospitals or the algorithms employed by health insurers. Nonetheless, it serves as a valuable resource for clinicians and healthcare systems looking to reassess their approach to race in medical decision-making.
Visweswaran emphasizes the importance of recognizing the history and implications of these algorithms as healthcare guidelines continue to evolve. As the medical community works towards addressing the issues raised by race-based algorithms, understanding their origins and impact is crucial for promoting equitable and unbiased healthcare practices.
