Warren, Wyden, Booker, and Lee question the use of race-based algorithms in standard medical practice

Pictured: United States Senator Elizabeth Warren (D-Mass.), official portrait 114th Congress.(Photo: United States Senate), Public Domain)

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Lawmakers say pandemic and its disproportionate consequences for communities of color have starkly revealed that racism itself is a public health crisis

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United States Senator Elizabeth Warren (D-Mass.)

"In order to reduce health disparities among communities of color, we must ensure that medicine and public health organizations reevaluate the ways in which current practices, including the use of race-based algorithms, could be worsening outcomes for people of color."

Text of Letter (PDF)

United States Senators Elizabeth Warren (D-Mass.), Ron Wyden (D-Ore.), Cory Booker (D-N.J.) and Congresswoman Barbara Lee (D-Calif.), sent a letter to the Agency for Healthcare Research and Quality (AHRQ) requesting a review of the use of race-based clinical algorithms in standard medical practices.

"The ongoing coronavirus disease 2019 (COVID-19) pandemic and its disproportionate consequences for communities of color have starkly revealed that racism itself is a public health crisis," the lawmakers wrote. "In order to reduce health disparities among communities of color, we must ensure that medicine and public health organizations take a staunchly anti-racist approach to medical care and reevaluate the ways in which current practices, including the use of race-based algorithms, could be worsening outcomes for people of color."

Race-based clinical algorithms inform how clinicians adjust medical test results based on their patient's race and predict health care needs, treatment regimens and overall assessments of health These algorithms risk embedding racism into medical practice when, for example, the National Football League's concussion protocols assumed that Black NFL players have lower cognitive functioning compared to white players. Across the U.S., some practitioners are challenging the use of race in these algorithms. Several hospital systems, including Beth Israel Deaconess Medical Center in Boston, Massachusetts, have removed the inclusion of race from some clinical algorithms-citing findings that suggest that these algorithms may be worsening both health outcomes and the ability of former employees sustaining injuries on the job to qualify for fair compensation because of their race.

In order to better understand these algorithms and their current effects on medical care, the lawmakers requested a review of their use by Agency for Healthcare Research and Quality.

In the letter, the lawmakers asked Agency for Healthcare Research and Quality a series of questions about the steps the agency is taking to address any disparities stemming from race-based assumptions embedded into medical care through these algorithms including, the extent to which race-based clinical algorithms are used in medical practice, whether race-based algorithms are based on scientifically sound, sufficiently powered studies, how these algorithms currently affect patients, and what approaches different hospital and medical systems have taken in removing race from these algorithms.

Earlier this month, Senator Warren introduced the Anti-Racism in Public Health Act which would help expand research and investment into the public health impacts of structural racism and require the federal government to begin actively developing anti-racist health policy. 

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