CP9 - Reviewing the Medical Utility of Incorporating Racial Identifiers in Common Diagnostic Tools
Poster Type: Research
Track/Topic: A. T. Still University; Quality of Care and Quality Improvement; Social Determinants of Health
Research Objectives: To identify the usefulness of racial identifiers in 6 commonly used healthcare diagnostic tests. Through literature review, evidence against the use of racial identifiers in some diagnostic tests were found. Our aim is to increase awareness of this evidence and how racial identifiers have been used in these diagnostic tests.
Research Study Design/Methods: Our project started with a literature review of 6 diagnostic tools that commonly reference racial identifiers. We gained a better understanding of how race plays a part in these tests and corresponding conditions. Based on what was learned, we created an informational video of our findings and presented it to providers at HealthPoint, who then completed a qualitative survey that included questions assessing their opinions on how the racial identifiers were used and their interest in learning more about racism in healthcare. As an incentive for participation, a free catered lunch was offered to the site with the most participants.
Research Principal Findings and Quantitative/Qualitative Results: After investigation, VBAC, STONE, Breast Cancer Risk Assessment and DEXA lacked sufficient evidence to support continued use of racial identifiers. Bilitool and Hemoglobinopathy screening has evidence supporting continued use of self-identified race until a better method is clinically available. Overall, the providers’ responses (n=60) supported that they understood and agreed with the evidence presented. Over 60% of providers agreed the use of race lacked support in VBAC (83.33%, n=50), STONE (78.33%, n=47), Breast Cancer Risk Assessment (61.67%, n=37) and DEXA screening (66.77%, n=40). Maintaining self-identified race in BiliTool and Hemoglobinopathy was more controversial with 48.33% (n=29) supporting continued inclusion.
Research Conclusions on Impact on Health Centers: Overall, our project showed that the validity of including racial identifiers in patient care is varied, and the literature is limited. We also need to consider if race is being included as a proxy for social determinants of health, such as access to care, income and social status. Using it this way, it disregards the diversity of social determinants of health within each racial category. Further research should be conducted before using racial identifiers, as unnecessary usage, except in the case of a biologically significant association, has the potential to lead to unnecessary testing or worsened health outcomes.
Naomi Mathews, OMS-II, A.T. Still University School of Osteopathic Medicine