Is there evidence of racial disparity/inequity in medical diagnosis?

Art Papier apapier at VISUALDX.COM
Fri Oct 13 16:04:11 UTC 2017


We published a paper on disparities in healthcare knowledge in dermatology.  There has been a persistent
bias in most of the literature to showing examples of disease in light skin.
Erythema is a sign of inflammation, and purpura is frequently a sign of
systemic disease such as vasculitis.  These are very difficult to recognize
in people that are deeply pigmented.  Redness and purple are easy to see in
light skin, in deeply pigmented skin these colors appear dark brown or
black.  We do not adequately teach physicians about these important physical
exam clues.  Since the 90's I have been focused on this in our work.  We
have a free open access website which is used by medical schools globally to
teach the descriptive skin terminology of the physical exam of the skin.
There is a page that briefly describes this challenge and has an example of
meningococcemia in light and dark skin.

Anyone with particular interest in this topic should feel free to contact


Art Papier MD

CEO VisualDx

Associate Professor of Dermatology and Medical Informatics

University of Rochester


From: Ruth Ryan [mailto:ruth at RYAN-GRAHAM.COM] 
Sent: Friday, October 13, 2017 9:42 AM
Subject: [IMPROVEDX] Is there evidence of racial disparity/inequity in
medical diagnosis?


Hello all,


There appears to be a lot of evidence for racial/ethnic/gender disparities
in medical treatment and outcomes.

We all know diagnosis is the gateway to treatment and outcomes.

So is there evidence for racial disparity/inequity in medical diagnosis?

The Sunday NY Times reiterated the study about job resumes receiving
significantly different response rates from employers based on whether they
came from a black or a white sounding name.  The article reports on a new
study of response to simple email queries to public offices (sheriff,
library, school district) from back and white sounding names and show an
8-13% higher rate of no-response or less cordial response to inquiries from
blacks, worse in more heavily white geographic areas.  This was presumed to
be due to unconscious bias.  

I'm looking for material (studies, articles, writers, speakers) on
racial/ethnic/gender disparities related to diagnosis. Or treatment/outcome
disparities linked back to diagnosis.  Know of any?






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