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

Sittig, Dean F Dean.F.Sittig at UTH.TMC.EDU
Fri Oct 13 21:12:21 UTC 2017


Ruth:
Not all the data mining for unfollowed up test results are from asymptomatic people. Many of the tests results we review (urine cultures, TSH, iron, etc) were likely ordered based on patient reported symptoms and still were not followed up appropriately.
Re: screening of asymptomatic people, it was drummed into my pea-brain, that if you are not prepared to do something with the data, you shouldn't collect it. I think this applies to clinical care or research!
Dean


From: Ruth Ryan [mailto:ruth at RYAN-GRAHAM.COM]
Sent: Friday, October 13, 2017 11:01 AM
To: IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG
Subject: Re: [IMPROVEDX] Is there evidence of racial disparity/inequity in medical diagnosis?

Michael,

You raise a great question.

Does mass screening of asymptomatic people for disease belong in our world of diagnostic safety? Do we own it?

We seem to claim it, at least to the extent of data-mining for unfollowed-up test results.

Ruth

From: Michael H. Kanter [mailto:Michael.H.Kanter at kp.org]
Sent: Friday, October 13, 2017 12:53 PM
To: Society to Improve Diagnosis in Medicine <IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG<mailto:IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG>>; Ruth Ryan <ruth at ryan-graham.com<mailto:ruth at ryan-graham.com>>
Subject: RE: [IMPROVEDX] Is there evidence of racial disparity/inequity in medical diagnosis?

If one considers screening tests for cancer part of the diagnostic error /reliability issue , there is evidence of differences in cancer screening rates based on race/ethnicity.

From: Ruth Ryan [mailto:ruth at RYAN-GRAHAM.COM]
Sent: Friday, October 13, 2017 6:42 AM
To: IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG<mailto:IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG>
Subject: [IMPROVEDX] Is there evidence of racial disparity/inequity in medical diagnosis?


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________________________________
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?

Ruth

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