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The Use of Race in Risk Assessment Tools Contributes to Systemic Racism.

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Race should not be included in risk calculators for total joint arthroplasty (TJA) readmission. A patient's race does not impact their risk of complications after hip or knee replacement surgery.

Keywords:
ReadmissionsRisk assessmentSystemic racismTotal joint arthroplasty

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Area of Science:

  • Orthopedic surgery
  • Medical informatics
  • Health equity

Background:

  • Osteoarthritis commonly affects hips and knees, leading many patients to undergo total joint arthroplasty (TJA).
  • Risk calculators are valuable tools for informed decision-making regarding TJA surgery.
  • Current risk assessment tools may contain biases that affect patient outcomes.

Purpose of the Study:

  • To evaluate the appropriateness of including race as a factor in TJA readmission risk calculators.
  • To advocate for the removal of race from TJA risk prediction models.

Main Methods:

  • Analysis of existing TJA risk calculators and their methodologies.
  • Review of literature on racial bias in healthcare algorithms.
  • Ethical and clinical assessment of race-based risk stratification.

Main Results:

  • The inclusion of race in TJA readmission risk calculators is scientifically unfounded.
  • Race is not a predictor of complication risk following total joint replacement.
  • Using race in these calculators perpetuates health inequities.

Conclusions:

  • Race should be excluded from TJA risk calculators to ensure equitable and accurate patient assessment.
  • Removing race from risk models promotes fair shared decision-making between patients and surgeons.
  • Future research should focus on developing unbiased risk prediction tools for TJA.