Achieving Equity in Pediatric Clinical Guidance.

Area of Science:

• Medical Ethics
• Health Disparities Research
• Biomedical Informatics

Background:

• Growing scholarly and organizational opposition to race-based medicine.
• Concerns regarding the inappropriate use of race in clinical algorithms and guidelines.
• Recognition of race and racism as structural determinants of health outcome disparities.

Purpose of the Study:

• To critically examine the role of race in clinical decision-making.
• To highlight the challenges to race correction, race norming, and race adjustment.
• To underscore the need to move beyond race as a proxy for biological variables in research.

Main Methods:

• Literature review of scholarly attention and policy statements.
• Analysis of recommendations from bodies like the National Academies of Science, Medicine, and Engineering.
• Examination of existing scientific literature on race in clinical decision-making.

Main Results:

• Significant scholarly and organizational pushback against race-based medicine.
• National Academies' 2024 report advises against unsupported inferences from race/ethnicity in research.
• Evidence of race embedded in clinical decision-making, potentially causing harm.

Conclusions:

• The use of race as a proxy for biological variables in clinical algorithms is being vigorously challenged.
• There is a critical need to address structural racism's impact on health disparities.
• Future research and clinical practice must move beyond simplistic reliance on race.