心脏计算机断层扫描中的种族转诊偏差:差异、差距还是歧视?

Benjamin J W Chow, Saad Balamane, Anahita Tavoosi, Lucas Dirienzo, Yeung Yam, Li Chen, Aun Yeong Chong
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引用次数: 0

摘要

背景:医学中存在差异,会影响对患者的护理。我们试图了解心脏 CT(CCT)人群在诊断测试中种族偏见的影响:方法:2006 年 2 月至 2021 年 11 月期间,我们采集了 CCT 患者、转诊医生和集水区人口的种族信息。结果:在 21,241 名 CCT 患者中,有 21,241 人因种族原因而被转诊:在 21,241 名 CCT 患者中,17,514 名(82.5%)患者为白人。非白人中包括 467 名土著人(2.2%)、656 名黑人(3.1%)、932 名亚裔人(4.4%)、276 名南亚人(1.3%)、1100 名中东人(5.2%)和 296 名拉丁美洲人(1.4%)。集水区人口为 907,675 人,其中 619,514 人被认定为白人,占 69.7%。与服务区人口相比,白人的转诊率明显高于非白人。白人的转诊指数高于非白人(1.2 对 0.6,p):CCT 转诊中存在种族差异。这些差异与疾病流行率、医生种族或从业年限无关。这项研究表明,有必要更好地了解造成差异的原因,并制定策略来减少潜在的偏见。
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Racial referral bias in cardiac computed tomography: Differences, disparities or discrimination?

Background: Disparities exist in medicine and can affect patient care. We sought to understand influences of racial biases in diagnostic testing within a Cardiac CT (CCT) population.

Methods: Race of CCT patients, referring physicians and the population in the catchment area were captured between February 2006 and November 2021. The frequency of CCT referrals for each race was indexed to the catchment population.

Results: Of 21,241 CCT patients, 17,514 (82.5 ​%) patients were White. The Non-White population was comprised of 467(2.2 ​%) Indigenous, 656(3.1 ​%) Black, 932(4.4 ​%) Asian, 276(1.3 ​%) South Asian, 1100(5.2 ​%) Middle Eastern and 296(1.4 ​%) Latin American races. The catchment population was 907,675, with 619,514 individuals of whom 69.7 ​% identified as White. Compared to the catchment population, there was a disproportionately higher referral rate for Whites than Non-Whites. The referral index for Whites was higher than Non-Whites (1.2 versus 0.6, p ​< ​0.001)). This pattern was consistent across all racial minorities and age categories. A total of 356 physicians (236(66.3 ​%) White, 4(1.2 ​%) Black, 39(12.0 ​%) Asian, 30(9.2 ​%) South Asian, 43(13.2 ​%), Middle Eastern and 4 (1.2 ​%) Latin American) made referrals to CCT. The racial difference in referral patterns was independent of physician race and was independent of their years in practice.

Conclusions: Racial differences exist in CCT referrals. These differences are independent of prevalence of disease, physician race or years in practice. This study supports the need to better understand reasons for disparity and strategies to mitigate potential bias.

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