Three questions to ask before using race-adjusted clinical algorithms

Over the years medical groups have adopted diagnostic algorithms and practice guidelines that include “race corrections” intended to control for biological differences. But there is mounting evidence that race is not a reliable proxy for genetic variation.

When developing or applying algorithms and practice guidelines with a racial component, physicians should ask these three questions:¹

1. Is the need for race correction based on robust evidence and statistical analyses (with consideration of internal and external validity, potential confounders, and bias)?

2. Is there a plausible causal mechanism for the racial difference that justifies the race correction?

3. Would implementing this race correction relieve or exacerbate health inequities?

1. Vyas DA, Eisenstein LG, Jones DS. Hidden in plain sight — reconsidering the use of race correction in clinical algorithms. N Engl J Med. 2020;383(9):874–882.

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