AMA to US officials: Algorithms contribute to medical racism

In an open letter to the Agency for Healthcare Research and Quality, the American Medical Association outlined how algorithms in healthcare settings factor in biases and compound racism, according to a June 23 article published by the AMA.

Five things to know:

  1. Congress requested the healthcare research agency launch a study on how algorithms in the healthcare setting compound bias. The agency issued a request on how algorithms "influence access to care, quality of care or health outcomes for racial and ethnic minorities and people who are socioeconomically disadvantaged."

  2. "The use of race or ethnicity in clinical algorithms used in cardiology, nephrology, obstetrics and urology, among others, have been questioned and subjected to close scrutiny," AMA CEO and Executive Vice President James Madara, MD, wrote in an open letter to David Meyers, MD, the agency's acting director.

  3. Dr. Madara added that research involving stakeholders from medical societies and patient organizations is vital to understanding how they contribute to "medical racism and bias in clinical decision-making."

  4. In one example, Dr. Madara cited a commercially used algorithm that used health costs as a proxy for health to target patients for high-risk care management programs. Researchers found Black patients were consistently assigned lower risk scores than white patients, as algorithms failed to account for inequities in spending on Black patients.

  5. In another example cited, the American Society of Nephrology and the National Kidney Foundation set out to reconsider the inclusion of race in predicting kidney function. The estimated glomerular filtration rate automatically gives Black patients a higher score based on the provider's perception of the patient's race. The eGFR may show Black patients' kidneys are healthier than they are, which puts Black patients at risk for not getting timely kidney care.

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