The commitment By Jessica Wen, MD, PhD
RISE: R
Research with inclusion, social justice and equity
esearch with inclusion, social justice and equity (RISE) is a new health equity initiative created by Stanford radiology
residents and faculty. RISE is focused on increasing racial/ethnic data transparency in medical research cohorts. Unfortunately, 95% of medical research is currently colorblind,1
which
is an “an ideology or worldview that minimizes the role of systemic racism in shaping outcomes for people of color and attributes racial disparities to the choices and poor behavior of racial minorities.”2
The state of medical research cohorts In modern medicine, treatment guidelines are created from evidence- based research outcomes, and colorblind medical research can perpetuate systemic racism with devastating impacts on a diverse national and global patient population. For example, JAMA recently published a study showing that pulse oximeters overestimate oxygen saturation levels in African-American, Hispanic and Asian patients compared to white patients.3
A follow-up study
confirmed that patients of color in the hospital with COVID-19 were more likely to receive less than adequate oxygen supplementation compared to white patients.4
If pulse oximeters had been
developed and tested on a diverse patient population prior to reaching the market, such an outcome may have been circumvented.
Similarly, higher rates of amputation are reported in African-American
patients with peripheral arterial disease as compared to white patients.5
Lack
of diversity in clinical trials results in the creation of pharmaceuticals and interventions with uncertain efficacy and safety in underrepresented populations. Additionally, bias in artificial intelligence algorithms created from unbalanced datasets can further perpetuate systemic racism. For example, one algorithm published in Science suggests that African-American patients should receive comparatively less care as compared to white patients based on datasets reflecting the disproportionate lack of access to healthcare in the African-American population.6
In 2021, in light of increasing health disparities highlighted by the COVID- 19 pandemic, the New York Times claimed, “Medical Journals Blind to Racism as a Health Crisis.” RISE was created to address this public outcry for health equity in medical research. The RISE mission is to empower clinicians and clinical researchers nationally to report the breakdown of underrepresented populations in all future work, as appropriate.
The RISE solution The first step to combating colorblindness in medical research is ubiquitous racial/ethnic data
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