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How an Algorithm Blocked Kidney Transplants to Black Patients


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Image from a kidney scan.

In 64 cases, Black patients scores would have qualified them for a kidney transplant wait list. None had been referred or evaluated for transplant.

Credit: James Cavallini/Science Source

Black people in the US suffer more from chronic diseases and receive inferior health care relative to white people. Racially skewed math can make the problem worse.

Doctors often make life-changing decisions about patient care based on algorithms that interpret test results or weight risks, like whether to perform a particular procedure. Some of those formulas factor in a person's race, meaning patients' skin color can affect access to care.

A new study of patients in the Boston area is one of the first to document the harm that can cause. It examined the effect on care of a widely used but controversial formula for estimating kidney function that by design assigns Black people healthier scores.

The study analyzed health records for 57,000 people with chronic kidney disease from the Mass General Brigham health system that includes Harvard teaching hospitals Massachusetts General and Brigham and Women's. One third of Black patients, more than 700 people, would have been placed into a more severe category of kidney disease if their kidney function had been estimated using the same formula as for white patients.

That could have affected decisions such as when to refer someone to a kidney specialist, or refer them for a kidney transplant. In 64 cases, patients' recalculated scores would have qualified them for a kidney transplant wait list. None had been referred or evaluated for transplant, suggesting that doctors did not question the race-based recommendations.

From Wired
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