Study finds cardiovascular risk calculator may lead to overtreatment of black patients

Study finds cardiovascular risk calculator may lead to overtreatment of black patients

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According to a study published this month in The Lancet, a risk calculator from the American College of Cardiology and the American Heart Association predicts cardiovascular health for black patients much worse than white patients, even if their risk profile Different from race.

The author of the Boston University School of Medicine who conducted the analysis described these differences as “biologically incredible.” ReportThese findings illustrate another way that black patients are treated differently from white patients. Unlike previous analysis that showed that black patients may not receive adequate care, this new study provides an example of the risk that this population is at risk of excessive medical care.

“Although the direction of this potential bias seems somewhat reassuring (as opposed to blacks not receiving statins with white counterparts), the risks associated with overtreatment—that is, financial, psychological, side effects, and the meaning of quality of life— —Not trivial,” the author wrote.

The American College of Cardiology and the American Heart Association did not respond to requests for comment.

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Researchers created a combination of approximately 50,000 different risk factors through research. Calculator According to Boston University School of Medicine, carefully check those that produce high enough scores to show the doctor that the patient needs preventive care Press Releases.

Factors such as cholesterol levels, smoking history, and race were recorded in calculators created by two medical groups. If the score for events such as heart attack or stroke in the next 10 years is higher than 7.5%, the American College of Cardiology and the American Heart Association recommend the use of statins and other treatments.

According to Boston University School of Medicine, in approximately 20% of the risk factor combinations, “the black and white differences in risk predicted by these equations will lead to different treatment decisions.” “More often, blacks are prescribed statins because they are considered to be at higher risk. The difference in predicted risk (blacks and whites with the same risk factors) may be as high as 22.8% for men and 26.8% for women.”

The researchers wrote that race itself should not replace actual risk factors for heart disease, which may include social determinants of health, such as housing security, food insecurity, and economic challenges.

“In any risk prediction equation, race should be replaced by various potential causal factors represented by race, and these factors can be addressed through intervention,” the author wrote.

These discoveries are as more and more push Access to race data in the healthcare environment-and warn It may not be appropriate to use these data in predictive algorithms. Race is not necessarily the same as socioeconomic status, genetics, or environment, and may lead to overtreatment or undertreatment.

In a companion editorial, The Lancet Digital Health editor is committed to collecting demographic data, for example, for all submitted research papers including race and ethnicity, and asking the author to explain why this information is not available without including this information.

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