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Racial categories in medical practice and research

How useful are racial categories in medical practice and research?

PLOS

Is it good medical practice for physicians to "eyeball" a patient's race when assessing their medical status or even to ask them to identify their race" Three articles in this week's PLoS Medicine discuss the pitfalls of such racial profiling in both clinical practice and medical research. Anne Fausto-Sterling and colleagues from the Race, Medicine, and Science Workshop, Cambridge, USA, discuss how racial categories have become embedded in medical research.

For example, since 2001, researchers funded by the US National Institutes of Health have been required to categorize study participants into five racial or ethnic categories. "State-sanctioned but ill-defined categories of race have entered medical research and practice," say the authors, "with the admirable intent of ensuring full racial and gender inclusion in clinical trials, but with unanticipated consequences for health outcomes."

One of these consequences, say the authors, is that clinicians and researchers may use these categories, which are social and historical in nature, as "biological or attributive categories appropriate for individual treatment." In other words, there is a risk that race becomes inappropriately used as a proxy for biological difference.

"Race remains a social characteristic of populations," say Fausto-Sterling and colleagues, and it is inappropriate to use it as a central diagnostic tool for an individual patient."

In a related perspective article, George Ellison (St George's, University of London, UK) and colleagues say there is a lack of consensus about what race and ethnicity mean and how these should be operationalised. Yet even though researchers themselves often recognise that racial and ethnic categories are imprecise markers of genotypic and socio-cultural determinants of variation in health, say the authors, "they have adopted an essentially pragmatic response to the perceived need for standardised, salient, and politically sensitive classifications."

Finally, an editorial by the PLoS Medicine editors discusses what role medical journals can play in ensuring that race, ethnicity, and other human variables are accurately described. "Editors should insist," they say, "that authors of studies based on different human categories should make their methods of categorizing human populations transparent, justify their study design, and control for confounding variables."

Citation: Braun L, Fausto-Sterling A, Fullwiley D, Hammonds EM, Nelson A, et al. (2007) Racial categories in medical practice: How useful are they" PLoS Med 4(9): e271.

PLEASE ADD THE LINK TO THE PUBLISHED ARTICLE IN ONLINE VERSIONS OF YOUR REPORT: http://medicine.plosjournals.org/perlserv/?request=get-document&doi=10.1371/journal.pmed.0040271

PRESS-ONLY PREVIEW OF THE ARTICLE: http://www.plos.org/press/plme-04-09-fausto-sterling.pdf

Related image for press use: http://www.plos.org/press/plme-04-09-sismondo.jpg
Caption: Race Cube: Daisy Duke. (Created by: Nathan Gibbs, http://www.nathangibbs.com/race-cube/)

CONTACT: Anne Fausto-Sterling, Brown University, Molecular Biology, Cell Biology and Biochemistry
Box G
Providence, RI 02912
United States of America
Tel.: 1-401-863-2109
E-mail: anne_fausto-sterling@brown.edu

Related PLoS Medicine Perspective:

Citation: Ellison GTH, Smart A, Tutton R, Outram SM, Ashcroft R (2007) Racial categories in medicine: A failure of evidence-based practice" PLoS Med 4(9): e287.

IN YOUR ARTICLE, PLEASE LINK TO THIS URL, WHICH WILL PROVIDE ACCESS TO THE PUBLISHED PAPER:
http://medicine.plosjournals.org/perlserv/?request=get-document&doi=10.1371/journal.pmed.0040287

PRESS-ONLY PREVIEW OF THE ARTICLE: http://www.plos.org/press/plme-04-09-ellison.pdf

CONTACT: George Ellison, University of London
St George's
Cranmer Terrace
London, SW17 0RE
United Kingdom
Tel.: 44-20-8725-3924
E-mail: gellison@hscs.sghms.ac.uk

Related PLoS Medicine Editorial:

Citation: Brown M, the PLoS Medicine Editors (2007) Defi ning human differences in biomedicine. PLoS Med 4(9): e288.

IN YOUR ARTICLE, PLEASE LINK TO THIS URL, WHICH WILL PROVIDE ACCESS TO THE PUBLISHED PAPER:
http://medicine.plosjournals.org/perlserv/?request=get-document&doi=10.1371/journal.pmed.0040288

PRESS-ONLY PREVIEW OF THE ARTICLE: http://www.plos.org/press/plme-04-09-editorial.pdf

CONTACT: PLoS Medicine Editors
E-mail: medicine_editors@plos.org

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PLoS Medicine is an open access, freely available international medical journal. It publishes original research that enhances our understanding of human health and disease, together with commentary and analysis of important global health issues. For more information, visit http://www.plosmedicine.org

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