New initiative aims to eliminate harmful use of race in clinical algorithms

Key takeaways:

• CMSS’ new initiative will look to improve patient care by ensuring equity is encoded in algorithms.
• The initiative will include ongoing meetings, grants, educational outreach and a change management toolkit.

The Council for Medical Specialty Societies, or CMSS, announced the launch of a new initiative that aims to reduce clinicians’ reliance on race in clinical decision-making and patient harms.

“We are going to work together to build a coalition that ensures that equity is encoded,” Helen Burstin, MD, MPH, CMSS chief executive officer, said during a meeting held by CMSS, the Doris Duke Foundation (DDF) and the National Academies of Science, Engineering and Medicine. “We have to make sure that those who have been harmed, especially those who have been harmed by bias algorithms, receive the best possible care.”

The initiative, “Encoding Equity in Clinical Research and Practice,” is supported by a 3-year, $3 million grant from DDF and features an alliance between the foundation and CMSS.

According to Burstin, the initiative will aim to:

• ensure clinical algorithms reflect valid and unbiased evidence;
• change the way race is considered in research designs and ensure patients experience the best possible health outcomes; and
• bring together leaders in clinical medicine, AI, technology and research to help reduce harms and improve health equity.

These goals “will take sustained effort across our communities, and that’s really what these resources will allow us to do,” Burstin said.

She noted that an advisory committee will be formed to lead the alliance, and task forces will be created to develop specific action plans for areas like medical education, specialty societies and clinical research.

Healio spoke with Burstin last year about the use of race within clinical algorithms and instances where including race has led to harmful outcomes.

For example, the inclusion of Black race in the estimated glomerular filtration rate — the equation of kidney function — led to Black patients being likelier to be diagnosed with kidney failure later and subsequently get on kidney transplant waitlists later.

“Inaction is unacceptable. It is time to address this issue and move forward,” Burstin said at the meeting. “We want to make sure that we remove whatever remains of inappropriate race in algorithm guidelines [and] get to more equitable decision-based tools.”

She highlighted several other components of the initiative, which will include:

• ongoing meetings where lessons learned can be shared and collaborative relationships will be built;
• a series of competitive grants to specialty societies that will support efforts to analyze and address the use of race in clinical algorithms and guidance;
• educational outreach activities that will promote best practices and understanding; and
• a change management toolkit that features best practices to support assessing, updating and deimplementing problematic algorithms and clinical guidelines.

“At the end of the day, care ultimately affects everyone,” Burstin said. “We envision a future where race is appropriately used in research design and clinical guidance.”