School of Medicine and Health Sciences Poster Presentations
An International Study of Race and Ethnicity in Clinical Guidelines
Poster Number
230
Document Type
Poster
Publication Date
3-2016
Abstract
Clinical guidelines are published statements that distill current scientific evidence into recommendations for clinical decision-making. Some guidelines suggest using patient race and ethnicity in determining clinical management. These race specific guidelines (RSGs) have an implied counterstatement about the management of patients who are not in the ethnic group specified. This emphasis on ethnicity rather than other disease factors could lead to decreased quality of care. This study aims to provide a comprehensive review of the prevalence and evidence for race and ethnicity in guidelines internationally. We created a library of approximately 3500 guidelines published by medical and public health organizations in 12 English-speaking and non-English speaking nations. From these, a keyword search was used to identify those guidelines that referenced race and ethnicity. Selection criteria were then applied to determine if each guideline was an RSG. Our findings include 26 RSGs from Europe, New Zealand, Scotland, United Kingdom and the USA. We classified these guidelines based on the context in which race and ethnicity were referenced: treatment (type A, 10 RSGs), screening (type B, 12 RSGs), diagnosis (type C 1 RSG), and patient education (type D, 1 RSG). Level of evidence (CEBM classification) varied between these guidelines. Although race and ethnicity are used in only a small fraction of clinical guidelines, their use is not uniformly evidence based. Further work is needed to delineate their role in clinical practice. The relationship between ethnicity and disease is epidemiologically important, but should be applied clinically with caution.
Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.
Open Access
1
An International Study of Race and Ethnicity in Clinical Guidelines
Clinical guidelines are published statements that distill current scientific evidence into recommendations for clinical decision-making. Some guidelines suggest using patient race and ethnicity in determining clinical management. These race specific guidelines (RSGs) have an implied counterstatement about the management of patients who are not in the ethnic group specified. This emphasis on ethnicity rather than other disease factors could lead to decreased quality of care. This study aims to provide a comprehensive review of the prevalence and evidence for race and ethnicity in guidelines internationally. We created a library of approximately 3500 guidelines published by medical and public health organizations in 12 English-speaking and non-English speaking nations. From these, a keyword search was used to identify those guidelines that referenced race and ethnicity. Selection criteria were then applied to determine if each guideline was an RSG. Our findings include 26 RSGs from Europe, New Zealand, Scotland, United Kingdom and the USA. We classified these guidelines based on the context in which race and ethnicity were referenced: treatment (type A, 10 RSGs), screening (type B, 12 RSGs), diagnosis (type C 1 RSG), and patient education (type D, 1 RSG). Level of evidence (CEBM classification) varied between these guidelines. Although race and ethnicity are used in only a small fraction of clinical guidelines, their use is not uniformly evidence based. Further work is needed to delineate their role in clinical practice. The relationship between ethnicity and disease is epidemiologically important, but should be applied clinically with caution.
Comments
Presented at: GW Research Days 2016