Sharad Goel

B.S., M.S., Ph.D.

Harvard University

Professor of Public Policy

NLST (Learn more about this study)

NLST-1121

Sep 5, 2023

Reevaluating the Use of Race and Ethnicity in Medical Risk Assessments

There is active debate over whether to consider patient race and ethnicity when estimating disease risk. By accounting for race and ethnicity, it is possible to improve the accuracy of risk predictions, but there is concern that their use may encourage a racialized view of medicine. In diabetes risk models, despite substantial gains in statistical accuracy from using race and ethnicity, the gains in clinical utility are surprisingly modest. These modest clinical gains stem from two empirical patterns: first, the vast majority of individuals receive the same screening recommendation regardless of whether race or ethnicity are included in risk models; and second, for those who do receive different screening recommendations, the difference in utility between screening and not screening is relatively small. Our results are based on broad statistical principles, and we believe they are likely to generalize to many other risk-based clinical decisions. Building off our past work on the use of race and ethnicity in diabetes risk assessments, we are interested to see if and how and the clinical utility of race-aware risk assessments varies with new diseases, such as lung cancer.