Thursday, September 27, 2007

Race in Medicine, PLoS Med, cont.

Racial Categories in Medicine: A Failure of Evidence-Based Practice?

George T. H. Ellison, Andrew Smart, Richard Tutton, Simon M. Outram, Richard Ashcroft, Paul Martin

PLoS Med 4(9): e287

This is the second paper in PLoS Medicine that focuses on the use of race in medicine. I found it interesting mainly for this part:
"At the same time, alternative attributive markers of genotypic, cultural, and structural determinants of variation in health and access to health care need to be developed in order to: (1) improve the aetiological precision of biomedical research; and (2) facilitate the translation of research on the causes of variation in health across racial and ethnic groups into appropriate care for individual patients. This more precise approach would help to address a long-standing problem with evidence-based practice, which often struggles to apply the results of epidemiological research on populations to the clinical care of individuals [15].
they also stress the difficulties of coming up with a "consensus about what race and ethnicity mean [3] and how these should be operationalised [4]":
... our proposal for the use of different racial and ethnic categories as descriptive variables in different scientific, clinical, and social contexts, and for more precise genotypic, cultural, and structural variables to attribute the causes of racial and ethnic inequalities in health and health care, faces a number of difficult challenges. These include a lack of consensus on whether, and how, race and ethnicity should be operationalised in different scientific, clinical, and social contexts [3,4,14,17], and the need to develop standard instruments for capturing genotypic, cultural, and structural characteristics amenable for use across these contexts. It is also unclear who might be best placed to promote such consensus or develop such instruments.
hmmm.... all I can say for now: Clines vs. Clusters, G vs. E ... to be continued...

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