Relevant bibliographies by topics / Blacks in medicine

Contents

  1. Journal articles
  2. Dissertations / Theses
  3. Books
  4. Book chapters
  5. Conference papers
  6. Reports

Academic literature on the topic 'Blacks in medicine'

Author: Grafiati
Published: 4 June 2021
Last updated: 31 July 2024

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Journal articles on the topic "Blacks in medicine"

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Anderson, Winston A., James H. Wyche, and Vivian Ovelton Sammons. "Blacks in Science and Medicine." Journal of Negro Education 59, no. 3 (1990): 518. http://dx.doi.org/10.2307/2295582.

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De Meillon, Francois. "Industrialisasie, verstedeliking en gesondheid: die gesondheid van swartes in Brakpan 1919-1945." New Contree 32 (November 30, 1992): 7. http://dx.doi.org/10.4102/nc.v32i0.584.

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From the town's attainment of municipal status in 1919, the Brakpan health department experienced serious difficulties in providing all aspects of proper health care due to the population growth. Within the context of the health legislation of that time and white conceptions of black inferiority, the health services offered to blacks in Brakpan had serious limitations. Blacks were excluded from formal health structures and the quality of both medical services and health facilities for blacks was distinctly lower than those for whites. However over this period blacks gradually moved away from their traditional health practices as they began to experience the advantages of western medicine.
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Travis, Toni-Michelle C. "Boston: The Unfinished Agenda." PS 19, no. 3 (1986): 610–17. http://dx.doi.org/10.1017/s0030826900626322.

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In January 1986 Bruce Boiling, a member of the Boston City Council, became the first black president in the council's 166-year history. Boiling's presidency marks the culmination of the slow, but steadily growing empowerment of blacks in Boston politics. While blacks have always been present in Boston politics they have more often been observers, rather than participants as the Yankees and the Irish have dominated the political stage. In order to understand the role of blacks in Boston it is necessary to have some background knowledge of how Yankee paternalism retarded black political development and how Irish displacement of the Yankees resulted in the exclusion of blacks from Democratic party politics.Historical AntecedentsBoston politics has its roots in the historical relationships among the Yankees, the Irish, and the blacks. Under Yankee domination colonial and pre-Civil War blacks experienced racial harmony in an atmosphere where they could enjoy civil and political rights. Wealthy Yankee traders viewed free blacks paternalistically, as a low income class of people (Lupo, 1977, p. 124). Since Yankees were members of the political and cultural elite they did not perceive blacks as an economic threat to their position. Consequently, blacks could freely operate businesses, buy property, and run for office (Horton, 1979).As slavery became an increasingly important issue in the 1850s free blacks and Yankee abolitionists formed integrated organizations to end slavery. Abolitionist organizations provided an opportunity for free blacks to learn organizational and political skills. Yet, blacks often found that their efforts to become leaders were thwarted by white patrons who expected blacks to work only as obedient followers. A notable case among many was the conflict between white abolitionist William Lloyd Garrison and Frederick Douglass, a former slave, over the crucial issue of the future role of blacks in electoral politics (Quarles, 1969). Frederick Douglass broke with Garrison who felt that blacks should not be encouraged to vote in a political system where the Constitution protected the rights of slaveholders (Horton, 1979, p. 86). Douglass adamantly advocated electoral participation and pulled some black abolitionists from Garrison's ranks. Douglass felt that participation in the electoral process was a necessary step in the political development of blacks. To affirm his convictions Douglass ran on the Liberal ticket for an office in New York state.
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Hebert, L. A., G. Agarwal, S. E. Ladson-Wofford, M. Reif, L. Hiremath, S. G. Carlton, N. S. Nahman, M. E. Falkenhain, and A. Agarwal. "Nocturnal blood pressure in treated hypertensive African Americans Compared to treated hypertensive European Americans." Journal of the American Society of Nephrology 7, no. 10 (October 1996): 2130–34. http://dx.doi.org/10.1681/asn.v7102130.

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Previous studies have shown that African Americans (blacks) tend to have higher nocturnal blood pressure than European Americans (whites). The study presented here was undertaken to determine whether treatment of hypertension influences nocturnal blood pressure differently in blacks than in whites. To answer this question, this study measured nocturnal blood pressure by ambulatory blood pressure monitoring (ABPM) in treated hypertensive blacks and whites whose daytime blood pressures were comparable. Inclusion criteria for this study were: diagnosis of essential hypertension, absence of renal failure, and documentation of antihypertensive therapy, diabetic status, proteinuria status, and body weight. All of the black patients in our programs who underwent ABPM and met the above criteria were included in this study. White patients were included on the basis of having the same inclusion criteria as blacks and showing, by ABPM, daytime mean arterial pressure (MAP) in the same range as that of the blacks selected for this study. The results of nocturnal blood pressure were unknown to the investigators when the patients were selected for this study. In the blacks (N = 62) and whites (N = 72) selected for study, the mean daytime (0600 to 2200 h) MAP was 107 +/- 1 SE mm Hg for both the black and white cohorts. To assess nocturnal blood pressure, the period from 0100 to 0500 h was chosen because it likely encompassed an interval of sleep, which is associated with the nadir of nocturnal blood pressure. This interval was termed 0100 to 0500 h, "middle night." Mean middle night MAP was 97 +/- 12 mm Hg in blacks versus 90 +/- 14 mm Hg in whites (P < 0.006, unpaired t test). The greater middle night MAP in blacks compared with whites was a result of the higher diastolic pressure in blacks (80 +/- 11 mm Hg) versus whites (75 +/- 11 mm Hg) (P = 0.003). Mean middle night systolic blood pressure was numerically higher in blacks than whites (131 +/- 18 mm Hg versus 128 +/- 17 mm Hg), but this difference did not achieve statistical significance. The higher middle night blood pressure in blacks versus whites could not be explained by differences between the groups in daytime MAP, age, gender, body weight, serum creatinine level, proteinuria, diabetic status, or greater use of short-acting antihypertensive agents in blacks versus whites. It was concluded that when treated hypertensive blacks and whites are matched for the same daytime blood pressure, blacks tend to have significantly higher nocturnal blood pressure than whites. The magnitude of this difference suggests that it could contribute importantly to the greater target-organ damage that is seen in hypertensive blacks compared with hypertensive whites.
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Yium, J., P. Gabow, A. Johnson, W. Kimberling, and M. Martinez-Maldonado. "Autosomal dominant polycystic kidney disease in blacks: clinical course and effects of sickle-cell hemoglobin." Journal of the American Society of Nephrology 4, no. 9 (March 1994): 1670–74. http://dx.doi.org/10.1681/asn.v491670.

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Autosomal dominant polycystic kidney disease (ADPKD) is a frequent cause of ESRD, but its frequency in blacks has not been well delineated and its course and the effects of sickle hemoglobin in this disease in blacks have not been previously reported. The occurrence of ADPKD in blacks and whites was determined in two ESRD populations: all ESRD patients seen over a 16-yr period in one area of Southeast Tennessee and all ESRD patients in 15 hemodialysis units in Tennessee and Atlanta, GA. The frequency of sickle hemoglobin was determined and compared in a group of nonrelated blacks with ESRD with and without ADPKD. The age at onset of ESRD and factors that might affect ADPKD such as gender, hypertension, and hemoglobin type were examined. ADPKD was a less frequent cause of ESRD in blacks than whites (1.4 versus 6.8%). However, after adjusting for the population rate, the incidence rates in blacks and whites were similar (0.48 and 0.47 of 100,000). There was a higher incidence of sickle hemoglobin in nonrelated blacks with ADPKD versus other black ESRD patients (50 versus 7.5%; P < 0.005). Blacks had an earlier onset of ESRD than whites (43.2 versus 55.4 yr; P < 0.0001), as did blacks with sickle-cell trait versus blacks without (38.2 versus 48.1 yr; P < 0.003). In this population, hypertension and gender had no effect on the onset of ESRD. ADPKD accounted for a smaller percentage of blacks than whites with ESRD because of the high percentage of blacks with renal disease from other causes.(ABSTRACT TRUNCATED AT 250 WORDS)
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James, Keturah, and Ayana Jordan. "The Opioid Crisis in Black Communities." Journal of Law, Medicine & Ethics 46, no. 2 (2018): 404–21. http://dx.doi.org/10.1177/1073110518782949.

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While much of the social and political attention surrounding the nationwide opioid epidemic has focused on the dramatic increase in overdose deaths among white, middle-class, suburban and rural users, the impact of the epidemic in Black communities has largely been unrecognized. Though rates of opioid use at the national scale are higher for whites than they are for Blacks, rates of increase in opioid deaths have been rising more steeply among Blacks (43%) than whites (22%) over the last five years. Moreover, the rate of opioid overdose deaths among Blacks already exceeds that of whites in several states. The lack of discussion of Black overdose deaths in the national opioid discourse further marginalizes Black people, and is highly consistent with a history of framing the addictions of people of color as deserving of criminal punishment, rather than worthy of medical treatment. This article argues that, because racial inequalities are embedded in American popular and political cultures as well as in medicine, the federal and state governments should develop more culturally targeted programs to benefit Black communities in the opioid crisis. Such programs include the use of faith-based organizations to deliver substance use prevention and treatment services, the inclusion of racial impact assessments in the implementation of drug policy proposals, and the formal consideration of Black people's interaction with the criminal justice system in designing treatment options.
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Williams, N., O. Abo Al Haija, A. Workneh, D. Sarpong, E. Keku, G. Ogedegbe, S. I. McFarlane, and G. Jean-Louis. "Excessive Daytime Sleepiness among Hypertensive US-Born Blacks and Foreign-Born Blacks: Analysis of the CAATCH Data." International Journal of Hypertension 2013 (2013): 1–4. http://dx.doi.org/10.1155/2013/852389.

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Background. Evidence shows that blacks exhibit greater daytime sleepiness compared with whites, based on the Epworth Sleepiness Scale. In addition, sleep complaints might differ based on individuals’ country of origin. However, it is not clear whether individuals’ country of origin has any influence on excessive daytime sleepiness (EDS).Study Objectives. We tested the hypothesis that US-born blacks would show a greater level of EDS compared with foreign-born blacks. The potential effects of sociodemographic and medical risk were also determined.Design. We used the Counseling African-Americans to Control Hypertension (CAATCH) data. CAATCH is a group randomized clinical trial that was conducted among 30 community healthcare centers in New York, yielding baseline data for 1,058 hypertensive black patients.Results. Results of univariate logistic regression analysis indicated that US-born blacks were nearly twice as likely as their foreign-born black counterparts to exhibit EDS (OR=1.87, 95% CI: 1.30–2.68,P<0.001). After adjusting for effects of age, sex, education, employment, body mass index, alcohol consumption, and smoking habit, US-born blacks were 69% more likely than their counterparts to exhibit EDS (OR=1.69, 95% CI: 1.11–2.57,P<0.01).Conclusion. Findings demonstrate the importance of considering individuals’ country of origin, in addition to their race and ethnicity, when analyzing epidemiologic sleep data.
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Zhang, Qian, and Yu Sun. "From Identity Crisis to Identity Construction: A Study of Identity Issues in Beloved." International Journal of Languages, Literature and Linguistics 9, no. 3 (June 2023): 220–23. http://dx.doi.org/10.18178/ijlll.2023.9.3.408.

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The 1993 Nobel Prize winner Toni Morrison is one of the most prominent black female writers in contemporary American literature. Beloved is her very outstanding work and wins the Pulitzer Prize for Best Novel. It reveals the darkness of slavery and its torture towards the blacks. This paper tries to show the tragic destiny of the blacks, criticize the extremely negative influence of cultural hegemony and the other, and explore ways to construct identity. The colonialism and racism of cultural hegemony and the other are the prime causes of identity crisis. The blacks should face the miserable history bravely, dissolve the erosion of white culture, recover and develop black culture on the basis of traditional culture. Only in this way, can they come out of the shadow and obtain true freedom.
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Abo, Muthana Al, Wen-Chi Foo, Lauren Howard, Monika Anand, Daniel J. George, Steven R. Patierno, and Jennifer A. Freedman. "Abstract A001: Differential alternative RNA splicing and transcription events between Black and White prostate cancer patients involve genes promoting cancer aggressiveness and associate with patient survival." Cancer Research 83, no. 11_Supplement (June 2, 2023): A001. http://dx.doi.org/10.1158/1538-7445.prca2023-a001.

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Abstract Black patients suffer disproportionately from prostate cancer (PCa) progression to lethal disease compared with Asian and White patients. Comparing the molecular landscape of PCa in Black and White men has the potential to identify targets for development of new precision medicine interventions. Alternative RNA splicing and transcription events (ARS/Ts) can alter gene function. Cancer may exploit ARS/Ts to enhance proliferation, metastasis, and drug resistance. Here, we isolated RNA from fresh frozen PCa specimens and tumor-associated normal (TAN) specimens from 35 self-reported Black and 37 self-reported White patients diagnosed with Gleason-high or -low PCa and undergoing radical prostatectomy or biopsy. Analysis of follow-up clinical data for patients participating in our study show an increased hazard ratio of PCa progression among Black patients compared to White patients (HR = 2.13 and p &lt; 0.05). We performed comparative transcriptomic analysis between Gleason-high or -low tumor and TAN samples among Blacks, among Whites, or between Blacks and Whites with Gleason-high or –low PCa. Among differential ARS/Ts identified between tumors and TANs among Blacks, 532 are unique to Gleason-high and 673 are unique to Gleason-low. Among differential ARS/Ts between Blacks and Whites, 360 are unique to Gleason-high and 242 are unique to Gleason-low. Interestingly, we found that even in TANs, there are 802 differential ARS/Ts between Blacks and Whites, with 459 and 343 in Gleason-high and Gleason-low, respectively. Among the genes undergoing differential ARS/Ts between Blacks and Whites are FGFR1, AKT1, H6PD, MDM2, and RAD51D in Gleason-high and CDK7 and VEGFA in Gleason-low. Notably, the number of genes undergoing ARS/Ts between Blacks and Whites with Gleason-high or -low tumors was higher than the number of genes undergoing differential aggregate gene expression between Blacks and Whites. Using gene set enrichment analysis, we found that genes undergoing ARS/Ts function in cancer relevant pathways. For example, the genes undergoing ARS/Ts between Blacks and Whites with Gleason-high or -low tumors were enriched in spermatogenesis and P53 hallmark pathways, respectively. Importantly, survival analysis shows a number of differential ARS/Ts between Blacks and Whites with Gleason-high or -low tumors are individually associated with progression-free survival. In summary, we have investigated the biology of PCa and TAN tissue between Black and White patients at the exon level. A number of genes undergoing newly identified differential ARS/Ts between Blacks and Whites are in genes reported to promote cancer aggressiveness and a number are in genes whose function in cancer was unreported prior to our findings, and a number are associated with patient progression-free survival. Our findings have identified novel targets with potential for precision oncology for PCa. Estimation of genetic ancestry of study participants and in vitro and in vivo validation of prioritized targets for PCa biology are underway. Citation Format: Muthana Al Abo, Wen-Chi Foo, Lauren Howard, Monika Anand, Daniel J. George, Steven R. Patierno, Jennifer A Freedman. Differential alternative RNA splicing and transcription events between Black and White prostate cancer patients involve genes promoting cancer aggressiveness and associate with patient survival [abstract]. In: Proceedings of the AACR Special Conference: Advances in Prostate Cancer Research; 2023 Mar 15-18; Denver, Colorado. Philadelphia (PA): AACR; Cancer Res 2023;83(11 Suppl):Abstract nr A001.
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Manning, Kenneth R. "Blacks in Science and Medicine. Vivian Ovelton Sammons." Isis 83, no. 1 (March 1992): 181–83. http://dx.doi.org/10.1086/356106.

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Dissertations / Theses on the topic "Blacks in medicine"

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Green, Vernard Darrell. "Completion Characteristics of Non-Hispanic Blacks with Tuberculosis and HIV." ScholarWorks, 2017. https://scholarworks.waldenu.edu/dissertations/6568.

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Tuberculosis (TB) and human immunodeficiency virus (HIV) are difficult conditions to manage, in tandem they pose even more challenges to public health programs in identifying coinfection to ensure that all TB cases are treated to completion of therapy (COT). The purpose of this study was to test variables that predicted COT among the HIV/TB coinfected population of non-Hispanic, U.S.-born Blacks alive at the time of diagnosis. Social determinants of health were the theoretical foundation used to guide the study based on data from the Report of Verified Cases of TB (RVCT) between 2009 and 2014. Relationships were tested between ethnic/racial group membership and the likelihood of COT, and whether any association to COT was moderated by COT eligibility; a Centers for Disease Control and Prevention calculated algorithm considering disease severity, site, age, and disease complexity. The research design was a longitudinal quantitative approach using binary logistic regression to identify correlated variables associated with COT in the final model. The results showed no statistically significant differences among racial/ethnic groups, age, and gender for COT. COT was moderated by COT eligibility; odds ratio (5.4 - 11.6) times more likely to complete therapy. This study supports positive social change for programs by providing data driven outcomes to providers that support outreach, patient education, and disease prevention. In addition, this research describes an evaluation metric based on performance to set a foundation for collaboration among partners who manage other comorbidities in the United States.
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Roker, Rosalyn. "Perspectives of older Blacks and Whites living with serious mental illness about outpatient mental health services." Scholar Commons, 2018. https://scholarcommons.usf.edu/etd/7708.

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In the United States, over three million adults, age 50 and older, reported a diagnosis of serious mental illness (SMI) in the past year. Most of them live in community-settings and are less likely than younger adults to utilize mental health treatment. Lack of and insufficient treatment for SMI places them at increased risk of morbidity, earlier mortality, cognitive decline, and diminished quality of life. The current study aimed to: (1) examine the factors that influence Black and White older adults, who live with SMI, to seek and engage in outpatient mental health treatment; (2) identify the perspectives of Black and White older adults, who live with SMI, on the issues of accessibility, affordability, appropriateness, and availability of outpatient mental health services; and (3) determine whether the perspectives of Blacks and Whites are different on the issues of accessibility, affordability, appropriateness, and availability of outpatient mental health services. I developed a qualitative, interview-based study using the health belief model (HBM) as the theoretical framework. Individual semi-structured interviews were conducted with 19 participants, between the ages of 50-70 years (mean age 58.9), who had a clinical diagnosis of bipolar disorder, schizoaffective disorder, and schizophrenia. The interviews were audiotaped, transcribed verbatim, coded and analyzed using thematic analysis. Data themes related to factors that influenced outpatient mental health treatment and services were identified and organized based on the six HBM constructs. Perceived barriers to mental health treatment engagement included lack of knowledge about available treatment and services in the community, poor mental health literacy, and stigma. Improved sense of well-being and increased socialization were perceived benefits of mental health treatment engagement. Risk of homelessness emerged from the data as the main influence for Black and White older adults, who live with SMI, to seek and engage in outpatient mental health treatment. For all participants, access to and availability of mental health services were not current issues. All except one participant had some type of medical coverage for their treatment and most of them felt that their current treatment was appropriate. There were no differences between Black and White older adults on the issues of accessibility, affordability, appropriateness, and availability of outpatient mental health services. In addition, Black participants did not feel a need for mental health services to be specifically tailored to Black older adults, and instead indicated they saw no differences in Blacks and Whites related to mental health services. These findings are contrary to existing research and may be indicative of the gravity of mental illness-related stigma, compared to racial stigma. Better promotion of available mental health services in the community, mental health outreach, and community education about mental illness may be helpful for earlier identification of symptoms related to mental illness, earlier treatment and intervention, stigma reduction, and improved health and quality of life for community-residing older adults who live with SMI.
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Kahn, Marc Simon. "The interface between Western mental health care and indigenous healing in South Africa: Xhosa psychiatric nurses' views on traditional healers." Thesis, Rhodes University, 1996. http://hdl.handle.net/10962/d1002508.

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Xhosa psychiatric nurses stand unique at the interface between Western mental health care and indigenous healing in South Africa. They stem from a cultural history that is embedded within traditional health care discourses and yet are trained and work within a Western psychiatric model. In embodying the intersection between these two paradigms, they are faced with the challenge of making sense of such an amalgamation. These nurses' views are thus valuable in reflecting this intersection and illustrating many of the central concerns that surround it. This study explicates the views of these nurses toward traditional healers and their potential role in mental health care in South Africa. In addition, it illuminates some of the cultural dynamics at work amongst these subjects as they struggle to make sense of their unique cultural position. Using a questionnaire-based methodology, the views of Xhosa psychiatric nurses in a psychiatric hospital in the Eastern Cape, toward traditional healers and their role in mental-health care, were examined. The findings reveal that the vast majority of these nurses believe in traditional cosmology, involve themselves in traditional ritual practices and regularly visit traditional healers as patients. In suggesting ways in which indigenous healing and Western mental health care can work together, 75% of the nurses were in favour of a general referral system between the hospital and traditional healers, most (77%) agreed that certain patients would be better off being treated by both the hospital and traditional healers than they would if they were only being treated by the hospital alone, and 85% of the subjects agreed that patients who are already seeing traditional healers should check if psychiatric medication might help them. These findings indicate that these nurses operate across two healing systems which are at this point not conceptually compatible. This results in deep cultural tension for the nurses. In being entangled in the dialectical tension created in this context, the nurses manage the incongruencies in three general ways: a) Most, in one form or another, incorporate beliefs from both systems into an integrative model, b) some assimilate their cultural belief system into the Western mental health paradigm, throwing off their beliefs in traditional healing, and c) others remain ambivalent in the dialectic between traditional and Western health care discourses. Although this may suggest that these nurses reside within a cultural milieu that is somewhat unhealthy, at another level, in managing and containing the incompatibility between the two systems, these nurses ensure a space for on-going and healthy critique of the underlying assumptions involved in this health care malaise.
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Crowder, Steve. "Black folk medicine in southern Appalachia." [Johnson City, Tenn. : East Tennessee State University], 2001. http://etd-submit.etsu.edu/etd/theses/available/etd-0322101-181118/unrestricted/crowder0416.pdf.

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Tabane, Elizabeth Mamatle. "Opinions of African caretakers of children at Red Cross War Memorial Children's Hospital regarding the linking of traditional healers to western health settings." Master's thesis, University of Cape Town, 1995. http://hdl.handle.net/11427/21772.

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Bibliography: leave 85-90.
Health care systems play an important role in maintaining good health in communities. In South Africa, Africans are continually faced with the dilemma of choosing western or traditional values. The literature has shown that African people use both western and traditional systems simultaneously. The South African government is also considering to include traditional healers in the national health policy .This study examines the opinions of African parents or caretakers of children at Red Cross War Memorial Children' s Hospital regarding their use of western and traditional health systems and their opinion regarding their linkage. The research method for this exploratory study was a focus group and structured interview. The results indicated that in the communities from which the respondents were drawn there are many Africans who consult traditional healers. The results further indicated that many Africans consult both western doctors and traditional healers for the same medical problem. The results also indicated that the respondents considered it necessary to link traditional healers to western health settings. Recommendations for future research are included.
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Campano, Erik. "Artificially Intelligent Black Boxes in Emergency Medicine : An Ethical Analysis." Thesis, Umeå universitet, Institutionen för psykologi, 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-160696.

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Det blir allt vanligare att föreslå att icke-transparant artificiell intelligens, s.k. black boxes, används inom akutmedicinen. I denna uppsats används etisk analys för att härleda sju riktlinjer för utveckling och användning av black boxes i akutmedicin. Analysen är grundad på sju variationer av ett tankeexperiment som involverar en läkare, en black box och en patient med bröstsmärta på en akutavdelning. Grundläggande begrepp, inklusive artificiell intelligens, black boxes, metoder för transparens, akutmedicin och etisk analys behandlas detaljerat. Tre viktiga områden av etisk vikt identifieras: samtycke; kultur, agentskap och privatliv; och skyldigheter. Dessa områden ger upphov till de sju variationerna. För varje variation urskiljs en viktig etisk fråga som identifieras och analyseras. En riktlinje formuleras och dess etiska rimlighet testas utifrån konsekventialistiska och deontologiska metoder. Tillämpningen av riktlinjerna på medicin i allmänhet, och angelägenheten av fortsatt etiska analys av black boxes och artificiell intelligens inom akutmedicin klargörs.
Artificially intelligent black boxes are increasingly being proposed for emergency medicine settings; this paper uses ethical analysis to develop seven practical guidelines for emergency medicine black box creation and use. The analysis is built around seven variations of a thought experiment involving a doctor, a black box, and a patient presenting chest pain in an emergency department. Foundational concepts, including artificial intelligence, black boxes, transparency methods, emergency medicine, and ethical analysis are expanded upon. Three major areas of ethical concern are identified, namely consent; culture, agency, and privacy; and fault. These areas give rise to the seven variations. For each, a key ethical question it illustrates is identified and analyzed. A practical guideline is then stated, and its ethical acceptability tested using consequentialist and deontological approaches. The applicability of the guidelines to medicine more generally, and the urgency of continued ethical analysis of black box artificial intelligence in emergency medicine, are clarified.
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Lutfi, Khaleeq J. "Examining the Association between Racial Residential Segregation, Risky Sexual Behaviors, and Sexually Transmitted Infections." FIU Digital Commons, 2017. http://digitalcommons.fiu.edu/etd/3481.

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Sexually transmitted infections (STIs) disproportionately impact non-Hispanic blacks in the United States. Racial differences in sexual networks can contribute to these disparities. Racial residential segregation, the separation of racial groups in a residential context, is a community factor known to influence sexual networks and has been associated with negative health outcomes. Our objective was to examine the association between racial residential segregation (henceforth, referred to as segregation), risky sexual behavior, concurrent partnerships, and STI diagnoses among non-Hispanic blacks. Demographic, sexual behavior, and STI diagnosis data for non-Hispanic blacks 15–44 years of age were obtained from the 2006–2010 National Survey of Family Growth. Segregation and community poverty data were obtained from the U.S. Census. Five distinct dimensions measured segregation, each with a representative index. Multilevel logistic regressions were conducted to test how each of the five indices were associated with risky sexual behavior, concurrent partnerships, and STI diagnoses. Risky sexual behavior results showed 16.1% (n=588) of participants engaged in risky sexual behavior. The association was stronger for the absolute centralization (adjusted odds ratio [aOR] 2.07; 95% confidence interval [CI] 2.05 – 2.08) and relative concentration indices (aOR 2.05; 95% CI 2.03 – 2.07). This suggests risky sexual behavior is most strongly associated with segregation in neighborhoods with a high density of non-Hispanic blacks and accumulation of non-Hispanic blacks in an urban core. STI diagnosis results showed 7.4% (n=305) of participants reported a STI diagnosis, and segregation was associated with STI diagnosis. The association was strongest measured with the dissimilarity index (aOR 2.41; 95% CI 2.38 – 2.43) and stronger for males. Concurrent partnerships results showed 15.6% (n=645) of participants reported concurrent partnerships. Multilevel analyses showed segregation to be associated with concurrent partnerships with the association strongest measured with the dissimilarity index. Segregation acted as a risk and a protective factor with risky sexual behavior, concurrent partnerships, and STI diagnosis, depending on the segregation measure. Additional work is needed to understand the mechanisms of how specific segregation dimensions influence risky sexual behaviors and sexually transmitted infections.
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Jefferson, Lowest. "Primary Factors Affecting Breastfeeding in African American Communities." ScholarWorks, 2015. https://scholarworks.waldenu.edu/dissertations/1266.

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Prior research has shown that African Americans are less likely than are Hispanics and Whites to breastfeed their children. Compounding this problem is the scarcity of research that examines African American's culture, perceptions, and beliefs about breastfeeding. This study was conducted to gain a greater understanding of the phenomenon of breastfeeding through the perspectives of African American mothers. Guided by the theories of reasoned action and planned behavior, this ethnographic study elicited African American mothers' perspectives on breastfeeding by examining what influenced their decision to breastfeed or not. This study took place in Washington State. Ten women recruited through purposeful sampling took part in the study. Data were largely collected through interviews utilizing open-ended semi-structured questions, which were used as the level-1 priori codes for data analysis. Inductive codes were developed from additional information provided by subjects during interviews. Sublevels were developed as needed. Codes with 2 or more responses from subjects were utilized in the analysis. Findings were based on the data and solely on the experiences and information shared by the subjects. The findings revealed that, among this sample of women, breastfeeding figured prominently in the African American culture. Most participants indicated they would breastfeed regardless of any support. Barriers to breastfeeding included the stigma that only the poor breastfeed, perceived inconsistency in information and assistance provided by health care personnel to African Americans as compared to other groups, and mothers not being aware of available resources. These results can be used to enhance social change initiatives, laws, and policies on breastfeeding for African Americans.
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Williams, Sarah. "Authentication and investigation of potential hepatotoxicity of Black Cohosh." Thesis, De Montfort University, 2017. http://hdl.handle.net/2086/16145.

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Black Cohosh (Actaea racemosa) is one of the highest selling medicinal plants, ranking as the sixth best seller in the US in 2015 (Smith et al., 2016). However, this popularity has been tarnished by claims of hepatotoxicity. The investigation of these reports has determined that implicated products did not contain Black Cohosh plant material. Other reports were shown to be incomplete or had other factors contributing. This has led to the suspicion that cases of adverse reactions may in fact be linked to cases of substitution or adulterations with Asian species of Actaea, rather than to A. racemosa. (Jordan et al., 2010). This shows the need for authentication of Black Cohosh products. In this study various DNA based authentication methods were developed. The first, PlantID is capable of discriminating between Actaea racemosa and four potential adulterant species; Actaea cimicifuga, Actaea cordifolia, Actaea podocarpa and Caulophyllum thalictroides, in a single PCR reaction. The resulting fragments are scrutinized using gel electrophoresis. Other platforms of analysis were trialled with little success. The second was a qPCR based method. These assays are competent in detecting A. racemosa, A. cimicifuga and A. dahurica species and are compared to a generic primer capable of amplification of ten Actaea species. This enables the user to detect specific species in comparison to how much Actaea species are present as a whole. This assay was extensively tested on many materials and products available in the UK and the USA. Out of 34 products assessed it was possible to extract DNA from 32. From the UK market it was found that five products contained undeclared species. From the US market it was found that six products contained undeclared species. All of the THR registered products were found to contain only the authentic species Actaea racemosa. This was a reassuring result from the analysis and adds further value to the scheme of THR. Sequence data from GenBank was used to assist in assigning species to sequenced DNA samples. The data contained on GenBank was scrutinised using various bioinformatics tools. Sequences were organised into molecular taxonomic units using tree diagram software. This showed efficiently and iii visually which sequence entries were reliable to use based upon grouping. This analysis showed that the nuclear internal transcribed spacer (nrITS) was an ideal barcoding region and that maturase K (MatK) was a poor choice for Actaea species. To address the issue of hepatotoxicity claims, cultured human hepatocyte derived cells were treated with 60% ethanol extracts of Actaea racemosa and Asian Actaea. A qPCR array was utilised to assess 84 genes associated with hepatotoxicity across various concentrations of extract. The collective array output gave a plethora of data which was analysed using bespoke online software from the manufacturer. Stringent quality controls were included on the arrays which gave confidence of results. There were small changes noted for Actaea racemosa and some activity for the Asian Actaea treated cells was also seen. An LDH and MTT assay were used to assess cell viability and toxicity in two human hepatocyte derived cell lines. Actaea racemosa showed no significant effects whereas the Asian Actaea extract showed a notable decrease in cell viability and significant release of LDH indicating toxicity. The Asian Actaea material used to manufacture extracts was of questionable species origin but determined to be either A. dahurica or A. cimicifuga. The results from these experiments were unfortunately not as conclusive as hoped, but did show some evidence of a more likely culprit of toxicity originating from Asian Actaea species.
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Price, Suzanne Phillips. "The black student medical school experience /." Access Digital Full Text version, 1992. http://pocketknowledge.tc.columbia.edu/home.php/bybib/1106299x.

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Thesis (Ed.D)--Teachers College, Columbia University, 1992.
Typescript; issued also on microfilm. Sponsor: Ellen Condliffe Lagemann. Dissertation Committee: Gary Natriello. Includes bibliographical references (p. 113-117).
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Books on the topic "Blacks in medicine"

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Williams, Richard Allen. Blacks in Medicine. Cham: Springer International Publishing, 2020. http://dx.doi.org/10.1007/978-3-030-41960-8.

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Sammons, Vivian O. Blacks in science and medicine. New York: Hemisphere Pub. Corp., 1990.

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Maria Thereza L. A. Camargo. Plantas medicinais e de rituais afro-brasileiros. São Paulo, Brasil: ALMED, 1988.

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Northington, Gamble Vanessa, ed. Germs have no color line: Blacks and American medicine, 1900-1940. New York: Garland Pub., 1989.

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Curtis, James L. Affirmative Action in Medicine. Ann Arbor: University of Michigan Press, 2009.

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Encuentro Continental de la Medicina Indígena, Negra, Popular y Tradicional (1st 1992 Estelí, Nicaragua). Memorias: 500 años de resistencia indígena, negra y popular. Estelí, Nicaragua: Centro Nacional de la Medicina Popular Tradicional "Dr. Alejandro Dávila Bolaños,", 1992.

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Encuentro Continental de la Medicina Indígena, Negra, Popular y Tradicional (1st 1992 Estelí, Nicaragua). Memorias: 500 años de resistencia indígena, negra y popular. Estelí, Nicaragua: Centro Nacional de la Medicina Popular Tradicional "Dr. Alejandro Dávila Bolaños,", 1992.

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John, Mayhew. Doc Mayhew: Rugby's medicine man. Auckland, N.Z: Hodder Moa Beckett, 2004.

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E, Rothenberg Diane, ed. Blacks in American medicine: A bibliography of secondary sources, 1970-1987 : 340 citations. Bethesda, Md: U.S. Dept. of Health and Human Services, Public Health Service, National Institutes of Health, National Library of Medicine, 1988.

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Burkhart, Gregor. Die Kinder Omulús: Der Einfluss afrobrasilianischer Kultur auf die Wahrnehmung von Körper und Krankheit. Frankfurt am Main: P. Lang, 1994.

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Book chapters on the topic "Blacks in medicine"

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Williams, Richard Allen. "Evolution of the Black Physician: Medical Education and Treatment Facilities for Blacks." In Blacks in Medicine, 61–72. Cham: Springer International Publishing, 2020. http://dx.doi.org/10.1007/978-3-030-41960-8_3.

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Williams, Richard Allen. "Five Diseases That Are Devastating the African American Population." In Blacks in Medicine, 1–31. Cham: Springer International Publishing, 2020. http://dx.doi.org/10.1007/978-3-030-41960-8_1.

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Williams, Richard Allen. "Conclusion and Afterword." In Blacks in Medicine, 185–92. Cham: Springer International Publishing, 2020. http://dx.doi.org/10.1007/978-3-030-41960-8_10.

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Williams, Richard Allen. "Profiles in Courage: African American Medical Pioneers in the United States—The Earliest Black Practitioners." In Blacks in Medicine, 33–59. Cham: Springer International Publishing, 2020. http://dx.doi.org/10.1007/978-3-030-41960-8_2.

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Williams, Richard Allen. "The Impact of Black Medical Organizations on African American Health." In Blacks in Medicine, 73–90. Cham: Springer International Publishing, 2020. http://dx.doi.org/10.1007/978-3-030-41960-8_4.

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Williams, Richard Allen. "Healthcare Reform Law (Obamacare): Update on “The Good, the Bad, and the Ugly” and the Persistence of Polarization on Repeal and Replace." In Blacks in Medicine, 91–95. Cham: Springer International Publishing, 2020. http://dx.doi.org/10.1007/978-3-030-41960-8_5.

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Williams, Richard Allen. "Outstanding Black Physicians and Other Health Professionals in American History." In Blacks in Medicine, 97–154. Cham: Springer International Publishing, 2020. http://dx.doi.org/10.1007/978-3-030-41960-8_6.

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Williams, Richard Allen. "The Importance of Trust in the Physician-Patient Relationship and in Medical Care." In Blacks in Medicine, 155–68. Cham: Springer International Publishing, 2020. http://dx.doi.org/10.1007/978-3-030-41960-8_7.

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Williams, Richard Allen. "Current Health Status of Blacks in the United States: The Case for Future Improvement of Healthcare Delivery." In Blacks in Medicine, 169–76. Cham: Springer International Publishing, 2020. http://dx.doi.org/10.1007/978-3-030-41960-8_8.

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Williams, Richard Allen. "The Socioeconomic Determinants of Health and Their Impact on African American Healthcare Delivery." In Blacks in Medicine, 177–83. Cham: Springer International Publishing, 2020. http://dx.doi.org/10.1007/978-3-030-41960-8_9.

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Conference papers on the topic "Blacks in medicine"

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Redwine, Christina L., Folakemi Odedina, Debra Lyon, and Jennifer Nguyen. "Abstract A18: Exploration of Florida blacks' understanding of precision medicine for cancer care and treatment." In Abstracts: Eighth AACR Conference on The Science of Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; November 13-16, 2015; Atlanta, Georgia. American Association for Cancer Research, 2016. http://dx.doi.org/10.1158/1538-7755.disp15-a18.

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Wyatt, Tasha. ""All Patients Are Not Treated as Equal": Black/African Americans' Social Contract in Medicine." In 2021 AERA Annual Meeting. Washington DC: AERA, 2021. http://dx.doi.org/10.3102/1690067.

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Kharutsa, Daria Ivanovna, and Olga Vladimirovna Nesterova. "Analysis of Prospects for the Use of Raw Materials of Black Currant in Medicine and Pharmacy." In Internationa Extra-murral Online Conference. TSNS Interaktiv Plus, 2020. http://dx.doi.org/10.21661/r-541213.

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Bright‐Gbebry, Mireille J. "Abstract B19: Complementary and alternative medicine use among postmenopausal breast cancer survivors: The Black Women's Health Study." In Abstracts: AACR International Conference on Frontiers in Cancer Prevention Research‐‐ Dec 6–9, 2009; Houston, TX. American Association for Cancer Research, 2010. http://dx.doi.org/10.1158/1940-6207.prev-09-b19.

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Wu, Jl-Zong, Feng-Lin Zhang, and Shi-Ke Huang. "Study of the false color processing method by digital segmentation and optical combination and Its use In medicine." In OSA Annual Meeting. Washington, D.C.: Optica Publishing Group, 1987. http://dx.doi.org/10.1364/oam.1987.mw4.

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The principle and method of false color processing techniques for black and white images processed by digital segmentation and optical combination have been studied. The results of medical images processed by this method are given.
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"Efficacy and safety of black cohosh in women with breast cancer." In International Conference on Medicine, Public Health and Biological Sciences. CASRP Publishing Company, Ltd. Uk, 2016. http://dx.doi.org/10.18869/mphbs.2016.188.

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Wang, Hongliang. "Precise Benefit Management: The Way to Solve The Black Hole Of Information Technology." In International Conference on Electronics, Mechanics, Culture and Medicine. Paris, France: Atlantis Press, 2016. http://dx.doi.org/10.2991/emcm-15.2016.48.

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Silkin, Yuriy, Michail Silkin, Yelizaveta Silkina, Anastasiya Diulina, and Anatoliy Stolbov. "ATPases OF PLASMATIC MEMBRANE OF ERYTHROCYTES OF THE SOME BLACK SEA FISHES." In XV International interdisciplinary congress "Neuroscience for Medicine and Psychology". LLC MAKS Press, 2019. http://dx.doi.org/10.29003/m556.sudak.ns2019-15/378-379.

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"Blank page." In 1992 14th Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE, 1992. http://dx.doi.org/10.1109/iembs.1992.5761010.

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"Blank page." In 1992 14th Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE, 1992. http://dx.doi.org/10.1109/iembs.1992.5761011.

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Reports on the topic "Blacks in medicine"

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Ozduzen, Ozge, Billur Aslan Ozgul, Bogdan Ianosev, Alireza Karduni, Nelli Ferenczi, Wenwen Dou, Matthew Adams, and Monika Frątczak. Medicine is Still Against Black People. The British Academy, February 2023. http://dx.doi.org/10.5871/c19-recovery/o-o-b-a-o-a-kn-f-w-d-m-a-m-f-french.

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Ozduzen, Ozge, Billur Aslan Ozgul, Bogdan Ianosev, Alireza Kardini, Nelli Ferenczi, Wenwen Dou, Matthew Adams, and Monika Frątczak. Medicine is Still Against Black People. The British Academy, February 2023. http://dx.doi.org/10.5871/c19-recovery/o-o-b-a-o-a-kn-f-w-d-m-a-m-f-russian.

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Ozduzen, Ozge, Billur Aslan Ozgul, Bogdan Ianosev, Alireza Karduni, Nelli Ferenczi, Wenwen Dou, Matthew Adams, and Monika Frątczak. Medicine is Still Against Black People. The British Academy, February 2023. http://dx.doi.org/10.5871/c19-recovery/o-o-b-a-o-a-kn-f-w-d-m-a-m-f-arabic.

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Ozduzen, Ozge, Billur Aslan Ozgul, Bogdan Ianosev, Alireza Karduni, Nelli Ferenczi, Wenwen Dou, Matthew Adams, and Monika Frątczak. Medicine is Still Against Black People. The British Academy, February 2023. http://dx.doi.org/10.5871/c19-recovery/o-o-b-a-o-a-kn-f-w-d-m-a-m-f-spanish.

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Ozduzen, Ozge, Billur Aslan Ozgul, Bogdan Ianosev, Alireza Karduni, Nelli Ferenczi, Wenwen Dou, and Matthew Adams. Medicine is Still Against Black People. The British Academy, February 2023. http://dx.doi.org/10.5871/c19-recovery/o-o-b-a-o-a-kn-f-w-d-m-a-m-f-romani.

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Buyx, Alena, ed. Opening the black box of participation in medicine and healthcare (ITA manu:script 16-01). Vienna: self, 2016. http://dx.doi.org/10.1553/ita-ms-16-01.

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Xin, Yuning, Hongyu Li, Gungyu Cheng, Junfeng Cui, Yinghui Liu, Aidong Liu, Xiaolin Xu, Pengfei Li, and Huize Han. Evaluation of the Effectiveness and Safety of Acupuncture in the Treatment of Cervicogenic Hypertension A Protocol for Systematic Review and Meta-analysis. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, December 2022. http://dx.doi.org/10.37766/inplasy2022.12.0036.

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Review question / Objective: The purpose of this study is to explore the efficacy and safety of acupuncture in the treatment of patients with cervicogenic hypertension，Through scientific verification, it provides clinicians with application reference and provides more choices for patients to solve pain. Patients included should have a clear diagnosis of cervicogenic hypertension(In the absence of antihypertensive drugs, blood pressure was measured 3 times a day, systolic blood pressure ≥ 140 mmHg and/or diastolic blood pressure ≥ 90 mmHg; or a clear history of hypertension and Diagnosis of cervical spondylosis using computed tomography, magnetic resonance imaging, and other imaging methods)；The intervention group received acupuncture treatment alone or acupuncture combined with treatment by Chinese herbal medicine or conventional Western medicine; The control group was a blank control group, a placebo group, a fake acupuncture group or received treatment only through conventional Western medicine； The Inclusion criteria of study type was an RCT; The outcomes of the main analyses were efficacy of clinical symptoms，systolic blood pressure value，Diastolic blood pressure value；Secondary outcome indicators were Traditional Chinese Medicine syndrome curative effects, Traditional Chinese Medicine syndrome scores,and adverse reactions.
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Woods, Rachel, Alison Zhong, and Madelyn Vincent. Factors Associated with Influenza & Tdap Vaccine Uptake in Pregnant Patients at the UT Family Medicine Clinic in Memphis. University of Tennessee Health Science Center, 2021. http://dx.doi.org/10.21007/com.lsp.2020.0003.

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INTRODUCTION: Given the increased risk for infections among pregnant patients and newborns, vaccination against influenza (>50,000,000 annual US cases affecting all ages) and pertussis (>15,000 annual US cases disproportionately affecting newborns) are recommended among pregnant patients in order to protect them and their babies via passive immunity to cover a newborn’s window of vaccine ineligibility. Though flu and Tdap vaccination rates among pregnant patients have been trending upwards nationally, there is still room for improvement to achieve optimal rates. OBJECTIVES: The primary objectives were to study factors that affect the vaccination rates at the University of Tennessee Family Medicine Clinic at Memphis (UTFMC-M), compare those rates with national pregnancy flu/Tdap vaccination rates, and to generate recommendations based off observed factors associated with vaccine uptake to improve flu/Tdap vaccination rates in UTFMC-M pregnant patients. METHODS: This was a retrospective chart review of UTFMC-M patients who were pregnant from September 1, 2019-April 24, 2020 (included 2019-2020 flu season) (n=465). Variables studied included demographic data (race, age, insurance), immunization history (vaccine status, history of physician encouragement), and prenatal history (parity, number of prenatal visits, trimester at first visit, high risk clinic (HRC) admittance status). Vaccination status was based on ACIP recommendations (Flu shot eligible = any gestational age; Tdap eligible = ≥27 weeks). Positive HRC admittance was noted for patients with ≥2 visits to the UTFMC-M HRC, a clinic that specializes in high risk pregnant patient care. RESULTS: The patient sample was predominantly black (84.3%) and insured by Medicaid programs (88%). Among eligible UTFMC-M pregnant patients, 50.1% were flu-vaccinated (n=465); 73.8% were Tdap-vaccinated (n=317); and 52.1% were Flu+Tdap-vaccinated (n=317). No significant associations were found between vaccine uptake and HRC status, parity, and age. However, statistically significant relationships were found between vaccine uptake and physician encouragement (positive relationship with flu shot: X2(1, N = 465) =131, p < 0.001, Tdap: X2 (6, N = 465) =476, p < 0.001), number of prenatal visits (flu shot group median 8 visits, Tdap group median 9 visits vs. unvaccinated group median 4 visits; p < 0.001), and early trimester age at first prenatal visit (X2(6, N = 465) =47.635 , p CONCLUSION: 2019-2020 UTFMC-M vaccination rates were on par with 2018-2019 US flu vaccine rates and higher than 2018-2019 US Tdap and Flu+Tdap rates. There were statistically significant relationships between vaccine uptake at UTFMC-M and physician encouragement, number of prenatal visits, and early trimester age at first prenatal visit but no significant relationships with UTFMC-M HRC admittance, parity, or age. Recommendations following from our observations to address further vaccine rate improvement include: continue vaccine encouragement, continue booking multiple visits (8 for flu, 9 for Tdap), prioritize Tdap vaccine higher for late trimester intake patients, and focus on flu vaccine encouragement and education.
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Burkett, Tonia. Black Women's Health: A Content Analysis of the Journal of the American Medical Association, the American Journal of Public Health, and the New England Journal of Medicine (1989-1998). Portland State University Library, January 2000. http://dx.doi.org/10.15760/etd.3037.

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Tipton, Kelley, Brian F. Leas, Emilia Flores, Christopher Jepson, Jaya Aysola, Jordana Cohen, Michael Harhay, et al. Impact of Healthcare Algorithms on Racial and Ethnic Disparities in Health and Healthcare. Agency for Healthcare Research and Quality (AHRQ), December 2023. http://dx.doi.org/10.23970/ahrqepccer268.

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Objectives. To examine the evidence on whether and how healthcare algorithms (including algorithm-informed decision tools) exacerbate, perpetuate, or reduce racial and ethnic disparities in access to healthcare, quality of care, and health outcomes, and examine strategies that mitigate racial and ethnic bias in the development and use of algorithms. Data sources. We searched published and grey literature for relevant studies published between January 2011 and February 2023. Based on expert guidance, we determined that earlier articles are unlikely to reflect current algorithms. We also hand-searched reference lists of relevant studies and reviewed suggestions from experts and stakeholders. Review methods. Searches identified 11,500 unique records. Using predefined criteria and dual review, we screened and selected studies to assess one or both Key Questions (KQs): (1) the effect of algorithms on racial and ethnic disparities in health and healthcare outcomes and (2) the effect of strategies or approaches to mitigate racial and ethnic bias in the development, validation, dissemination, and implementation of algorithms. Outcomes of interest included access to healthcare, quality of care, and health outcomes. We assessed studies’ methodologic risk of bias (ROB) using the ROBINS-I tool and piloted an appraisal supplement to assess racial and ethnic equity-related ROB. We completed a narrative synthesis and cataloged study characteristics and outcome data. We also examined four Contextual Questions (CQs) designed to explore the context and capture insights on practical aspects of potential algorithmic bias. CQ 1 examines the problem’s scope within healthcare. CQ 2 describes recently emerging standards and guidance on how racial and ethnic bias can be prevented or mitigated during algorithm development and deployment. CQ 3 explores stakeholder awareness and perspectives about the interaction of algorithms and racial and ethnic disparities in health and healthcare. We addressed these CQs through supplemental literature reviews and conversations with experts and key stakeholders. For CQ 4, we conducted an in-depth analysis of a sample of six algorithms that have not been widely evaluated before in the published literature to better understand how their design and implementation might contribute to disparities. Results. Fifty-eight studies met inclusion criteria, of which three were included for both KQs. One study was a randomized controlled trial, and all others used cohort, pre-post, or modeling approaches. The studies included numerous types of clinical assessments: need for intensive care or high-risk care management; measurement of kidney or lung function; suitability for kidney or lung transplant; risk of cardiovascular disease, stroke, lung cancer, prostate cancer, postpartum depression, or opioid misuse; and warfarin dosing. We found evidence suggesting that algorithms may: (a) reduce disparities (i.e., revised Kidney Allocation System, prostate cancer screening tools); (b) perpetuate or exacerbate disparities (e.g., estimated glomerular filtration rate [eGFR] for kidney function measurement, cardiovascular disease risk assessments); and/or (c) have no effect on racial or ethnic disparities. Algorithms for which mitigation strategies were identified are included in KQ 2. We identified six types of strategies often used to mitigate the potential of algorithms to contribute to disparities: removing an input variable; replacing a variable; adding one or more variables; changing or diversifying the racial and ethnic composition of the patient population used to train or validate a model; creating separate algorithms or thresholds for different populations; and modifying the statistical or analytic techniques used by an algorithm. Most mitigation efforts improved proximal outcomes (e.g., algorithmic calibration) for targeted populations, but it is more challenging to infer or extrapolate effects on longer term outcomes, such as racial and ethnic disparities. The scope of racial and ethnic bias related to algorithms and their application is difficult to quantify, but it clearly extends across the spectrum of medicine. Regulatory, professional, and corporate stakeholders are undertaking numerous efforts to develop standards for algorithms, often emphasizing the need for transparency, accountability, and representativeness. Conclusions. Algorithms have been shown to potentially perpetuate, exacerbate, and sometimes reduce racial and ethnic disparities. Disparities were reduced when race and ethnicity were incorporated into an algorithm to intentionally tackle known racial and ethnic disparities in resource allocation (e.g., kidney transplant allocation) or disparities in care (e.g., prostate cancer screening that historically led to Black men receiving more low-yield biopsies). It is important to note that in such cases the rationale for using race and ethnicity was clearly delineated and did not conflate race and ethnicity with ancestry and/or genetic predisposition. However, when algorithms include race and ethnicity without clear rationale, they may perpetuate the incorrect notion that race is a biologic construct and contribute to disparities. Finally, some algorithms may reduce or perpetuate disparities without containing race and ethnicity as an input. Several modeling studies showed that applying algorithms out of context of original development (e.g., illness severity scores used for crisis standards of care) could perpetuate or exacerbate disparities. On the other hand, algorithms may also reduce disparities by standardizing care and reducing opportunities for implicit bias (e.g., Lung Allocation Score for lung transplantation). Several mitigation strategies have been shown to potentially reduce the contribution of algorithms to racial and ethnic disparities. Results of mitigation efforts are highly context specific, relating to unique combinations of algorithm, clinical condition, population, setting, and outcomes. Important future steps include increasing transparency in algorithm development and implementation, increasing diversity of research and leadership teams, engaging diverse patient and community groups in the development to implementation lifecycle, promoting stakeholder awareness (including patients) of potential algorithmic risk, and investing in further research to assess the real-world effect of algorithms on racial and ethnic disparities before widespread implementation.
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