National Healthcare Quality and Disparities Report
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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
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1 to 2 of 2 Research Studies DisplayedBonner SN, Lagisetty K, Reddy RM
Clinical implications of removing race-corrected pulmonary function tests for African American patients requiring surgery for lung cancer.
This study’s objective was to identify how many hospitals providing lung cancer surgery use race correction in pulmonary function tests (PFTs), examine the association of race correction with predicted lung function, and test the effect of decorrection on surgeons' treatment recommendations. Percent predicted preoperative and postoperative forced expiratory volume in 1 second (FEV1) was calculated for African American patients who underwent lung cancer resection between January 1, 2015, and September 31, 2022, using race-corrected and race-neutral equations for hospitals performing race correction. Randomization of US cardiothoracic surgeons was conducted to receive 1 clinical vignette that differed by the use of Global Lung Function Initiative equations for (1) African American patients (percent predicted postoperative FEV1, 49%), (2) other race or multiracial patients (percent predicted postoperative FEV1, 45%), and (3) race-neutral patients (percent predicted postoperative FEV1, 42%). A total of 515 African American patients (308 [59.8%] female; mean age, 66.2 years) were included in the study. Among these patients, the percent predicted preoperative FEV1 and postoperative FEV1 would have decreased by 9.2% and 7.6%, respectively, if race-neutral equations had been used. A total of 225 surgeons (194 male [87.8%]; mean time in practice, 19.4 years) were successfully randomized and completed the vignette items regarding risk perception and treatment outcomes (76% completion rate). Surgeons randomized to the vignette with African American race-corrected PFTs were more likely to recommend lobectomy (79.2%) compared with surgeons randomized to the other race or multiracial-corrected (61.7%) or race-neutral PFTs (52.8%).
AHRQ-funded; HS028038.
Citation: Bonner SN, Lagisetty K, Reddy RM .
Clinical implications of removing race-corrected pulmonary function tests for African American patients requiring surgery for lung cancer.
JAMA Surg 2023 Oct; 158(10):1061-68. doi: 10.1001/jamasurg.2023.3239..
Keywords: Racial and Ethnic Minorities, Cancer: Lung Cancer, Cancer, Surgery, Diagnostic Safety and Quality
Bourgeois FC, Hart NJ, Dong Z
Partnering with patients and families to improve diagnostic safety through the OurDX tool: effects of race, ethnicity, and language preference.
This study’s objective was to explore differences in race, ethnicity, and language preference associated with patient and family contributions and concerns using an electronic previsit tool designed to engage pediatric patients and their families in the diagnostic process (DxP). This cross-sectional study included 5,731 patients and families presenting to three subspecialty clinics at an urban pediatric hospital May to December 2021 who completed a previsit tool, which was codeveloped and tested with patients and families. Patients/families were invited to share visit priorities, recent histories, and potential diagnostic concerns prior to each visit. The authors conducted chart review on a random subset of visits to review concerns and determine whether patient/family contributions were included in the visit note. Compared with patients self-identifying as White, those self-identifying as Black (odds ratio [OR]: 1.70) or "other" race (OR: 1.48) were more likely to report a diagnostic concern. Participants who preferred a language other than English were more likely to report a diagnostic concern than English-preferring patients (OR: 2.53). No significant differences were found in physician-verified diagnostic concerns or in integration of patient contributions into the note based on race, ethnicity, or language preference.
AHRQ-funded; HS027367.
Citation: Bourgeois FC, Hart NJ, Dong Z .
Partnering with patients and families to improve diagnostic safety through the OurDX tool: effects of race, ethnicity, and language preference.
Appl Clin Inform 2023 Oct; 14(5):903-12. doi: 10.1055/s-0043-1776055..
Keywords: Diagnostic Safety and Quality, Patient Safety, Racial and Ethnic Minorities