Short Report: Race and Ethnicity Misclassification in Kidney Transplantation Research.
Short Report: Race and Ethnicity Misclassification in Kidney Transplantation Research.
复制标题
简短报告：肾脏移植研究中的种族和种族错误分类。
DOI：
10.1097/txd.0000000000001373
复制
发表时间：
2022-10
影响因子：
2.3
通讯作者：
中科院分区：
文献类型：
--
作者：
最近，滥用种族作为一个生物变量，而不是一个社会结构，在生物医学研究中，已收到全国关注的医疗偏见的贡献。在国家移植登记数据中，由于收集的是提供者感知的种族而不是患者自己的自我报告，因此测量不精确可能会导致偏倚。我们将移植受者科学登记数据与一项针对成年肾移植患者的前瞻性多中心队列研究（2008年12月至2020年2月）相关联，该研究收集了患者报告的种族。我们计算了Cohen的kappa统计量，以估计2个数据源中提供者感知和患者报告的种族之间的一致性。我们使用了一个未经调整的广义线性模型，以检查随着时间的推移，协议的变化。在2942例肾移植患者中，亚裔患者几乎完全一致，（kappa = 0.88，95%置信区间[CI]，0.84-0.92），黑人（kappa = 0.97，95% CI，0.96-0.98）和白色类别（kappa = 0.95，95% CI，0.93-0.96），西班牙裔/拉丁裔之间的一致性较差（kappa = 0.66，95% CI，0.57-0.74）和夏威夷原住民/其他太平洋岛民类别（kappa = 0.40，95% CI，0.01-0.78）。一致性百分比随时间推移而降低（一致性百分比差异=-0.55，95% CI，-0.75至-0.34）。然而，不同人种的这些趋势存在差异：亚裔为-0.07/年，95% CI，-0.21至0.07;黑人为-0.06/年，95% CI，-0.28至0.16;西班牙裔/拉丁裔为-0.01/年，95% CI，-0.21至0.19;白色分类为-0.43/y，95% CI，-0.58至-0.28。随着时间的推移，种族错误分类可能导致越来越多的偏见研究估计，特别是对于亚洲，西班牙裔/拉丁裔和夏威夷土著/其他太平洋岛民研究人群。种族测量的改进包括强制患者报告种族，扩大种族类别以更好地反映当代美国人口统计数据，并允许在数据收集表格上填写，以及通过定性访谈或文化身份，血统和歧视的有效措施补充数据。
Recently, the misuse of race as a biological variable, rather than a social construct, in biomedical research has received national attention for its contributions to medical bias. In national transplant registry data, bias may arise from measurement imprecision because of the collection of provider-perceived race rather than patients’ own self-report. We linked Scientific Registry of Transplant Recipients data to a prospective, multicenter cohort study of adult kidney transplant patients (December 2008–February 2020) that collects patient-reported race. We computed Cohen’s kappa statistic to estimate agreement between provider-perceived and patient-reported race in the 2 data sources. We used an unadjusted generalized linear model to examine changes in agreement over time. Among 2942 kidney transplant patients, there was almost perfect agreement among Asian (kappa = 0.88, 95% confidence interval [CI], 0.84-0.92), Black (kappa = 0.97, 95% CI, 0.96-0.98), and White categories (kappa = 0.95, 95% CI, 0.93-0.96) and worse agreement among Hispanic/Latino (kappa = 0.66, 95% CI, 0.57-0.74) and Native Hawaiian/Other Pacific Islander categories (kappa = 0.40, 95% CI, 0.01-0.78). The percent agreement decreased over time (difference in percent agreement = –0.55, 95% CI, –0.75 to –0.34). However, there were differences in these trends by race: –0.07/y, 95% CI, –0.21 to 0.07 for Asian; –0.06/y, 95% CI, –0.28 to 0.16 for Black; –0.01/y, 95% CI, –0.21 to 0.19 for Hispanic/Latino; –0.43/y, 95% CI, –0.58 to –0.28 for White categories. Race misclassification has likely led to increasingly biased research estimates over time, especially for Asian, Hispanic/Latino, and Native Hawaiian/Other Pacific Islander study populations. Improvements to race measurement include mandating patient-reported race, expanding race categories to better reflect contemporary US demographics, and allowing write-ins on data collection forms, as well as supplementing data with qualitative interviews or validated measures of cultural identity, ancestry, and discrimination.