Doris Duke Foundation Pledges $10M To Health Groups To Reform Racial Bias In Medical Algorithms

The Doris Duke Foundation has a mission to “[support] the well-being of people and the planet for a more creative, equitable and sustainable future,” according to its website.

According to The Chronicle of Philanthropy via The (Grand Junction, CO) Daily Sentinel, its current efforts include funding $10 million to five health organizations to promote equity in medical research by reevaluating the role of race in medical algorithms.

“Race is not a biological proxy,” said the foundation’s incoming chief health equity officer, Joseph Wright. “Race is a social construct and has no place being embedded in a clinical guideline like this.”

Sindy Escobar Alvarez, program director for medical research at the Doris Duke Foundation, said the foundation’s involvement is a result of the limited research that has been done to examine the impact and composition of “race-aware” algorithms.

Four national medical organizations and one New York City-based coalition will receive funding: The American Academy of Pediatrics, The American Heart Association, The American Society of Hematology, The Coalition to End Racism in Clinical Algorithms (New York), and The National Academies of Sciences, Engineering, and Medicine.

The funding will include grants ranging from $1.36 million to $3.4 million to research the use of medical algorithms in hospitals with the ultimate goal of reforming and creating guidelines for these tools that consider race.

Medical assessment tools have influenced decisions regarding patient care since the 1970s, according to the outlet. Research has shown that using algorithms can lead to worse outcomes and biased assessments for patients of color. Recent studies demonstrate that some algorithms can also lead to denying treatment for these patients.

Previous concerns about the consequences of using race-based medical algorithms were not discussed. David Jones, a professor at Harvard Medical School, said minimal attention was given to this issue until 2016 when medical students began to raise questions about the use of race in clinical calculations leading hospitals such as Beth Israel Deaconess Medical Center and Zuckerberg San Francisco General to refrain from using calculators that factor in a patient’s race.

Other professionals who are not receiving funding shared insight on the use of algorithms. Nwamaka Eneanya, nephrologist and assistant professor at the University of Pennsylvania, said, “The inequities of the pandemic and the murder of George Floyd really served as catalyst to change things.”

Some organizations that received funding, such as the American Academy of Pediatrics, have begun to update their guidelines. However, some medical-society members support keeping race in clinical equations, and others believe finding an alternative for medical algorithms may be more beneficial.