The American Heart Association (AHA) Get with the Guidelines–Heart Failure Risk Score predicts the risk of death in patients admitted to the hospital.9 It assigns three additional points to any patient identified as “nonblack,” thereby categorizing all black patients as being at lower risk. The AHA does not provide a rationale for this adjustment. Clinicians are advised to use this risk score to guide decisions about referral to cardiology and allocation of health care resources. Since “black” is equated with lower risk, following the guidelines could direct care away from black patients.
From the NEJM article. This is the exact opposite of Zvi’s conclusions (“Not factoring this in means [blacks] will get less care”).
Is Zvi/NYT referring to a different risk calculator? There are a lot of them out there. The NEJM also discuses a surgical risk score that has the opposite directionality, so maybe that one? Though there the conclusion is also about less care for blacks: “When used preoperatively to assess risk, these calculations could steer minority patients, deemed to be at higher risk, away from surgery.” Of course, less care could be a good thing here!
From the NEJM article. This is the exact opposite of Zvi’s conclusions (“Not factoring this in means [blacks] will get less care”).
I confirmed the NEJM’s account by using an online calculator for that score. https://www.mdcalc.com/calc/3829/gwtg-heart-failure-risk-score Setting a patient with black=No gives higher risk than black=yes. Similarly so for a risk score from the AHA,: https://static.heart.org/riskcalc/app/index.html#!/baseline-risk
Is Zvi/NYT referring to a different risk calculator? There are a lot of them out there. The NEJM also discuses a surgical risk score that has the opposite directionality, so maybe that one? Though there the conclusion is also about less care for blacks: “When used preoperatively to assess risk, these calculations could steer minority patients, deemed to be at higher risk, away from surgery.” Of course, less care could be a good thing here!
I agree that this looks complicated.