Getting the numbers right: statistical mischief and racial profiling in heart failure research.
The claim that blacks die from heart failure at a rate twice that of whites is informing efforts to develop and market the drug BiDil, which is currently undergoing clinical trials to be approved by the FDA as the first drug ever specified to treat African Americans--and only African Americans--for heart failure. The drug and its companion statistic have since come to play prominent roles in debates about so-called "racial profiling" in medicine and the legitimacy of using social categories of race in biomedical research. Nonetheless, this statistic is wrong. The most current data available place the black:white mortality ratio for heart failure at approximately 1.1:1. The article tells the story of attempts to get to the source of the supposed 2:1 mortality ratio and explores some of the implications of the acceptance of these erroneous data, both for the allocation of resources to combat disease and for our broader understanding of the nature and meaning of race.
Research Center, Center for Bioethics, University of Minnesota, Minneapolis 55455-0346, USA. Kahnx015@umn.edu
Jonathan
J
Kahn
D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D000368:Aged; D002986:Clinical Trials as Topic / Q000592:standards; D003627:Data Interpretation, Statistical; D004338:Drug Combinations; D015340:Epidemiologic Research Design; D005260:Female; D006333:Heart Failure / Q000188:drug therapy / Q000208:ethnology* / Q000401:mortality; D006801:Humans; D006830:Hydralazine / Q000627:therapeutic use; D007548:Isosorbide Dinitrate / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D011287:Prejudice; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data
D004338:Drug Combinations; C431665:isosorbide-hydralazine combination; D006830:Hydralazine; D007548:Isosorbide Dinitrate