title: Unsupported labeling of race as a risk factor for certain diseases in a widely used medical textbook.
abstract: OBJECTIVE
  Confounding of racial, socioeconomic, and behavioral characteristics may lead to the misidentification of race as a risk factor for certain diseases. The authors evaluated the validity of attributing race as a risk factor in a widely used pathology textbook.
  
  
  METHODS
  In 2009-2010, the authors searched Robbins and Cotran Pathologic Basis of Disease, Professional Edition (8th ed) for assertions that African Americans have a different disease profile than do individuals of other races. They evaluated the references cited in the textbook, assessing the quality of the sources and whether those authors controlled for confounding variables, such as socioeconomic status and behavioral characteristics. For statements that remained unconfirmed, the authors searched the literature for evidence supporting or contradicting the claims made in the textbook. The authors classified each statement from the textbook as supported, unconfirmed, or contradicted.
  
  
  RESULTS
  Of the 31 relevant statements, 11 were supported by the literature review, 17 remained unconfirmed, and three were contradicted.
  
  
  CONCLUSIONS
  About two-thirds of the assertions that different risk factors exist for African Americans found in a widely used pathology textbook could not be supported by the published literature. Failure to separate race from other socioeconomic and behavioral characteristics as risk factors for certain diseases may contribute to the misdiagnosis of patients and interfere with efforts to identify and remove causes of health disparities.
authors.affiliation: University of Missouri-Columbia School of Medicine, Columbia, Missouri, USA. LincolnSheets@gmail.com
authors.forename: Lincoln
authors.initials: L
authors.lastname: Sheets
authors.forename: Jessica
authors.initials: J
authors.lastname: Johnson
authors.forename: Timothy
authors.initials: T
authors.lastname: Todd
authors.forename: Timothy
authors.initials: T
authors.lastname: Perkins
authors.forename: Chris
authors.initials: C
authors.lastname: Gu
authors.forename: Megan
authors.initials: M
authors.lastname: Rau
mesh_terms: D004194:Disease / Q000208:ethnology*; D004501:Education, Medical / Q000379:methods*; D004813:Epidemiology / Q000193:education*; D006801:Humans; D010338:Pathology, Clinical / Q000193:education*; D044469:Racial Groups; D012189:Retrospective Studies; D012307:Risk Factors; D013782:Textbooks as Topic / Q000592:standards*; D014481:United States