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How Neglecting Minorities in Medical Research Has Led to Deadly Outcomes

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Re: How Neglecting Minorities in Medical Research Has Led to Deadly Outcomes

#41

Post by marchenko »

indubitable wrote: post #29
citricsquid wrote: post #2

https://www.propublica.org/article/nothing-protects-black-wo... This is a longer article on the subject of poorer health outcomes for minorities, covering the situation for black women and one family's experience, which is very much worth reading, but here are the key points: Statistics: * A black woman is 22% more likely to die from heart disease than a white woman * ...71 percent more likely to perish from cervical…

According to the CDC, the average weight [1] of a black woman aged 20-39 years in the US is 179 lbs, 158 lbs for a white woman. Converting to BMI (to adjust for height differences), the story is the same with an average 30.2 vs 26.7, or 'moderately obese' versus 'overweight.' Remove any notions of race and compare the stats based entirely on equivalent weight/BMI I you will find nearly all differences would disappear…

>Remove any notions of race and compare the stats based entirely on equivalent weight/BMI I you will find nearly all differences would disappear.

This is not only false, but dangerously false. We are in the process of discovering that certain classes of popularly-prescribed drugs (eg ACE inhibitors for blacks, certain chemotherapy drugs for Asians) are ineffective or even toxic for populations not represented in the relevant drug development research cohorts. It's not identity politics to note that pharmacokinetics can differ between individuals and populations. These differences do not explain all of the population-level morbidity and mortality differences between ethnicities, but they are significant when investigating differences between groups on the same course of treatment.

Re: How Neglecting Minorities in Medical Research Has Led to Deadly Outcomes

#42

Post by jackpirate »

blaurenceclark wrote: post #4

I'm the founder of HDP Health, if you have any questions or want clarifications please ask away!

I'm a machine learning researcher, currently working on robust models (i.e. models that handle outliers properly). More traditional statistics has good techniques for making models robust, but current machine learning techniques do not.

Do you have any thoughts on how improvements in these sorts of machine learning algorithms could make clinical trials more fair? I ask because you specifically mention that HDP uses AI in the article.

Re: How Neglecting Minorities in Medical Research Has Led to Deadly Outcomes

#43

Post by blaurenceclark »

jackpirate wrote: post #42
blaurenceclark wrote: post #4

I'm the founder of HDP Health, if you have any questions or want clarifications please ask away!

I'm a machine learning researcher, currently working on robust models (i.e. models that handle outliers properly). More traditional statistics has good techniques for making models robust, but current machine learning techniques do not. Do you have any thoughts on how improvements in these sorts of machine learning algorithms could make clinical trials more fair? I ask because you specifically mention that HDP uses A…

Actually the AI portion of our product is mostly for making clinical trial recruitment more efficient, although we consciously add demographic tweaks to our algorithms to help identify specific patient populations that many researchers simply don't think about.

What we are also working on to make things more fair is helping open critical clinical trials in areas where there is a higher density of minority populations, as well as using demographic data in identifying where minority patients exist that match up to the latest clinical trials to prove to pharma companies that opening them in those areas is not only a moral improvement, but a financial one as well. (Disclaimer we do all of this de-identified).

Would definitely be great to have a larger discussion on this topic!

Re: How Neglecting Minorities in Medical Research Has Led to Deadly Outcomes

#44

Post by golemotron »

marchenko wrote: post #41
indubitable wrote: post #29

Earlier quoted context omitted.

According to the CDC, the average weight [1] of a black woman aged 20-39 years in the US is 179 lbs, 158 lbs for a white woman. Converting to BMI (to adjust for height differences), the story is the same with an average 30.2 vs 26.7, or 'moderately obese' versus 'overweight.' Remove any notions of race and compare the stats based entirely on equivalent weight/BMI I you will find nearly all differences would disappear…

>Remove any notions of race and compare the stats based entirely on equivalent weight/BMI I you will find nearly all differences would disappear. This is not only false, but dangerously false. We are in the process of discovering that certain classes of popularly-prescribed drugs (eg ACE inhibitors for blacks, certain chemotherapy drugs for Asians) are ineffective or even toxic for populations not represented in the…

The same is true for men and women. The narrative we like to repeat is that men and women are the same except for the shapes of their genitals but there are numerous biochemical and metabolic differences that should affect dosages for several classes of medication [1]. The real tragedy is that many drug trials were never done with women so we may not even be sure of what the doses should should be [2]. The same problem exists with children. These are not simple body weight issues.

[1] https://www.scientificamerican.com/article/psychotropic-drug...

[2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4800017/

Re: How Neglecting Minorities in Medical Research Has Led to Deadly Outcomes

#45

Post by dominotw »

blaurenceclark wrote: post #32
indubitable wrote: post #29

Earlier quoted context omitted.

According to the CDC, the average weight [1] of a black woman aged 20-39 years in the US is 179 lbs, 158 lbs for a white woman. Converting to BMI (to adjust for height differences), the story is the same with an average 30.2 vs 26.7, or 'moderately obese' versus 'overweight.' Remove any notions of race and compare the stats based entirely on equivalent weight/BMI I you will find nearly all differences would disappear…

Then why is asthma medication less effective on Latino's and African Americans? And why did my friend have to visit 5 doctors and it wasn't until he found the Black doctor that his skin condition (which is common to only African Americans regardless of weight) was properly diagnosed and treated? I'm not saying weight is not a problem, I come from a black family where unhealthy diets are a tradition (but that leads ba…

> Asians who typically have a lower BMI than white individuals have higher incidences of Diabetes?

Perhaps I missed it but where in that link does it say Asians have "higher incidences of Diabetes" than whites?

Re: How Neglecting Minorities in Medical Research Has Led to Deadly Outcomes

#46

Post by blaurenceclark »

dominotw wrote: post #45
blaurenceclark wrote: post #32

Earlier quoted context omitted.

Then why is asthma medication less effective on Latino's and African Americans? And why did my friend have to visit 5 doctors and it wasn't until he found the Black doctor that his skin condition (which is common to only African Americans regardless of weight) was properly diagnosed and treated? I'm not saying weight is not a problem, I come from a black family where unhealthy diets are a tradition (but that leads ba…

> Asians who typically have a lower BMI than white individuals have higher incidences of Diabetes? Perhaps I missed it but where in that link does it say Asians have "higher incidences of Diabetes" than whites?

It is an indirect correlation. BMI is a factor related to the likelihood of having diabetes, and what's considered a safe range for white people is an unsafe range for Asians. Thus if you have a white person at a 25 BMI and an Asian person at 25 BMI, the Asian person has a higher likelihood of getting diabetes.

"The educated [Asian] population knows that they're getting diabetes and hypertension and all these things at a much lower BMI, but if you're in a culture where everybody's really fat and you're thin, you tend to go around and think, 'Well, I'm protected,'"

Re: How Neglecting Minorities in Medical Research Has Led to Deadly Outcomes

#47

Post by Banthum »

charlescearl wrote: post #38
pkaye wrote: post #6

Earlier quoted context omitted.

But this seems to be different situation from what the article is talking about which is the inadequate involvement of minorities in drug trials. You are highlighting the lack of adequate health coverage which is a different issue in the US. But this bring up a question if blacks and other minorities have the poorer health outcomes in other countries? Japan, China, South Korea for example does their own drug testing…

Or generally if historically oppressed minorities get poorer health outcomes. It seems a complex question that has many facets. Two tickets that come to mind: 1. When US sociologists and political scientists talk about “systemic and structural racism” this is one of the manifestations. That in general the well being of Native peoples in the US, of African Americans is devalued. It is witnessed in the exclusion in dru…

>That in general the well being of Native peoples in the US, of African Americans is devalued. It is witnessed in the exclusion in drug trials, in the diseases that pharma considers worthwhile to address...

Speaking about medical research specifically:

You seem to say these outcomes are because of white racists "devaluing" black and native peoples' well-being in an evil act of collective racism.

A simpler explanation would be: There are far fewer blacks and natives than whites in America, which means fewer sick people to help and fewer customers, which means their unique illnesses get less research focus.

The same effect happens between common diseases and rare diseases irrespective of race. Common diseases get studied first, because that's where the most good can be done. This isn't because the well-being of people with rare diseases is "devalued".

Frankly I'm concerned you jump so quickly to a mass accusation of collective racial evil (which echoes historic hatred against other high-performing ethnic groups) when a simpler explanation is so obvious.

Re: How Neglecting Minorities in Medical Research Has Led to Deadly Outcomes

#48

Post by BearGoesChirp »

golemotron wrote: post #44
marchenko wrote: post #41

Earlier quoted context omitted.

>Remove any notions of race and compare the stats based entirely on equivalent weight/BMI I you will find nearly all differences would disappear. This is not only false, but dangerously false. We are in the process of discovering that certain classes of popularly-prescribed drugs (eg ACE inhibitors for blacks, certain chemotherapy drugs for Asians) are ineffective or even toxic for populations not represented in the…

The same is true for men and women. The narrative we like to repeat is that men and women are the same except for the shapes of their genitals but there are numerous biochemical and metabolic differences that should affect dosages for several classes of medication [1]. The real tragedy is that many drug trials were never done with women so we may not even be sure of what the doses should should be [2]. The same probl…

>The same problem exists with children.

I feel like the problem is worse with children due to them having a developing brain, where the impacts of medication can have impacts into changing the very person taking them. I am especially concerned with medication for mental illnesses that are prescribed to children, often times off label, but the risk exists for most any medication.

Re: How Neglecting Minorities in Medical Research Has Led to Deadly Outcomes

#49

Post by BigChiefSmokem »

m1el wrote: post #18
blaurenceclark wrote: post #4

I'm the founder of HDP Health, if you have any questions or want clarifications please ask away!

Do you find the opening statement "With more than 50 percent of the population estimated to be a minority by 2044" ridiculous? When did we start ignoring what words mean? That's not what the word "minority" means. There's many ways you can rephrase it and still be correct, mind you.

I would of said it this way, "No racial group is predicted to be over 50% of the overall population in 2044"

Re: How Neglecting Minorities in Medical Research Has Led to Deadly Outcomes

#50

Post by arionhardison »

Banthum wrote: post #47
charlescearl wrote: post #38

Earlier quoted context omitted.

Or generally if historically oppressed minorities get poorer health outcomes. It seems a complex question that has many facets. Two tickets that come to mind: 1. When US sociologists and political scientists talk about “systemic and structural racism” this is one of the manifestations. That in general the well being of Native peoples in the US, of African Americans is devalued. It is witnessed in the exclusion in dru…

>That in general the well being of Native peoples in the US, of African Americans is devalued. It is witnessed in the exclusion in drug trials, in the diseases that pharma considers worthwhile to address... Speaking about medical research specifically: You seem to say these outcomes are because of white racists "devaluing" black and native peoples' well-being in an evil act of collective racism. A simpler explanation…

> Frankly I'm concerned you jump so quickly to a mass accusation of collective racial evil (which echoes historic hatred against other high-performing ethnic groups) when a simpler explanation is so obvious.

Do you live in America? Are you familiar with US history? If both of these are true then I dont understand why its so hard for you to grasp the fact that much of this was done out of malice.

https://en.wikipedia.org/wiki/Tuskegee_syphilis_experiment - I guess you think this was a "mistake" too?

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