NCPA - National Center for Policy Analysis

Bias In Heart Care Disputed

September 16, 1999

A study published earlier this year in the New England Journal of Medicine found blacks and women get unequal treatment when it comes to heart care. However, some experts say the study's authors exaggerated some differences in care and published a rebuttal in a July issue of the journal.

The original study, by researcher Kevin Schulman of Georgetown University Medical Center, found that blacks and women with chest pain were about 40 percent less likely to get a common test for heart disease than whites or men.

Schulman and his colleagues based that finding on evaluations by 700 doctors of videotapes of actors and actresses describing chest pains.

  • However, Steven Woloshin and others at the Veterans Administration examined the raw data, and found that doctors recommended referring the white men, black men and white women in the videotapes for the same heart test at about the same rate -- 90 percent.
  • Black women were referred for the diagnostic test, called cardiac catheterization, about 78 percent of the time.
  • Cardiologists says the difference is quite small and could have reflected chance.
  • Moreover, Woloshin's group contend the 90 percent figure is extraordinarily high and may not reflect the best care or doctors' actual practice.

Interestingly, readers of the original study did not see the raw numbers, because they were edited out by reviewers at the New England Journal of Medicine.

Source: Kathleen Fackelmann, "Does Unequal Treatment Really Have Roots in Racism?" USA Today, September 16, 1999.


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