Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, PA.
Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA.
J Appl Lab Med. 2021 Jan 12;6(1):274-284. doi: 10.1093/jalm/jfaa143.
A health disparity is a health outcome that presents in a lesser or greater extent between populations. Health disparities in diseases are products of complex interactions between social, economic, and to a lesser extent, biological factors and can be mediated by structural racism and discriminatory policies. The objective of this review is to understand how both laboratorians and nonlaboratorians think about the relationship between laboratory medicine and health disparities and to highlight ways in which laboratory medicine can play a role in eliminating health disparities.
We developed an electronic survey from which we selected the top responses reported by the 215 participants to frame a discussion around why laboratorians perceive health disparities exists, and how they can reduce health disparities.
We found that both laboratorians and nonlaboratorians feel that laboratory medicine can and should play a role in reducing health disparities using many tools already in use in the clinical laboratory. The skills of laboratory workers in data generation, the establishment of reference ranges, control over the presentation of laboratory results, generation of test menus, and the development of novel diagnostics may impact health disparities. Laboratorians' responses in our survey indicated that they felt that they could reduce health disparities by using laboratory data to proactively track in cooperation with healthcare providers individuals with chronic conditions to prevent acute events, ensuring gender and ethnic diversity in new clinical trials, including appropriate curriculum in laboratory medicine training, using equations and reference intervals based on physiological differences and participating in unconscious bias training.
健康差异是指在不同人群中存在的健康结果差异,程度较轻或较重。疾病中的健康差异是社会、经济因素,在一定程度上还有生物因素之间复杂相互作用的产物,并且可以由结构性种族主义和歧视性政策来调节。本综述的目的是了解实验室人员和非实验室人员如何看待检验医学与健康差异之间的关系,并强调检验医学在消除健康差异方面可以发挥的作用。
我们从电子调查中选取了 215 名参与者报告的最常见回答,以此来展开讨论,即实验室人员认为健康差异存在的原因,以及他们如何减少健康差异。
我们发现,实验室人员和非实验室人员都认为,检验医学可以并且应该利用临床实验室中已经使用的许多工具来减少健康差异。实验室工作人员在数据生成、参考范围建立、控制实验室结果呈现、检验菜单生成和新型诊断方法开发方面的技能可能会对健康差异产生影响。我们的调查中实验室人员的回答表明,他们认为可以通过使用实验室数据与医疗保健提供者合作,主动跟踪患有慢性疾病的个体以预防急性事件,确保新临床试验中的性别和种族多样性,包括检验医学培训中的适当课程,使用基于生理差异的方程和参考区间,并参与无意识偏见培训,从而减少健康差异。