Raman, Balucan receive health equity research grantsSep. 9, 2021, 9:25 AM
by Craig Boerner
Rameela Raman, PhD, associate professor of Biostatistics, and Francis Balucan, MD, MBA, assistant professor of Clinical Medicine, are the recipients of the first annual Vanderbilt Center for Health Services Research (CHSR) Health Equity Research Grants.
The two grants, up to $10,000 each, will support one-year research projects aimed to advance equity in health care by addressing the use of race in diagnostic tests and clinical algorithms for risk assessment, diagnosis or treatment.
“The Center for Health Services Research is excited to build on our longstanding commitment to health equity by supporting these two innovative projects,” said Sunil Kripalani, MD, MSc, professor of Medicine and director of CHSR.
“Our goal is to foster research aimed at eliminating racial bias in clinical practices that may result from the use of biased formulas and algorithms, a form of structural racism. The selected projects have a high potential to lead to future research and impact patient care,” he said.
Raman and colleagues will examine neuropsychological cognitive tests used in intensive care unit (ICU) survivors. More than half of ICU patients who require mechanical ventilation will experience a new disability, including long-term cognitive impairment.
Diagnosis of ICU-related cognitive impairment is a crucial step in providing treatment and related support to improve health outcomes in these patients. However, many neurocognitive tests are scored differently based upon race, despite being developed and validated in primarily Caucasian populations. This practice of race-norming may lead to underdiagnosis and introduce bias into clinical decision making for minority patients.
Balucan and colleagues will examine the Vanderbilt Familiar Faces (VFF) program’s eligibility algorithm to determine if it may inadvertently contribute to structural inequities in access for patients. The program provides continuity and care coordination for high-utilizing, high-need, and medically and socially complex patients so they don’t have to rely on emergency care or repeated hospital stays for their health care needs.
Eligibility for VFF services is currently based on patterns of acute health care utilization only at Vanderbilt University Medical Center, which may introduce bias in program eligibility by not recognizing patients who also utilize other health care facilities. The team will examine health care utilization at multiple area hospitals to redefine a high utilizer population, and whether this expanded approach is more inclusive of racial and ethnic minorities.
“We are very excited about these research grants, and we look forward to supporting additional efforts that expand Vanderbilt’s role as a learning health system that seeks to improve care and address health equity,” said Russell Rothman, MD, MPP, professor of Medicine and director of the Vanderbilt Institute for Medicine and Public Health.