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Cited by 32Emergency and Acute Care StudiesHealth disparities and outcomesRace, Genetics, and Society

Patient race/Ethnicity and diagnostic imaging utilization in the emergency Department: A systematic review

Shan, Alan, Baumann, Glenn, Gholamrezanezhad, Ali·2021·Journal of the American College of Radiology
DOI 10.1016/j.jacr.2020.12.016
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Abstract

Purpose Diagnostic imaging often is a critical contributor to clinical decision making in the emergency department (ED). Racial and ethnic disparities are widely reported in many aspects of health care, and several recent studies have reported a link between patient race/ethnicity and receipt of imaging in the ED.Methods The authors conducted a systematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, searching three databases (PubMed, Embase, and the Cochrane Library) through July 2020 using keywords related to diagnostic imaging, race/ethnicity, and the ED setting, including both adult and pediatric populations and excluding studies that did not control for the important confounders of disease severity and insurance status.Results The search strategy identified 7,313 articles, of which 5,668 underwent title and abstract screening and 238 full-text review, leaving 42 articles meeting the inclusion criteria. Studies were predominately conducted in the United States (41), split between adult (13) and pediatric (17) populations or both (12), and spread across a variety of topics, mostly focusing on specific anatomic regions or disease processes. Most studies (30 of 42 [71.4%]) reported an association between Black, African American, Hispanic, or nonwhite race/ethnicity and decreased receipt of imaging.Conclusions Despite heterogeneity among studies, patient race/ethnicity is linked with receipt of diagnostic imaging in the ED. The strength and directionality of this association may differ by specific subpopulation and disease process, and more efforts to understand potential underlying factors are needed.

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  • Black, Hispanic, and non-White patients are less likely to undergo diagnostic imaging in the emergency department.

    “Black, Hispanic, and non-White patients are less likely to undergo diagnostic imaging in the emergency department. 32”

    From AI pitfalls and what not to do: mitigating bias in AI (2023) · cites this paper as [32]

  • Bias exists in who gets specific types of imaging, and when.

    “For example, bias exist in who gets specific types of imaging, and when.”

    From AI pitfalls and what not to do: mitigating bias in AI (2023) · cites this paper as [32]

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Authors
Shan, A., Baumann, G., & Gholamrezanezhad, A.
Affiliations
  • Johns Hopkins University (US)
  • University of Southern California (US)
Corresponding author
Shan, Alan
ORCID
Venue
Journal of the American College of Radiology
Publisher
Elsevier BV
Published
2021-06
Volume
18
Issue
6
Pages
795-808
ISSN
1546-1440 (ISSN-L)
DOI
10.1016/j.jacr.2020.12.016
OpenAlex
W3114176660
Cited by
32
References
70
Citations by year
2026: 5 · 2025: 5 · 2024: 3 · 2023: 10 · 2022: 8 · 2021: 1
FWCI
1.13
Type
journal article
Language
en
Open access
closed
Licence
Locations
  • Journal of the American College of Radiology (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Emergency Medicine › Emergency and Acute Care Studies
  • Social Sciences › Health › Health disparities and outcomes
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Race, Genetics, and Society
Keywords
racial and ethnic disparities, diagnostic imaging utilization, emergency department, health care disparities, Black patients, Hispanic patients, pediatric emergency care, access to imaging
MeSH terms
Adult, Black or African American, Child, Diagnostic Imaging, Emergency Service, Hospital, Ethnicity, Hispanic or Latino, Humans, United States

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