HEALTHCARE EQUITY AND OTHER SOURCES OF BIAS IN MEDICAL RESEARCH

The Alex Manfull Fund is keenly aware of two different but related issues that may inadvertently introduce bias into drawing conclusions from both research and the observations made in one’s practice. We would like to make all viewers aware of these issues as they relate to immune-mediated neuropsychiatric disorders. 

  • “Medical Equity” refers to all persons having the opportunity to reach their full potential of health and that no person’s opportunity shall be limited by race/ethnicity, age, sexual orientation, gender identity, nationality, socioeconomic status, or place of residence. As in so many areas of medicine, healthcare equity has not yet been established in the field of immune-mediated neuropsychiatric disorders such as PANDAS and PANS.  There are many reasons for this inequity: there are not enough qualified providers; they are not geographically distributed; treatment can be expensive; insurance often does not cover prescribed treatments; and stigma. Therefore, the anecdotal observations of the speakers at our symposium, while very important, may not reflect the realities of inequities in access to care. However, they are red flags calling out for more research.
  • Historically, research tends to favor white subjects. Great effort is being made to eliminate this bias but, for a variety of reasons, such bias still haunts almost all medical research, making it imperative that consumers of research, like contemporary researchers themselves, be mindful of this potential source of bias.

The speakers, experts in their respective fields, recognized the importance of balancing potential for bias with the importance of open discussion at this PANDAS/PANS symposium. A symposium is a formal meeting of specialists to discuss a particular subject in an open and convivial atmosphere.  It entails the presentation of scientific findings as well as any personal observations, thoughts, and questions that the participants may wish to share with their colleagues.  The goal is to elucidate the subject by generating discussion and research to determine the validity of these observations and ideas. In this symposium, personal observations, thoughts, and questions must be viewed as potential subjects of research, not scientific conclusions.

In a relatively new area of medical research such as immune-mediated neuropsychiatric disorders, discussion is critically important. What observations, questions, or thoughts do you have? What can be done to eliminate medical inequity and research bias?