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Race and ethnicity in clinical studies.

Gonzales et al recently published in the Bulletin of the American College of Surgeons an essay entitled, ‘‘Is there a role for race in science and medicine?’’ They concluded that ‘‘the term race is a social construct and should not be considered a biologic determinant with reference to science and medicine.’’ As though illustrating this point, the Journal of the American College of Surgeons subsequently published a study entitled ‘‘Racial, ethnic and insurance status disparities in use of posthospitalization care after trauma.’’ In their methods section, the authors of this study report that they used the National Trauma Data Standard (NTDS) as their data source. This database can apparently reliably record the insurance status of trauma patients. The authors found that uninsured patients were less likely to be discharged to home health care, rehabilitation facilities, or nursing homes compared to patients with private insurance. The study could not evaluate variables of education, income, or comorbidities relative to posthospital care because the NTDS ‘‘lacks complete data’’ on these variables. The NTDS, however, does provide racial categories for the trauma patients entered into the database. The authors proceeded to examine the effects of race as a variable according to the following criteria: