From the President’s Desk

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Of course, this is not the only area of institutional bias where we can and should make a difference. I am pleased that guidelines have changed for how we calculate estimated glomerular filtration rate (eGFR). In the past, we adjusted the score for patients who identified as Black; the adjustment may have prevented some African-American patients from qualifying for kidney transplants. The concept behind the adjustment was based on unscientific and antiquated ideas of race. Again, with our commitment to seeking the truth in all test results, we pathologists can reduce inequities in patient care by leading with science. If your lab has not adopted the latest eGFR testing guidelines that eliminate race-based calculations, I urge you to do so as soon as possible.

Another area where we can make health care more equitable is in establishing reliable reference ranges for our transgender and elderly patients. For transgender patients, these ranges are still being worked through, and I believe the CAP will help guide laboratories in choosing the optimal numbers. For geriatric patients, we may need reference ranges to more accurately represent the physiological differences among people who are 80 years or older. In both cases, we must rely on data to improve our understanding of ideal reference ranges for these patient groups. If you manage a lab, I encourage you to consider the community you serve and make sure that the reference ranges you’re using truly reflect that patient population.

There are many disparities in health care that cannot be fixed with greater attention to a patient’s numbers and how those numbers are generated or interpreted. But whenever we see an opportunity to deliver more equitable care based on laboratory strategies or technologies, we should work together and make the most of it.

Dr. Volk welcomes communication from CAP members. Write to her at president@cap.org.