Jan. 29 (UPI) — Black and Hispanic children in the United States less likely to get imaging tests during visits to the emergency room than White children, according to a study published Friday by JAMA Network Open.
The findings suggest that imaging tests including X-rays, MRIs and CT scans may be overused, or used unnecessarily, in young White ER patients, but that they are “probably” underused in young patients of color, as well, the researchers said.
The root cause likely stems from both patient preferences and implicit bias among providers, they said.
“Something else is going on here that’s beyond the clinical, that’s beyond the diagnoses,” study co-author Dr. Jennifer Marin said in a statement.
“Cultural factors that come with people’s race, gender, religion, etc., should not be associated with testing when getting that test is clearly not beneficial to the patient and potentially harmful,” said Marin, an associate professor of pediatrics, emergency medicine and radiology at the University of Pittsburgh.
Researchers analyzed pediatric emergency department billing data from 52 hospitals in 27 states and Washington, D.C., from 2016 to 2019 to measure racial disparities across all types of diagnostic imaging.
They found that Black children are 18% less likely to receive imaging tests, and Hispanic children are 13% less likely, than White children.
Even after taking other factors, such as health insurance coverage, diagnosis and household income into account, the date showed that doctors were ordering significantly fewer imaging tests for Black and Hispanic children than for White children.
While the data cannot distinguish between a test that was warranted and a test that wasn’t, other studies have found that imaging tests are ordered more frequently in White children compared to those of other races — with no differences in clinical outcomes — the researchers said.
Potential overuse of imaging tests, particularly CT scans and X-rays, could be exposing children to radiation unnecessarily, thus potentially increasing their cancer risk, they said.
“An unnecessary CT at 5 years old is not the same as an unnecessary CT at 70 years old,” Marin said.
“If you think of it in terms of lifetime risk, a five-year-old has 80-ish years to go on and develop malignancy, versus a 70-year-old who only has 15 years,” she said.