Background Use of race and ethnicity is common in medical tests and procedures, even though these categories are defined by sociological, historical, and political processes, and vary considerably in their definitions over time and place. Because all societies organize themselves around these constructs in some way, they are undeniable facets of the human experience, with myriad health consequences. In the biomedical literature, they are also commonly interpreted as representing biological heterogeneity that is relevant for health and disease. Content We review the use of race and ethnicity in medical practice, especially in the USA, and provide 2 specific examples to represent a large number of similar instances. We then critique these uses along a number of different dimensions, including limitations in measurement, within- versus between-group variance, and implications for informativeness of risk markers for individuals, generalization from arbitrary or nonrepresentative samples, perpetuation of myths and stereotypes, instability in time and place, crowding out of more relevant risk markers, stigmatization, and the tainting of medicine with the history of oppression. We conclude with recommendations to improve practice that are technical, ethical, and pragmatic. Summary Medicine has evolved from a mystical healing art to a mature science of human health through a rigorous process of quantification, experimentation, and evaluation. Folkloric traditions, such as race- and ethnic-specific medicine will fade from use as we become increasingly critical of outdated and irrational clinical practices and replace these with personalized, evidenced-based tests, algorithms, and procedures that privilege patients’ individual humanity over obsolete and misleading labels.

中文翻译：

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在医学测试和诊断中使用种族和民族类别：Primum Non Nocere

背景 种族和民族的使用在医学测试和程序中很常见，尽管这些类别是由社会学、历史和政治过程定义的，并且随着时间和地点的不同而在定义上存在很大差异。因为所有社会都以某种方式围绕这些结构组织起来，所以它们是人类经验中不可否认的方面，会带来无数的健康后果。在生物医学文献中，它们通常也被解释为代表与健康和疾病相关的生物异质性。内容 我们回顾了医疗实践中种族和民族的使用，尤其是在美国，并提供了 2 个具体示例来代表大量类似的实例。然后，我们从多个不同的维度批评这些用途，包括测量的限制，组内与组间差异，以及对个人风险标记信息量的影响、任意或非代表性样本的概括、神话和刻板印象的延续、时间和地点的不稳定性、挤出更多相关风险标记、污名化和污染医学与压迫的历史。最后，我们提出了改进技术、道德和务实实践的建议。总结 医学通过严格的量化、实验和评估过程，从一门神秘的治疗艺术发展成为一门成熟的人类健康科学。随着我们越来越批评过时和不合理的临床实践，取而代之的是个性化、循证测试，民俗传统，如种族和民族特定的医学将逐渐消失，