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Racial bias is everywhere in medicine, including the calculators doctors commonly use to predict a patient’s risk of disease and inform their treatment. A growing movement is encouraging medical specialties and hospitals to reconsider the use of race in those tools.

But a new study shows that removing bias isn’t as simple as taking race out of the equation.

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Using records from thousands of colorectal cancer patients in California, researchers from the University of Washington tested the performance of four algorithms that predicted the likelihood cancer would return after a tumor was removed. The model that included race and ethnicity as a predictive variable, they found, performed more equally across groups than a model with race redacted.

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