Critically appraising for antiracism

Abstract

Racial bias in research impacts a study’s relevancy, validity and reliability, though presently this aspect is not addressed in critical appraisal tools, and consequently appraisers may not take racial bias into account when assessing a paper’s quality. Drawing on Critical Race Theory (CRT) tenets that racism is ubiquitous and race a social construct, this paper discusses concerns regarding racism in research which have been broadly divided into two categories for critical appraisers to consider: the underrepresentation of minoritised ethnic groups in health studies, especially where minoritised populations see higher rates of disease occurrence and; the utilisation of racial/ethnicity data to interpret disparities in outcomes, including speculation of biological race, the misinterpretation of genetic ancestry as race, and the lack of investigation into social determinants of health, including systemic, institutional and interpersonal forms of racism. The injustices exposed in this paper impact the health of minoritised ethnic groups and are therefore a Black Lives Matter issue. They risk resurrecting dangerous theories regarding biological inferiority among minoritised ethnic populations, as well as hindering study findings. The application of CRT frameworks in health science research quality appraisal are discussed in relation to the above themes – using largely UK-based contexts with supporting examples from the US – followed by recommendations for critically appraising for antiracism. Further information to support critically appraising for antiracism can be found via https://www.criticallyappraisingantiracism.org/.

Catalogue of bias: racial bias

“…The STRIDE Project15 has produced eight recommendations specifically focused on enhancing the inclusion of ethnic groups in clinical trials. Additionally, the NIHR INCLUDE guideline16 was created to support the inclusion of under-served groups in research, while the Critically Appraising for Antiracism Tool serves as a valuable aid to researchers by identifying and addressing potential concerns related to racial bias in research 17…”

Health information equity: Rebalancing healthcare collections for racial diversity in UK public service contexts

“…Despite this, outdated beliefs around racial characteristics persist in medicine and science (Saini, 2019, p. 73, p. 120;Massie et al, 2021). Survey findings suggest lower awareness of critical appraisal for racial bias, as discussed by Naicker (2021), compared to other EDI workstreams, indicating a disparity in confidence to interrogate race in the scientific domain. While acknowledged as arbitrary, and non-biologic, racial categorisations are now key metrics in identifying and reducing health disparities (Pérez-Stable et al, 2021).…”