Intention to Treat

The ripple effects of U.S. anti-DEI policies extend far beyond individual labs: scientific discovery is slowing, early‑career investigators are reconsidering their futures, and the pipeline of medical school applicants is shifting in real time. A full transcript of this episode is available at https://www.nejm.org/doi/full/10.1056/NEJMp2601982.

The use of race in medicine is harming patients. What is being done to move away from these practices and to change a culture of medicine based on the false premise that race is biological? A full transcript of this episode is available at https://www.nejm.org/doi/full/10.1056/NEJMp2601981.

We now know that humans are more than 99.9% genetically alike. So why does medicine still link certain diseases to race? And what do genetics actually tell us about race, ancestry, and disease? A full transcript of this episode is available at https://www.nejm.org/doi/full/10.1056/NEJMp2601980.

How did a drug for congestive heart failure get approved and marketed for Black people only? A full transcript of this episode is available at https://www.nejm.org/doi/full/10.1056/NEJMp2601978.

The story of the pulse oximeter demonstrates that sometimes consideration of race is critical to diagnosis and treatment — as came starkly into light during the Covid-19 pandemic. A full transcript of this episode is available at https://www.nejm.org/doi/full/10.1056/NEJMp2601977.

Many Black veterans live below the poverty line, often struggling to manage their illnesses. As V.A. hospitals began to stop using race-corrected interpretation of Black patients’ spirometer readings, there was an epiphany: the race correction wasn’t just harming the health of Black patients, it was also hurting them financially. A full transcript of this episode is available at https://www.nejm.org/doi/full/10.1056/NEJMp2601976.

The history of race-based correction of lung-capacity measures can be traced to a pre–Civil War belief among slave owners that slaves had naturally inferior lung capacity. Despite work to show that race-corrected spirometers mask lung-disease severity in Black patients, the majority of U.S. hospitals still use them. A full transcript of this episode is available at https://www.nejm.org/doi/full/10.1056/NEJMp2601975.

Many clinical algorithms, including the eGFR test for kidney function, have actually had race baked into them and produce different results for Black patients. Most of us assume these algorithms are based on science, but what if the science is wrong? A full transcript of this episode is available at https://www.nejm.org/doi/full/10.1056/NEJMp2601974.

What happens when medicine gets race wrong? In a new 8-week series, The Race Equation confronts harmful assumptions about race in clinical medicine, why they endure, and what it will take to change. ​ ​Follow “Intention to Treat” on Apple Podcasts or wherever you get your podcasts.

New research using functional brain imaging reveals that many patients considered to be in a coma or vegetative state and who are unresponsive may actually be conscious and aware. A full transcript of this episode is available at nejm.org/doi/full/10.1056/NEJMp2408662.

The millions of people worldwide who are suffering from a vast array of disabling symptoms long after being infected with SARS-CoV-2 may eventually benefit from a new consensus definition of long Covid. A full transcript of this episode is available at nejm.org/doi/full/10.1056/NEJMp2407614.

In recent years, substantial progress has been made in developing brain-computer interfaces that could restore the ability of patients with neurodegenerative diseases and other conditions to communicate. A full transcript of this episode is available at nejm.org/doi/full/10.1056/NEJMp2407613.

As race-based diagnostic tools, such as pulse oximeters that function poorly on darker skin, continue to lead to inequitable care, a growing movement is working to weed them out of U.S. health care. A full transcript of this episode is available at nejm.org/doi/full/10.1056/NEJMp2407611.

A key measure of kidney function and a risk calculator for vaginal birth after cesarean delivery are among the many tools that have long contributed to health and health care inequities for Black patients. A full transcript of this episode is available at nejm.org/doi/full/10.1056/NEJMp2405797.

Claims that Black people had lower lung capacity than White people led to race-adjusted spirometry and poorer care for Black patients with lung disease. New equations are starting to change that. A full transcript of this episode is available at nejm.org/doi/full/10.1056/NEJMp2405796.

A new strain of H5N1 influenza is spreading in dairy cows in the United States. Will it cause an epidemic in humans? And what does our public health system need to do in order to be ready if it does? A full transcript of this episode is available at nejm.org/doi/full/10.1056/NEJMp2405795.

In the face of a growing childhood obesity epidemic, some parents and clinicians are turning to new tools such as GLP-1 receptor agonists. This episode explores the implications of that trend. A full transcript of this episode is available at nejm.org/doi/full/10.1056/NEJMp2400703.

This episode considers a new treatment for hypertrophic cardiomyopathy, the world’s most common inherited heart condition, which most affected people don’t even realize they have. A full transcript of this episode is available at nejm.org/doi/full/10.1056/NEJMp2400702.

This episode examines CAR T-cell therapy’s early successes, broader promise, and emerging risks, as the FDA considers reports of occasional secondary cancers. A full transcript of this episode is available at nejm.org/doi/full/10.1056/NEJMp2400701.

This episode explores the fastest-growing neurologic condition in the world, Parkinson’s disease. What have we learned in recent years, and where are the greatest hopes for the future? A full transcript of this episode is available at nejm.org/doi/full/10.1056/NEJMp2414003.