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Ethnicity and Emergency Department Analgesia-Reply

Knox H. Todd, MD; Jerome R. Hoffman, MD
JAMA. 1993;270(7):831-832. doi:10.1001/jama.1993.03510070053032.
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In Reply.  —Dr Mariani suggests that levels of pain and distress recorded in physicians' and nurses' notes might explain the disparity in analgesic administration between Hispanics and non-Hispanic whites. While we agree that this is an important question, such data tend to be inconsistently and imprecisely recorded in the medical record and thus could not be measured with any accuracy. We recently completed a study of the effect of ethnicity on the ability of physicians to assess pain accurately, and we plan to report these findings in the near future.Dr Morfesis questions whether alcohol intoxication, severity of injury, or socioeconomic status might confound our results. As noted in our discussion, records mentioning alcohol or other drug use were excluded, and time of day, occupational injury, and mechanism were controlled as potential proxies for alcohol or other drug use, with no change in our results. In addition, Hispanics tended to


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