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Act I: Inherited Decisions

Step 3Live-room allocation: 5:00

Open in Colab — 01_act1.ipynb, opens in a new tab
A group of clinicians seen from behind or in profile against a teal background. Most wear white coats; one person, with darker skin, wears teal scrubs.

The people in the room inherit the equation. None of them wrote it. Illustration: Brian Stauffer.

One patient crossing one line is an anecdote. The question is how many patients, and at which lines.

Every threshold below is one a clinician acts on. Run the same two equations across all 14,788 adults in the cohort and count who lands on a different side.

Threshold What it gates Black adults Non-Black adults
60 CKD (eGFR<60)2.41%0.00%
45 G3b0.79%0.00%
20 Transplant referral proxy0.03%0.00%

2.41% of Black adults in this cohort are newly classified as having chronic kidney disease once the race coefficient comes out. Not because anything about them changed — the blood draw is the same blood draw. The equation changed.

The same shift moves 0.79% across the G3b boundary, where dosing guidance tightens, and 0.03% across the threshold used as a transplant-referral proxy. The numbers get smaller as the thresholds get more consequential. They do not reach zero.

The right-hand column is 0.00% at every threshold, and it is the most misread number on this page.

It does not mean nothing happened to Non-Black adults. It means nothing happened in this direction. This table counts people moving into a diagnosis. It does not count people moving out of one.

The next step counts both.