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In Reply Adler and Yeh are to be commended for their culturally aware, close reading of our recent article1; we sincerely appreciate their thoughtfulness. Simply, patients self-identifying as racially white and ethnically “Hispanic or Latino” were categorized as Hispanic. This is not explicitly stated in the Methods section as published. Previous studies in this and other journals have published comparisons in similar fashion,2 and the Nationwide Inpatient Sample collects Hispanic ethnicity within the same variable as racial information.3 Of the 78 774 patients who self-identified as ethnically Hispanic in the US Renal Data System cohort (2006-2010), 74 239 (94.2%) also considered themselves racially white. It seems that these cultural values require an explicit standard to ensure a uniform analytical approach by researchers and relevant conclusions, as Adler and Yeh noted JAMA called for a decade ago.4
Zarkowsky DS, Canner JK, Malas MB. Identification of Race and Ethnicity in Large Databases—Reply. JAMA Surg. 2015;150(11):1099-1100. doi:10.1001/jamasurg.2015.2231