The study by Rama A. Salhi, MD, MHS, MSC, and colleagues examines the frequency of discordant documentation of patient race and ethnicity in emergency department (ED) visits. The research is crucial for assessing equity in medical research and quality measurement in the US, as accurate race and ethnicity data are essential for equity improvement efforts. The study analyzed data from a statewide, multicenter registry of ED visits in Michigan from December 1, 2018, to November 30, 2021, focusing on patients with at least two ED visits to the same hospital or health system. The primary outcome was the frequency of discordant documentation of race and ethnicity between ED visits. The results showed that 1.7% of adult patients and 7.0% of children had discordant racial and ethnic data across visits. Among adults, patients categorized as Black or other on the first visit had the highest proportions of discordant documentation (25.8% and 38.7%, respectively). Among children, those categorized as White, multiracial, or other on their first visit had the highest proportions of discordant documentation (32.3%, 17.7%, and 22.7%, respectively). The study highlights significant variability and inconsistency in the approach to assigning race and ethnicity, which can introduce errors into measurement, resource distribution, predictive modeling, policy, and reimbursement. The findings underscore the need for increased investment in best practices for primary data collection, particularly in the ED, to improve data quality and accuracy.The study by Rama A. Salhi, MD, MHS, MSC, and colleagues examines the frequency of discordant documentation of patient race and ethnicity in emergency department (ED) visits. The research is crucial for assessing equity in medical research and quality measurement in the US, as accurate race and ethnicity data are essential for equity improvement efforts. The study analyzed data from a statewide, multicenter registry of ED visits in Michigan from December 1, 2018, to November 30, 2021, focusing on patients with at least two ED visits to the same hospital or health system. The primary outcome was the frequency of discordant documentation of race and ethnicity between ED visits. The results showed that 1.7% of adult patients and 7.0% of children had discordant racial and ethnic data across visits. Among adults, patients categorized as Black or other on the first visit had the highest proportions of discordant documentation (25.8% and 38.7%, respectively). Among children, those categorized as White, multiracial, or other on their first visit had the highest proportions of discordant documentation (32.3%, 17.7%, and 22.7%, respectively). The study highlights significant variability and inconsistency in the approach to assigning race and ethnicity, which can introduce errors into measurement, resource distribution, predictive modeling, policy, and reimbursement. The findings underscore the need for increased investment in best practices for primary data collection, particularly in the ED, to improve data quality and accuracy.