Race and Use of Physical Restraints: Premature conclusions for "Disparities in Care"?

We read with interest the manuscript by Shnitzer et al.1 on the role of race in physical restraint use and the accompanying invited commentary by Corbin et al.2 We commend the effort put forth in this study as management of agitated patients is a challenging but often overlooked problem. In addition, we agree that racial bias likely exists with regards to physical restraint use, as described in the mental health literature3 and by Dr. Corbin's personal experiences as an African American emergency physician. However, we have several concerns with the methodology as well as the interpretation of the results.