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The reduction of race and gender bias in clinical treatment recommendations using clinician peer networks in an experimental setting

Bias in clinical practice, in particular in relation to race and gender, is a persistent cause of healthcare disparities. We investigated the potential of a peer-network approach to reduce bias in medical treatment decisions within an experimental setting. We created “egalitarian” information exchan...

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Autores principales: Centola, Damon, Guilbeault, Douglas, Sarkar, Urmimala, Khoong, Elaine, Zhang, Jingwen
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group UK 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8593068/
https://www.ncbi.nlm.nih.gov/pubmed/34782636
http://dx.doi.org/10.1038/s41467-021-26905-5
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author Centola, Damon
Guilbeault, Douglas
Sarkar, Urmimala
Khoong, Elaine
Zhang, Jingwen
author_facet Centola, Damon
Guilbeault, Douglas
Sarkar, Urmimala
Khoong, Elaine
Zhang, Jingwen
author_sort Centola, Damon
collection PubMed
description Bias in clinical practice, in particular in relation to race and gender, is a persistent cause of healthcare disparities. We investigated the potential of a peer-network approach to reduce bias in medical treatment decisions within an experimental setting. We created “egalitarian” information exchange networks among practicing clinicians who provided recommendations for the clinical management of patient scenarios, presented via standardized patient videos of actors portraying patients with cardiac chest pain. The videos, which were standardized for relevant clinical factors, presented either a white male actor or Black female actor of similar age, wearing the same attire and in the same clinical setting, portraying a patient with clinically significant chest pain symptoms. We found significant disparities in the treatment recommendations given to the white male patient-actor and Black female patient-actor, which when translated into real clinical scenarios would result in the Black female patient being significantly more likely to receive unsafe undertreatment, rather than the guideline-recommended treatment. In the experimental control group, clinicians who were asked to independently reflect on the standardized patient videos did not show any significant reduction in bias. However, clinicians who exchanged real-time information in structured peer networks significantly improved their clinical accuracy and showed no bias in their final recommendations. The findings indicate that clinician network interventions might be used in healthcare settings to reduce significant disparities in patient treatment.
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spelling pubmed-85930682021-11-19 The reduction of race and gender bias in clinical treatment recommendations using clinician peer networks in an experimental setting Centola, Damon Guilbeault, Douglas Sarkar, Urmimala Khoong, Elaine Zhang, Jingwen Nat Commun Article Bias in clinical practice, in particular in relation to race and gender, is a persistent cause of healthcare disparities. We investigated the potential of a peer-network approach to reduce bias in medical treatment decisions within an experimental setting. We created “egalitarian” information exchange networks among practicing clinicians who provided recommendations for the clinical management of patient scenarios, presented via standardized patient videos of actors portraying patients with cardiac chest pain. The videos, which were standardized for relevant clinical factors, presented either a white male actor or Black female actor of similar age, wearing the same attire and in the same clinical setting, portraying a patient with clinically significant chest pain symptoms. We found significant disparities in the treatment recommendations given to the white male patient-actor and Black female patient-actor, which when translated into real clinical scenarios would result in the Black female patient being significantly more likely to receive unsafe undertreatment, rather than the guideline-recommended treatment. In the experimental control group, clinicians who were asked to independently reflect on the standardized patient videos did not show any significant reduction in bias. However, clinicians who exchanged real-time information in structured peer networks significantly improved their clinical accuracy and showed no bias in their final recommendations. The findings indicate that clinician network interventions might be used in healthcare settings to reduce significant disparities in patient treatment. Nature Publishing Group UK 2021-11-15 /pmc/articles/PMC8593068/ /pubmed/34782636 http://dx.doi.org/10.1038/s41467-021-26905-5 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Article
Centola, Damon
Guilbeault, Douglas
Sarkar, Urmimala
Khoong, Elaine
Zhang, Jingwen
The reduction of race and gender bias in clinical treatment recommendations using clinician peer networks in an experimental setting
title The reduction of race and gender bias in clinical treatment recommendations using clinician peer networks in an experimental setting
title_full The reduction of race and gender bias in clinical treatment recommendations using clinician peer networks in an experimental setting
title_fullStr The reduction of race and gender bias in clinical treatment recommendations using clinician peer networks in an experimental setting
title_full_unstemmed The reduction of race and gender bias in clinical treatment recommendations using clinician peer networks in an experimental setting
title_short The reduction of race and gender bias in clinical treatment recommendations using clinician peer networks in an experimental setting
title_sort reduction of race and gender bias in clinical treatment recommendations using clinician peer networks in an experimental setting
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8593068/
https://www.ncbi.nlm.nih.gov/pubmed/34782636
http://dx.doi.org/10.1038/s41467-021-26905-5
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