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Does Implicit Bias Influence Medical Decision-Making? Developing and Validating Novel Models and Outcome Metrics

隐性偏见会影响医疗决策吗？

基本信息

批准号：
10408707
负责人：
CRISTINA M GONZALEZ
金额：
$ 10.54万
依托单位：
ALBERT EINSTEIN COLLEGE OF MEDICINE
依托单位国家：
美国
项目类别：
财政年份：
2019
资助国家：
美国
起止时间：
2019-08-27 至 2022-09-18
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10408707
关键词：
Address Behavior Black race Calibration Caring Chest Pain Clinical Clinical Research Cognitive Collaborations Communication Communities Conflict (Psychology)Consequentialism Consultations Decision Making Development Educational Intervention Effectiveness Evaluation Exercise Foundations Future Health Occupations Implicit Association Test Individual Institution Intervention Intervention Studies Intervention Trial K-Series Research Career Programs Knowledge Link Measurement Measures Medical Mentors Methods Modeling Outcome Outcome Measure Pain management Patient Care Patient Simulation Patient-Focused Outcomes Patients Pattern Perception Physicians Process Provider Psychometrics Publishing Race Reporting Reproducibility Research Research Design Research Personnel Standardization Statistical Data Interpretation Testing Training Work acute coronary syndrome base black patient clinical care clinical practice communication behavior computerized design effective intervention experience health disparity implicit bias improved medical specialties member negative affect novel primary outcome programs provider behavior racial disparity response secondary outcome simulation skills stressor unconscious bias virtual volunteer

项目摘要

Abstract Implicit, or unconscious, bias may contribute to health disparities via two facets of clinical practice behaviors: communication patterns and medical decision-making. The evidence for a correlation between physician racial implicit bias and disparities in communication by physicians with Black and White patients is strong. In contrast, research investigating the relationship between physician racial implicit bias and medical decision-making, has led to conflicting results. Moreover, investigators seeking to design skills-based interventions to enable physicians to recognize their biases and mitigate their influence on their clinical practice behaviors are limited by the lack of validated outcome metrics, such as checklists and global rating scales. In this proposal Dr. Cristina Gonzalez seeks to build on her expertise as a medical educator and qualitative researcher with new skills in standardized patient case development, psychometric measurement, validity evidence, statistical analysis, and clinical study design. The objectives of the proposal are to develop novel outcome metrics to assess both physician communication and medical decision-making and correlate them with implicit bias. Dr. Gonzalez will design high-fidelity standardized patient cases. Through a mixed-method approach, she will develop novel outcome measures in the form of validated checklists and global rating scales to assess specific clinical practice behaviors. The final aim of this proposal is a clinical study to examine any correlation between implicit bias and medical decision-making. The outcome of this final aim will address an important gap in knowledge relevant to the design future intervention studies. Dr. Gonzalez will emerge from this K award transformed from a medical educator into a clinician investigator able to conduct multi-institution intervention studies addressing physician racial implicit bias and patient outcomes.

摘要隐含的或无意识的偏见可能通过临床的两个方面导致健康差异实践行为：沟通模式与医疗决策。有证据表明，医生种族内隐偏见与沟通差异的相关性研究有黑人和白人病人的医生是强大的。相比之下，研究人员调查了医生种族内隐偏见与医疗决策的关系，导致了相互矛盾的结果。此外，寻求设计基于技能的干预措施的调查人员使医生认识到他们的偏见，并减轻他们对临床实践的影响行为受到缺乏有效结果衡量标准的限制，如核对表和全球评级等级。在这项建议中，克里斯蒂娜·冈萨雷斯博士试图利用她作为一名医生的专业知识在标准化患者病例开发方面拥有新技能的教育工作者和定性研究人员，心理测量，效度证据，统计分析，临床研究设计。这个该提案的目标是开发新的结果指标来评估两位医生沟通和医疗决策，并将它们与隐性偏见相关联。Dr。冈萨雷斯将设计高保真的标准化患者病例。通过混合方法她将以有效核对清单的形式制定新的成果衡量标准，并评估特定临床实践行为的全球评级标准。这项提议的最终目的是一项临床研究，旨在检验内隐偏见和医疗决策之间的任何相关性。这一最终目标的结果将解决与设计相关的知识的一个重要缺口未来的干预研究。冈萨雷斯博士将从这个K奖中脱颖而出将医学教育者转变为能够进行多机构干预的临床医生研究员关于医生种族隐含偏见和患者结局的研究。