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- W2040002569 abstract "Theory and research suggest that clinical decision-making is influenced by patient race, provider bias, and clinical ambiguity. Less is known about how these factors interact to influence pain care. In this report, we present preliminary data from an ongoing study in which resident physicians (N=33) made pain assessment (intensity, credibility) and treatment (opioid, non-opioid) decisions for 12 computer-simulated patients. Vignettes included a video and text description of a patient presenting with acute pain. Patient race (White, Black) and clinical ambiguity (low, high) were manipulated across vignettes. Participants also completed measures of implicit and explicit racial bias. We hypothesized: (1) Participants would make different assessment and treatment decisions for White vs. Black and low vs. high ambiguity patients; (2) Participants’ decisions would be more strongly associated with implicit than explicit bias. Idiographic GLM analyses indicated that patient race accounted for unique variance (p<.10) in the assessment and treatment decisions of 6-18% of participants. Significant race differences did not emerge at the nomothetic level due to the considerable individual variability in how participants were influenced by this cue. Ambiguity was a prominent and consistent predictor of participants’ decisions at the idiographic (12-67% of participants) and nomothetic levels; however, the direction of this effect differed across specific decisions. The sample demonstrated moderate-to-strong implicit bias favoring White over Black individuals (mean IAT score =.47, sd=.39) and indicated more positive feelings (explicit bias) toward Whites than Blacks (p<.01). Counter to hypotheses, participants’ explicit, but not implicit, biases were associated (p<.10) with opioid treatment and patient credibility ratings. This study highlights the complexity of pain management and suggests that patient race, provider bias, and clinical ambiguity interact to influence providers’ assessment and treatment decisions. These results may inform efforts to reduce disparities and improve pain care. Funded by an APS Future Leaders in Pain Research grant." @default.
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- W2040002569 date "2014-04-01" @default.
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- W2040002569 title "(511) The influence of patient race, provider bias, and clinical ambiguity on pain assessment and treatment decisions" @default.
- W2040002569 doi "https://doi.org/10.1016/j.jpain.2014.01.423" @default.
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