A Systematic Review of the Impact of Physician Implicit Racial Bias on Clinical Decision Making

作者：Erin E. Dehon, Nicole H. Weiss, Jonathan Spencer Jones, Whitney Faulconer, Elizabeth G. Hinton, Sarah M. Sterling · 发表于：Academic Emergency Medicine · 年份：2017 · DOI：10.1111/acem.13214 · 被引用次数：413 · 研究领域：Racial and Ethnic Identity Research、Diversity and Career in Medicine、Social and Intergroup Psychology

OBJECTIVES: Disparities in diagnosis and treatment of racial minorities exist in the emergency department (ED). A better understanding of how physician implicit (unconscious) bias contributes to these disparities may help identify ways to eliminate such racial disparities. The objective of this systematic review was to examine and summarize the evidence on the association between physician implicit racial bias and clinical decision making. METHODS: Based on PRISMA guidelines, a structured electronic literature search of PubMed, CINAHL, Scopus, and PsycINFO databases was conducted. Eligible studies were those that: 1) included physicians, 2) included the Implicit Association Test as a measure of implicit bias, 3) included an assessment of physician clinical decision making, and 4) were published in peer-reviewed journals between 1998 and 2016. Articles were reviewed for inclusion by two independent investigators. Data extraction was performed by one investigator and checked for accuracy by a second investigator. Two investigators independently scored the quality of articles using a modified version of the Downs and Black checklist. RESULTS: Of the 1,154 unique articles identified in the initial search, nine studies (n = 1,910) met inclusion criteria. Three of the nine studies involved emergency providers including residents, attending physicians, and advanced practice providers. The majority of studies used clinical vignettes to examine clinical decision making. Studies that i...