HealthDay News — Social class and race biases do not appear to affect clinical decision-making among surgical clinicians, according to a study published online in JAMA Surgery.

Using data from a survey among 215 clinicians, Adil H. Haider, MD, MPH, from the Johns Hopkins University School of Medicine in Baltimore, and colleagues examined whether clinicians’ unconscious race and/or social biases correlate with patient management decisions. Eight clinical vignettes, each with three management questions, were administered to assess the correlation between unconscious bias and clinical decision-making.

The researchers found that most respondents had implicit race and social class biases. The mean differential response times on the Implicit Association Test (IAT D scores) were 0.42 for race and 0.71 for social class among all clinicians, with similar scores across departments. Compared with men, women demonstrated less bias concerning race (mean IAT D score, 0.39 versus 0.44) and social class (mean IAT D score, 0.66 versus 0.82). There was an association between race/social class bias and thee of 27 possible patient-care decisions seen in univariate analysis; in multivariate analysis, no correlation was seen between the IAT D scores and vignette-based clinical assessments.

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“Further research incorporating patient outcomes and data from actual clinical interactions is warranted to clarify the effect of clinician implicit bias on the provision of health care and outcomes,” the authors write.


1. Haider AH. JAMA Surg. 2015;  doi:10.1001/jamasurg.2014.4038t