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Does Race Influence Risk Assessment and Recommendations for Lung Resection? A Randomized Trial
Mark K Ferguson1, Carley Demchuk2, Kristen Wroblewski3
1Department of Surgery, University of Chicago, Chicago, Illinois; Comprehensive Cancer Center, University of Chicago, Chicago, Illinois.
The Annals of Thoracic Surgery
|June 15, 2018
Summary
Physician race and standardized patient race did not influence surgical risk estimates or recommendations for lung cancer surgery. This study did not explain racial disparities in lung cancer treatment.
Area of Science:
- Medical research
- Surgical oncology
- Health disparities
Background:
- Racial disparities in lung cancer surgical treatment are documented in the U.S.
- Standardized patients (SPs) in videos can reveal factors influencing physician risk assessment.
- This study investigated if physician and SP race impact surgical decision-making.
Purpose of the Study:
- To determine if physician race influences surgical risk estimation and treatment recommendations.
- To assess if the race of standardized patients in videos affects surgeons' decisions.
- To explore potential reasons for racial disparities in lung cancer surgical therapy.
Main Methods:
- 113 surgeons (trainees and practicing) evaluated race-neutral vignettes of lung resection candidates.
- Surgeons provided initial risk estimates, viewed videos of Black or White SPs, and gave final risk estimates.
- Likelihood of recommending surgery and changes in risk estimates were analyzed in relation to patient and physician race.
Main Results:
- No significant association was found between patient race and changes in risk estimates (p=0.11).
- Physician race (White vs. other) did not significantly impact risk estimation (p=0.52) or surgical recommendations (p=0.79).
- Videos featuring Black SPs led to similar surgical recommendations as videos with White SPs (p=0.90).
Conclusions:
- Physician and patient race were not significant factors in surgical risk assessment or treatment recommendations in this study.
- The findings do not explain the observed racial disparities in lung cancer surgical treatment.
- Further research is necessary to uncover the mechanisms behind these disparities in care.
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