Provider Implicit Racial Bias in Pediatric Sickle Cell Disease

Area of Science:

• Medical Ethics
• Health Disparities
• Pediatric Care

Background:

• Implicit racial bias is a concern in healthcare.
• Sickle cell disease (SCD) disproportionately affects minority populations, highlighting potential disparities in care.

Purpose of the Study:

• To assess implicit racial bias in pediatric providers.
• To determine if implicit racial bias impacts clinical decision-making in pediatric sickle cell disease (SCD) pain management using virtual patient (VP) vignettes.

Main Methods:

• A cross-sectional study involved 52 pediatric SCD providers.
• Providers completed the race Implicit Association Test (IAT) and an explicit bias measure.
• Clinical decisions were simulated using VP vignettes of pediatric patients with SCD or cancer pain.

Main Results:

• Providers exhibited pro-White implicit bias on the race IAT for both adult and child faces.
• Explicit bias measures showed low agreement with negative SCD patient stereotypes.
• No significant differences were found in pain treatment decisions based on patient race or diagnosis (SCD vs. cancer).

Conclusions:

• Pediatric providers demonstrate implicit racial bias comparable to the general population.
• VP vignettes did not show race or diagnosis influencing pain treatment decisions, possibly due to standardized emergency department protocols.
• Further research is needed to understand implicit bias in clinical decision-making and the effectiveness of protocols in pediatric SCD pain care.