Do clinicians have an implicit bias in favor of specific disease over nonspecific illness?
Conscious bias
Explicit bias
Implicit bias
Musculoskeletal
Nonspecific illnesses
Specific illnesses
Unconscious bias
Journal
Journal of psychosomatic research
ISSN: 1879-1360
Titre abrégé: J Psychosom Res
Pays: England
ID NLM: 0376333
Informations de publication
Date de publication:
12 2022
12 2022
Historique:
received:
07
03
2022
revised:
03
10
2022
accepted:
04
10
2022
pubmed:
22
10
2022
medline:
7
12
2022
entrez:
21
10
2022
Statut:
ppublish
Résumé
Some patients and clinicians have an explicit preference to associate symptoms with specific pathology. This bias can manifest in relatively specific names for illnesses with nonspecific symptoms and signs such as radial tunnel syndrome, repetitive strain injury, and fibromyalgia. This might be a manifestation of a desire for a sense of control and measurable as an unconscious bias for specific over non-specific illnesses. There are no factors independently associated with orthopedic surgeon unconscious bias against non-specific illness; Is there a relationship between clinician unconscious bias and clinician explicit preference regarding non-specific illness? An implicit association test was used to evaluate clinician implicit bias regarding specific and nonspecific illnesses. Demographic information and explicit preference were collected from consented clinicians. Musculoskeletal clinicians have moderate explicit (conscious) and implicit (unconscious) bias in favor of specific illnesses over nonspecific illnesses. Musculoskeletal clinicians explicitly and implicitly favor specific over nonspecific illnesses. Given the notable prevalence of symptoms that are never associated with discrete pathology, care strategies designed to neutralize bias against non-specific illness have the potential to reduce low value tests and treatments; 2) avoid diagnoses that imply specific pathology when the illness is characterized by the absence of verifiable objective pathology; and 3) prioritize interventions known to enhance health among people with no identifiable pathology.
Sections du résumé
BACKGROUND
Some patients and clinicians have an explicit preference to associate symptoms with specific pathology. This bias can manifest in relatively specific names for illnesses with nonspecific symptoms and signs such as radial tunnel syndrome, repetitive strain injury, and fibromyalgia. This might be a manifestation of a desire for a sense of control and measurable as an unconscious bias for specific over non-specific illnesses.
QUESTIONS
There are no factors independently associated with orthopedic surgeon unconscious bias against non-specific illness; Is there a relationship between clinician unconscious bias and clinician explicit preference regarding non-specific illness?
PATIENTS AND METHODS
An implicit association test was used to evaluate clinician implicit bias regarding specific and nonspecific illnesses. Demographic information and explicit preference were collected from consented clinicians.
RESULTS
Musculoskeletal clinicians have moderate explicit (conscious) and implicit (unconscious) bias in favor of specific illnesses over nonspecific illnesses.
CONCLUSIONS
Musculoskeletal clinicians explicitly and implicitly favor specific over nonspecific illnesses.
CLINICAL RELEVANCE
Given the notable prevalence of symptoms that are never associated with discrete pathology, care strategies designed to neutralize bias against non-specific illness have the potential to reduce low value tests and treatments; 2) avoid diagnoses that imply specific pathology when the illness is characterized by the absence of verifiable objective pathology; and 3) prioritize interventions known to enhance health among people with no identifiable pathology.
Identifiants
pubmed: 36270118
pii: S0022-3999(22)00347-6
doi: 10.1016/j.jpsychores.2022.111062
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
111062Informations de copyright
Copyright © 2022 Elsevier Inc. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of Competing Interest No benefits in any form have been received or will be received related directly or indirectly to the subject of this article. RK and JK certify that they have no commercial associations (e.g. consultancies, stock ownership, equity interest, patent/licensing arrangements, etc.) that might pose a conflict of interest in connection with the submitted article. DR has or may receive payment or benefits from Skeletal Dynamics for elbow implants, Deputy Editor for Clinical Orthopaedics and Related Research, Universities and Hospitals, Lawyers outside the submitted work.