Unconscious race and class bias: Its association with decision making by trauma and acute care surgeons
Abstract
Background Recent studies have found that unconscious biases may influence physicians' clinical decision making. The objective of our study was to determine, using clinical vignettes, if unconscious race and class biases exist specifically among trauma/acute care surgeons and, if so, whether those biases impact surgeons' clinical decision making. Methods A prospective Web-based survey was administered to active members of the Eastern Association for the Surgery of Trauma. Participants completed nine clinical vignettes, each with three trauma/acute care surgery management questions. Race Implicit Association Test (IAT) and social class IAT assessments were completed by each participant. Multivariable, ordered logistic regression analysis was then used to determine whether implicit biases reflected on the IAT tests were associated with vignette responses. Results In total, 248 members of the Eastern Association for the Surgery of Trauma participated. Of these, 79% explicitly stated that they had no race preferences and 55% stated they had no social class preferences. However, 73.5% of the participants had IAT scores demonstrating an unconscious preference toward white persons; 90.7% demonstrated an implicit preference toward upper social class persons. Only 2 of 27 vignette-based clinical decisions were associated with patient race or social class on univariate analyses. Multivariable analyses revealed no relationship between IAT scores and vignette-based clinical assessments.…
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Three of these studies reported that 90.7% of doctors (n=215), 93% of nurses (n=245) and 86% of medical students (n=211) demonstrated an implicit preference towards people with High SES.
“Three of these studies reported that 90.7% of doctors (n=215)28, 93% of nurses (n=245)29 and 86% of medical students (n=211)27 demonstrated an implicit preference towards people with High SES.”
From Health professionals implicit bias of patients with low socioeconomic status (SES) and its effects on clinical decision-making: a scoping review (2024) · cites this paper as [28]
In these studies, the high levels of implicit SES bias were not evident in HP's decision-making.
“However, in these studies,27–29 the high levels of implicit SES bias were not evident in HP’s decision-making.”
From Health professionals implicit bias of patients with low socioeconomic status (SES) and its effects on clinical decision-making: a scoping review (2024) · cites this paper as [28]
Cites
Tversky, A., & Kahneman, D. (1974) · Science · doi:10.1126/science.185.4157.1124 · Cited by 28,810 · see citing works
Judgment under Uncertainty: Heuristics and Biases
Tversky, A., & Kahneman, D. (1975) · Utility, Probability, and Human Decision Making · doi:10.1007/978-94-010-1834-0_8 · Cited by 22,650 · see citing works
Measuring individual differences in implicit cognition: The implicit association test.
Greenwald, A. G., McGhee, D. E., & Schwartz, J. L. K. (1998) · Journal of Personality and Social Psychology · doi:10.1037//0022-3514.74.6.1464 · Cited by 11,720 · see citing works
Measuring individual differences in implicit cognition: the implicit association test
Greenwald, A. G., McGhee, D. E., & Schwartz, J. L. K. (1998) · Journal of Personality and Social Psychology · doi:10.1037/0022-3514.74.6.1464 · Cited by 9,210 · see citing works
Unequal treatment: confronting racial and ethnic disparities in health care
(2003) · Choice Reviews Online · doi:10.5860/choice.40-5843 · Cited by 7,043 · see citing works
Stereotypes and prejudice: Their automatic and controlled components
Devine, P. G. (1989) · Journal of Personality and Social Psychology · doi:10.1037/0022-3514.56.1.5 · Cited by 5,673 · see citing works
Green, A. R., Carney, D. R., Pallin, D. J., Ngo, L. H., Raymond, K. L., Iezzoni, L. I., & Banaji, M. R. (2007) · Journal of General Internal Medicine · doi:10.1007/s11606-007-0258-5 · Cited by 1,460 · see citing works
Patient-Centered Communication, Ratings of Care, and Concordance of Patient and Physician Race
Cooper, L. A., Roter, D. L., Johnson, R. L., Ford, D. E., Steinwachs, D. M., & Powe, N. R. (2003) · Annals of Internal Medicine · doi:10.7326/0003-4819-139-11-200312020-00009 · Cited by 1,371 · see citing works
Self-citationThe unequal burden of pain: confronting racial and ethnic disparities in pain
Green, C. R., Anderson, K. O., Baker, T. A., Campbell, L. C., Decker, S., Fillingim, R. B., Kaloukalani, D. A., Lasch, K. E., Myers, C., Tait, R. C., et al. (2003) · Pain Medicine · doi:10.1046/j.1526-4637.2003.03034.x · Cited by 1,248 · see citing works
Pervasiveness and correlates of implicit attitudes and stereotypes
Nosek, B. A., Smyth, F. L., Hansen, J. J., Devos, T., Lindner, N. M., Ranganath, K. A., Smith, C. T., Olson, K. R., Chugh, D., Greenwald, A. G., et al. (2007) · European Review of Social Psychology · doi:10.1080/10463280701489053 · Cited by 1,247 · see citing works
The Implicit Association Test at Age 7: A Methodological and Conceptual Review
Nosek, B. A., Greenwald, A. G., & Banaji, M. R. (2007) · Cited by 987 · see citing works
Instructional control of cognitive load in the training of complex cognitive tasks
Paas, F. G. W. C., & Van Merriënboer, J. J. G. (1994) · Educational Psychology Review · doi:10.1007/bf02213420 · Cited by 968 · see citing works
Ethnicity as a Risk Factor for Inadequate Emergency Department Analgesia
Todd, K. H. (1993) · JAMA · doi:10.1001/jama.1993.03500120075029 · Cited by 880 · see citing works
Cooper, L. A., Roter, D. L., Carson, K. A., Beach, M. C., Sabin, J. A., Greenwald, A. G., & Inui, T. S. (2012) · American Journal of Public Health · doi:10.2105/ajph.2011.300558 · Cited by 815 · see citing works
Self-citationEthnicity and analgesic practice
Todd, K. H., Deaton, C., D’Adamo, A. P., & Goe, L. C. (2000) · Annals of Emergency Medicine · doi:10.1016/s0196-0644(00)70099-0 · Cited by 638 · see citing works
Haider, A. H., Scott, V. K., Rehman, K. A., Velopulos, C., Bentley, J. M., Cornwell, E. E., & Al-Refaie, W. (2013) · Journal of the American College of Surgeons · doi:10.1016/j.jamcollsurg.2012.11.014 · Cited by 593 · see citing works
Self-citationPatient–Physician Relationships and Racial Disparities in the Quality of Health Care
Saha, S., Arbelaez, J. J., & Cooper, L. A. (2003) · American Journal of Public Health · doi:10.2105/ajph.93.10.1713 · Cited by 577 · see citing works
Self-citationRace and Insurance Status as Risk Factors for Trauma Mortality
Haider, A. H. (2008) · Archives of Surgery · doi:10.1001/archsurg.143.10.945 · Cited by 507 · see citing works
Self-citationRacial and Ethnic Disparities in Emergency Department Analgesic Prescription
Tamayo‐Sarver, J. H., Hinze, S. W., Cydulka, R. K., & Baker, D. W. (2003) · American Journal of Public Health · doi:10.2105/ajph.93.12.2067 · Cited by 367 · see citing works
Gender Disparity in Analgesic Treatment of Emergency Department Patients with Acute Abdominal Pain
Chen, E. H., Shofer, F. S., Dean, A. J., Hollander, J. E., Baxt, W. G., Robey, J. L., Sease, K. L., & Mills, A. M. (2008) · Academic Emergency Medicine · doi:10.1111/j.1553-2712.2008.00100.x · Cited by 351 · see citing works
Disparities in trauma care and outcomes in the United States
Haider, A. H., Weygandt, P. L., Bentley, J. M., Monn, M. F., Rehman, K. A., Zarzaur, B. L., Crandall, M. L., Cornwell, E. E., & Cooper, L. A. (2013) · The Journal of Trauma: Injury, Infection, and Critical Care · doi:10.1097/ta.0b013e31828c331d · Cited by 332 · see citing works
Self-citationPhysician Implicit Attitudes and Stereotypes About Race and Quality of Medical Care
Sabin, J. A., Rivara, F. P., & Greenwald, A. G. (2008) · Medical Care · doi:10.1097/mlr.0b013e3181653d58 · Cited by 325 · see citing works
Report of the Secretary's Task Force on Black and Minority Health.
(1986) · PubMed · Cited by 309 · see citing works
Haider, A. H., Sexton, J., Sriram, N., Cooper, L. A., Efron, D. T., Swoboda, S., Villegas, C. V., Haut, E. R., Bonds, M., Pronovost, P. J., et al. (2011) · JAMA · doi:10.1001/jama.2011.1248 · Cited by 274 · see citing works
Self-citationDisparities in trauma care and outcomes in the United States: A systematic review and meta-analysis
Haider, A. H., Weygandt, P. L., Bentley, J. M., Monn, M. F., Rehman, K. A., Zarzaur, B. L., Crandall, M. L., Cornwell, E. E., & Cooper, L. A. (2013) · The Journal of Trauma: Injury, Infection, and Critical Care · doi:10.1097/01586154-201305000-00002 · Cited by 248 · see citing works
Self-citationOccupational Status in 2000; Over a Century of Census-Based Measurement
Nam, C. B., & Boyd, M. (2004) · Population Research and Policy Review · doi:10.1023/b:popu.0000040045.51228.34 · Cited by 197 · see citing works
Tamayo-Sarver, J. H., Dawson, N. V., Hinze, S. W., Cydulka, R. K., Wigton, R. S., Albert, J. M., Ibrahim, S. A., & Baker, D. W. (2003) · Academic Emergency Medicine · doi:10.1111/j.1553-2712.2003.tb00608.x · Cited by 126 · see citing works
Haider, A. H. (2011) · Archives of Surgery · doi:10.1001/archsurg.2011.254 · Cited by 106 · see citing works
Self-citationGender and ethnic stereotyping and narcotic analgesic administration
McDonald, D. D. (1994) · Research in Nursing & Health · doi:10.1002/nur.4770170107 · Cited by 93 · see citing works
Disparities in the Use of Primary Prevention and Defibrillator Therapy Among Blacks and Women
Gauri, A. J., Davis, A. M., Hong, T. E., Burke, M. C., & Knight, B. P. (2006) · The American Journal of Medicine · doi:10.1016/j.amjmed.2005.08.021 · Cited by 83 · see citing works
Disparities in Health Care: An Overview
Cohen, J. J. (2003) · Academic Emergency Medicine · doi:10.1111/j.1553-2712.2003.tb00597.x · Cited by 45 · see citing works
Ethnicity and analgesia practice
Todd, K., Deaton, M., D'Adamo, A., & Goe, L. C. (2000) · Research Explorer (The University of Manchester) · Cited by 10 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Maina, I., Belton, T. D., Ginzberg, S. P., Singh, A., & Johnson, T. J. (2017) · Social Science & Medicine (1967) · doi:10.1016/j.socscimed.2017.05.009 · Cited by 716 · see citing works
Racism in healthcare: a scoping review
Hamed, S., Bradby, H., Ahlberg, B. M., & Thapar-Björkert, S. (2022) · BMC Public Health · doi:10.1186/s12889-022-13122-y · Cited by 444 · see citing works
How Socioeconomic Status Affects Patient Perceptions of Health Care: A Qualitative Study.
Arpey, N. C., Gaglioti, A. H., & Rosenbaum, M. E. (2017) · Journal of Primary Care & Community Health · doi:10.1177/2150131917697439 · Cited by 413 · see citing works
A systematic review of the impact of physician implicit racial bias on clinical decision making
Dehon, E., Weiss, N., Jones, J., Faulconer, W., Hinton, E., & Sterling, S. (2017) · Academic Emergency Medicine · doi:10.1111/acem.13214 · Cited by 404 · see citing works
The Effects of Oncologist Implicit Racial Bias in Racially Discordant Oncology Interactions
Penner, L. A., Dovidio, J. F., Gonzalez, R., Albrecht, T. L., Chapman, R., Foster, T. S., Harper, F. W. K., Hagiwara, N., Hamel, L. M., Shields, A. F., et al. (2016) · Journal of Clinical Oncology · doi:10.1200/jco.2015.66.3658 · Cited by 351 · see citing works
Learning to Predict Crisp Boundaries
Deng, R., Shen, C., Liu, S., Wang, H., & Liu, X. (2018) · Lecture notes in computer science · doi:10.1007/978-3-030-01231-1_35 · Cited by 299 · see citing works
The Impact of Cognitive Stressors in the Emergency Department on Physician Implicit Racial Bias
Johnson, T. J., Hickey, R. W., Switzer, G. E., Miller, E. P., Winger, D. G., Nguyen, M. B., Saladino, R. A., & Hausmann, L. R. M. (2016) · Academic Emergency Medicine · doi:10.1111/acem.12901 · Cited by 205 · see citing works
Setting a National Agenda for Surgical Disparities Research
Haider, A. H., Dankwa‐Mullan, I., Maragh‐Bass, A. C., Torain, M. J., Zogg, C. K., Lilley, E. J., Kodadek, L. M., Changoor, N. R., Najjar, P. A., Rose, J. A., et al. (2016) · JAMA Surgery · doi:10.1001/jamasurg.2016.0014 · Cited by 166 · see citing works
Self-citationSurgical Disparities: A Comprehensive Review and New Conceptual Framework
Torain, M. J., Maragh‐Bass, A. C., Dankwa‐Mullan, I., Hisam, B., Kodadek, L. M., Lilley, E. J., Najjar, P. A., Changoor, N. R., Rose, J. A., Zogg, C. K., et al. (2016) · Journal of the American College of Surgeons · doi:10.1016/j.jamcollsurg.2016.04.047 · Cited by 162 · see citing works
Self-citationDisparities in access to emergency general surgery care in the United States
Khubchandani, J. A., Shen, C., Ayturk, D., Kiefe, C. I., & Santry, H. P. (2017) · Surgery · doi:10.1016/j.surg.2017.07.026 · Cited by 153 · see citing works
Culturally Responsive Cognitive Behavioral Therapy for Ethnically Diverse Populations
Huey, S. J., Park, A. L., Galán, C. A., & Wang, C. X. (2023) · Annual Review of Clinical Psychology · doi:10.1146/annurev-clinpsy-080921-072750 · Cited by 160 · see citing works
Comparison of Physician Implicit Racial Bias Toward Adults Versus Children
Johnson, T. J., Winger, D. G., Hickey, R. W., Switzer, G. E., Miller, E. P., Nguyen, M. B., Saladino, R. A., & Hausmann, L. R. M. (2016) · Academic Pediatrics · doi:10.1016/j.acap.2016.08.010 · Cited by 117 · see citing works
Self-Awareness and Cultural Identity as an Effort to Reduce Bias in Medicine
White, A. A. I., Logghe, H. J., Goodenough, D., Barnes, L., Hallward, A., Allen, I., Green, D. W., Krupat, E., & Llerena-Quinn, R. (2018) · Journal of Racial and Ethnic Health Disparities · doi:10.1007/s40615-017-0340-6 · Cited by 95 · see citing works
Gender and ethnic diversity in academic general surgery department leadership
Kassam, A., Taylor, M., Cortez, A. R., Winer, L. K., & Quillin, R. C. (2020) · The American Journal of Surgery · doi:10.1016/j.amjsurg.2020.11.046 · Cited by 104 · see citing works
Shah, A. A., Zogg, C. K., Zafar, S. N., Schneider, E. B., Cooper, L. A., Chapital, A. B., Peterson, S., Havens, J. M., Thorpe, R. J., ROTER, D. L., et al. (2015) · Medical Care · doi:10.1097/mlr.0000000000000444 · Cited by 98 · see citing works
Self-citationRacial disparities in emergency general surgery
Zogg, C. K., Jiang, W., Chaudhary, M. A., Scott, J. W., Shah, A. A., Lipsitz, S. R., Weissman, J. S., Cooper, Z. R., Salim, A., Nitzschke, S. L., et al. (2016) · The Journal of Trauma: Injury, Infection, and Critical Care · doi:10.1097/ta.0000000000001004 · Cited by 97 · see citing works
Self-citationGlover, M., Daye, D., Khalilzadeh, O., Pianykh, O. S., Rosenthal, D. I., Brink, J. A., & Flores, E. J. (2017) · Journal of the American College of Radiology · doi:10.1016/j.jacr.2017.05.015 · Cited by 93 · see citing works
Ladin, K., Emerson, J. G., Berry, K. N., Butt, Z. A., Gordon, E. J., Daniels, N., Lavelle, T. A., & Hanto, D. W. (2018) · American Journal of Transplantation · doi:10.1111/ajt.14962 · Cited by 90 · see citing works
The Role of Bias by Emergency Department Providers in Care for American Indian Children
Puumala, S., Burgess, K. M., Kharbanda, A., Zook, H. G., Castille, D. M., Pickner, W. J., & Payne, N. (2016) · Medical Care · doi:10.1097/mlr.0000000000000533 · Cited by 72 · see citing works
Epidemiology of abdominal aortic aneurysms
Marcaccio, C. L., & Schermerhorn, M. L. (2021) · Seminars in Vascular Surgery · doi:10.1053/j.semvascsurg.2021.02.004 · Cited by 84 · see citing works
Racial and Ethnic Disparities in Radiology: A Call to Action
Betancourt, J. R., Tan‐McGrory, A., Flores, E. J., & López, D. (2019) · Journal of the American College of Radiology · doi:10.1016/j.jacr.2018.12.024 · Cited by 74 · see citing works
Implicit Bias in Pediatric Academic Medicine
Johnson, T. J., Ellison, A. M., Dalembert, G., Fowler, J., Dhingra, M., Shaw, K., & Ibrahim, S. (2017) · Journal of the National Medical Association · doi:10.1016/j.jnma.2017.03.003 · Cited by 67 · see citing works
Racial Implicit Associations in Psychiatric Diagnosis, Treatment, and Compliance Expectations
Tobón, A. L., Flores, J. M., Taylor, J. H., Johnson, I. N. S., Landeros-Weisenberger, A., Aboiralor, O., Avila-Quintero, V., & Bloch, M. (2021) · Academic Psychiatry · doi:10.1007/s40596-020-01370-2 · Cited by 36 · see citing works
Anesthetic Care for Orthopedic Patients
Memtsoudis, S. G., Poeran, J., Zubizarreta, N. J., Rasul, R., Opperer, M., & Mazumdar, M. (2016) · Anesthesiology · doi:10.1097/aln.0000000000001004 · Cited by 65 · see citing works
Unconscious Bias among Health Professionals: A Scoping Review
Meidert, U., Dönnges, G., Bücher, T., Wieber, F., & Gerber‐Grote, A. (2023) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph20166569 · Cited by 72 · see citing works
Conflict Management in the ICU
Kayser, J. B., & Kaplan, L. J. (2020) · Critical Care Medicine · doi:10.1097/ccm.0000000000004440 · Cited by 63 · see citing works
Beldhuis, I. E., Marapin, R. S., Jiang, Y. Y., Simões de Souza, N. F., Georgiou, A., Kaufmann, T., Castela Forte, J., & van der Horst, I. C. C. (2021) · Journal of Critical Care · doi:10.1016/j.jcrc.2021.04.012 · Cited by 58 · see citing works
Hall, J. M., & Carlson, K. (2016) · ANS. Advances in nursing science · doi:10.1097/ans.0000000000000123 · Cited by 42 · see citing works
Anastas, T. M., Miller, M. M., Hollingshead, N. A., Stewart, J. C., Rand, K. L., & Hirsh, A. T. (2020) · Annals of Behavioral Medicine · doi:10.1093/abm/kaaa016 · Cited by 56 · see citing works
Zogg, C. K., Scott, J. W., Jiang, W., Wolf, L. L., & Haider, A. H. (2016) · Surgery · doi:10.1016/j.surg.2016.06.002 · Cited by 55 · see citing works
Self-citationAlbon, D. P., Citters, A. D. V., Ong, T., Dieni, O., Dowd, C., Willis, A., Sabadosa, K. A., Scalia, P., Reno, K., Oates, G. R., et al. (2021) · Journal of Cystic Fibrosis · doi:10.1016/j.jcf.2021.09.006 · Cited by 49 · see citing works
From understanding to action: interventions for surgical disparities.
Hisam, B., Zogg, C., Chaudhary, M. A., Ahmed, A., Khan, H., Selvarajah, S., Torain, M. J., Changoor, N., & Haider, A. (2016) · Journal of Surgical Research · doi:10.1016/j.jss.2015.09.016 · Cited by 47 · see citing works
Self-citationD’Anna, L. H., Hansen, M. C., Mull, B., Canjura, C., Esther, L., & Sumstine, S. (2018) · Social Work in Public Health · doi:10.1080/19371918.2018.1434584 · Cited by 47 · see citing works
Job, C., Adenipekun, B., Cleves, A., Gill, P., & Samuriwo, R. (2024) · BMJ Open · doi:10.1136/bmjopen-2023-081723 · Cited by 44 · see citing works
Racial Bias and Its Impact on Children and Adolescents
Johnson, T. J. (2020) · Pediatric Clinics of North America · doi:10.1016/j.pcl.2019.12.011 · Cited by 43 · see citing works
Health Literacy and Time Spent With a Hand Surgeon
Menendez, M. E., Parrish, R. C., & Ring, D. (2016) · The Journal Of Hand Surgery · doi:10.1016/j.jhsa.2015.12.031 · Cited by 41 · see citing works
Changes in medical student implicit attitudes following a health equity curricular intervention
Leslie, K. F., Sawning, S., Shaw, M. A., Martin, L. J., Simpson, R. C., Stephens, J. E., & Jones, V. (2017) · Medical Teacher · doi:10.1080/0142159x.2017.1403014 · Cited by 34 · see citing works
Racial Implicit Bias and Communication Among Physicians in a Simulated Environment
González, C. M., Ark, T. K., Fisher, M. R., Marantz, P. R., Burgess, D. J., Milan, F. B., Samuel, M. T., Lypson, M. L., Rodríguez, C. J., & Kalet, A. L. (2024) · JAMA Network Open · doi:10.1001/jamanetworkopen.2024.2181 · Cited by 39 · see citing works
Ethnic bias and clinical decision-making among New Zealand medical students: an observational study
Harris, R. B., Cormack, D., Stanley, J., Curtis, E., Jones, R., & Lacey, C. J. (2018) · BMC Medical Education · doi:10.1186/s12909-018-1120-7 · Cited by 40 · see citing works
Racial Disparities in Spine Surgery
Mo, K., Ikwuezunma, I. A., Mun, F., Ortiz-Babilonia, C. D., Wang, K. Y., Suresh, K. V., Uppal, A., Sethi, I., Mesfin, A., & Jain, A. (2022) · Clinical Spine Surgery A Spine Publication · doi:10.1097/bsd.0000000000001383 · Cited by 39 · see citing works
Patient Satisfaction in an Outpatient Hand Surgery Office
Menendez, M. E., Loeffler, M., & Ring, D. (2015) · Quality Management in Health Care · doi:10.1097/qmh.0000000000000074 · Cited by 38 · see citing works
Applied Racial/Ethnic Healthcare Disparities Research Using Implicit Measures
Hagiwara, N., Dovidio, J. F., Stone, J., & Penner, L. A. (2020) · Social Cognition · doi:10.1521/soco.2020.38.supp.s68 · Cited by 38 · see citing works
A systematic review of implicit bias in health care: A call for intersectionality
Ogungbe, O., Mitra, A., & Roberts, J. (2019) · IMC Journal of Medical Science · doi:10.3329/imcjms.v13i1.42050 · Cited by 33 · see citing works
Cohen-Levy, W. B., Lans, J., Salimy, M. S., Melnic, C. M., & Bedair, H. S. (2022) · The Journal of Arthroplasty · doi:10.1016/j.arth.2022.02.041 · Cited by 33 · see citing works
Jala, S., Fry, M., & Elliott, R. M. (2023) · Journal of Clinical Nursing · doi:10.1111/jocn.16845 · Cited by 34 · see citing works
Disparities in surgical outcomes for low socioeconomic status patients in Australia
de Jager, E. C., Gunnarsson, R. K., & Ho, Y. (2022) · ANZ Journal of Surgery · doi:10.1111/ans.17675 · Cited by 32 · see citing works
Implicit Racial Bias in Pediatric Orthopaedic Surgery
Guzek, R. H., Goodbody, C., Jia, L., Sabatini, C., Sankar, W. N., Williams, B. A., & Shah, A. S. (2022) · Journal of pediatric orthopedics · doi:10.1097/bpo.0000000000002170 · Cited by 28 · see citing works
Medical Students' Implicit Bias and the Communication of Norms in Medical Education
Hernandez, R. A. (2018) · Teaching and learning in medicine · doi:10.1080/10401334.2017.1359610 · Cited by 26 · see citing works
The association of insurance status on the probability of transfer for pediatric trauma patients
Hamilton, E. C., Miller, C. C., Cotton, B. A., Cox, C. S., Kao, L. S., & Austin, M. T. (2016) · Journal of Pediatric Surgery · doi:10.1016/j.jpedsurg.2016.09.036 · Cited by 30 · see citing works
Surgical Care for Racial and Ethnic Minorities and Interventions to Address Inequities
Bonner, S. N., Powell, C. A., Stewart, J. W., & Dossett, L. A. (2023) · Annals of Surgery · doi:10.1097/sla.0000000000005858 · Cited by 28 · see citing works
Stapleton, S. M., Bababekov, Y. J., Perez, N. P., Fong, Z. V., Hashimoto, D. A., Lillemoe, K. D., Watkins, M. T., & Chang, D. C. (2018) · Journal of the American College of Surgeons · doi:10.1016/j.jamcollsurg.2017.12.038 · Cited by 27 · see citing works
Context factors in clinical decision-making: a scoping review
Schuler, K., Jung, I.-C., Zerlik, M., Hahn, W., Sedlmayr, M., & Sedlmayr, B. (2025) · BMC Medical Informatics and Decision Making · doi:10.1186/s12911-025-02965-1 · Cited by 31 · see citing works
Factors That Determine Cancer Treatment Choice Among Minority Groups
Luo, T., Spolverato, G., Johnston, F. M., Haider, A. H., & Pawlik, T. M. (2015) · Journal of Oncology Practice · doi:10.1200/jop.2015.003640 · Cited by 26 · see citing works
Self-citationNelson, L. D., Wilson, L., Albrecht, J. S., Arciniegas, D. B., Barthélemy, E. J., Fontaine, S. N., Gardner, R. C., Juengst, S. B., Pappadis, M. R., Ponsford, J. L., et al. (2025) · Journal of Neurotrauma · doi:10.1089/neu.2024.0569 · Cited by 25 · see citing works
Implicit Bias Training in Health Professions Education: A Scoping Review
Mavis, S. C., Caruso, C. G., Dyess, N. F., Carr, C. B., Gerberi, D., & Dadiz, R. (2022) · Medical Science Educator · doi:10.1007/s40670-022-01673-z · Cited by 26 · see citing works
González, C. M., Nava, S., List, J., Liguori, A., & Marantz, P. R. (2021) · MedEdPORTAL · doi:10.15766/mep_2374-8265.11162 · Cited by 23 · see citing works
Insurance Status Biases Trauma-system Utilization and Appropriate Interfacility Transfer
Zogg, C. K., Schuster, K. M., Maung, A. A., & Davis, K. A. (2018) · Annals of Surgery · doi:10.1097/sla.0000000000002954 · Cited by 23 · see citing works
Social Violence, Structural Violence, Hate, and the Trauma Surgeon
Zakrison, T. L., Valdés, D. M., & Muntaner, C. (2019) · International Journal of Health Services · doi:10.1177/0020731419859834 · Cited by 21 · see citing works
Racial Disparities in the Arteriovenous Fistula Care Continuum in Hemodialysis Patients
Qian, J., Lee, T. C., Thamer, M., Zhang, Y., Crews, D. C., & Allon, M. (2020) · Clinical Journal of the American Society of Nephrology · doi:10.2215/cjn.03600320 · Cited by 20 · see citing works
Underrepresented Populations in Pediatric Epilepsy Surgery
Armour, E. A., Yiu, A. J., Shrey, D. W., & Reddy, S. B. (2021) · Seminars in Pediatric Neurology · doi:10.1016/j.spen.2021.100916 · Cited by 20 · see citing works
Lo, C., Ross, P. A., Le, S. N. T., Kim, E. S., Keefer, M., & Rosales, A. (2020) · Children · doi:10.3390/children7120277 · Cited by 19 · see citing works
Scheetz, L. J., & Orazem, J. P. (2020) · Health Services Research · doi:10.1111/1475-6773.13270 · Cited by 19 · see citing works
Race and Insurance Status are Associated With Different Management Strategies After Thoracic Trauma
Salazar, D. R., Velez-Rosborough, A., DiMaggio, C. J., Krowsoski, L. S., Klein, M., Berry, C., Tandon, M., Frangos, S., & Bukur, M. (2021) · Journal of Surgical Research · doi:10.1016/j.jss.2020.11.026 · Cited by 18 · see citing works
Racial bias in cesarean decision-making
Edwards, S., Class, Q. A., Ford, C. E., Alexander, T., & Fleisher, J. D. (2023) · American Journal of Obstetrics & Gynecology MFM · doi:10.1016/j.ajogmf.2023.100927 · Cited by 17 · see citing works
Association of Racial and Socioeconomic Diversity With Implicit Bias in Acute Care Surgery
Zebib, L., Strong, B. L., Moore, G., Ruiz, G., Rattan, R., & Zakrison, T. L. (2019) · JAMA Surgery · doi:10.1001/jamasurg.2018.5855 · Cited by 17 · see citing works
Brandão, T., Campos, L., de Ruddere, L., Goubert, L., & Bernardes, S. F. (2019) · Pain Medicine · doi:10.1093/pm/pnz148 · Cited by 17 · see citing works
Beltrán, S., Lett, E., & Cronholm, P. F. (2019) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2019.06.005 · Cited by 17 · see citing works
Owodunni, O. P., Haut, E. R., Shaffer, D. L., Hobson, D. B., Wang, J., Yenokyan, G., Kraus, P. S., Aboagye, J., Florecki, K. L., Webster, K. L. W., et al. (2020) · PLoS ONE · doi:10.1371/journal.pone.0227339 · Cited by 17 · see citing works
Self-citationLeopold, S. S. (2018) · Clinical Orthopaedics and Related Research · doi:10.1097/corr.0000000000000522 · Cited by 16 · see citing works
Goedderz, A., & Hahn, A. (2022) · Journal of Experimental Social Psychology · doi:10.1016/j.jesp.2022.104374 · Cited by 15 · see citing works
Societal Burden of Trauma and Disparities in Trauma Care
Goddard, S. D., Jarman, M. P., & Hashmi, Z. G. (2023) · Surgical Clinics of North America · doi:10.1016/j.suc.2023.09.009 · Cited by 15 · see citing works
Healthcare staff's racialized talk: The perpetuation of racism in healthcare
Hamed, S., Bradby, H., Thapar‐Björkert, S., & Ahlberg, B. M. (2024) · Social Science & Medicine · doi:10.1016/j.socscimed.2024.117085 · Cited by 15 · see citing works
The Association of Race, Sex, and Insurance With Transfer From Adult to Pediatric Trauma Centers
Kulaylat, A. N., Hollenbeak, C. S., Armen, S. B., Cilley, R. E., & Engbrecht, B. W. (2020) · Pediatric Emergency Care · doi:10.1097/pec.0000000000002137 · Cited by 15 · see citing works
Disparities in Non-Fatal Health Outcomes in Pediatric General Trauma Studies
Ameratunga, S. N., Ramke, J., Jackson, N., Tin, S. T., & Gabbe, B. J. (2017) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph15010043 · Cited by 14 · see citing works
Impact of Race on the Surgical Management of Adhesive Small Bowel Obstruction
Chiu, A. S., Jean, R. A., Davis, K. A., & Pei, K. Y. (2017) · Journal of the American College of Surgeons · doi:10.1016/j.jamcollsurg.2017.11.006 · Cited by 14 · see citing works
Access to post-discharge inpatient care after lower limb trauma
Metcalfe, D., Davis, W. A., Olufajo, O. A., Rios-Diaz, A. J., Chaudhary, M. A., Harris, M. B., Zogg, C. K., Weaver, M. J., & Salim, A. (2016) · Journal of Surgical Research · doi:10.1016/j.jss.2016.02.036 · Cited by 13 · see citing works
#EAST4ALL: An introduction to the EAST equity, quality, and inclusion task force
Bonne, S. L., Williams, B. H., Martin, M. J., Kaafarani, H. M. A., Weaver, W. L., Rattan, R., Byers, P. M., Joseph, D. K., Ferrada, P. A., Joseph, B. A., et al. (2019) · The Journal of Trauma: Injury, Infection, and Critical Care · doi:10.1097/ta.0000000000002360 · Cited by 13 · see citing works
Racial Differences in Treatment Approaches and Mortality Following Arterial Trauma
Moreira, C., Farber, A. M., Rybin, D. V., Doros, G. D., Kalish, J. A., Eberhardt, R. T., Siracuse, J. J., & Hamburg, N. M. (2015) · Vascular and Endovascular Surgery · doi:10.1177/1538574415607360 · Cited by 12 · see citing works
Okafor, P., Stobaugh, D., van Ryn, M., & Talwalkar, J. (2016) · American Journal of Gastroenterology · doi:10.1038/ajg.2016.64 · Cited by 12 · see citing works
The Effects of an Indigenous Health Curriculum for Medical Students
Lewis, M. E. (2020) · Medical Science Educator · doi:10.1007/s40670-020-00971-8 · Cited by 12 · see citing works
Barriers and facilitators to surgical access in underinsured and immigrant populations
Bakillah, E., Brown, D. E., Syvyk, S., Wirtalla, C. J., & Kelz, R. R. (2023) · The American Journal of Surgery · doi:10.1016/j.amjsurg.2023.04.003 · Cited by 11 · see citing works
Georgeades, C., Farazi, M. R., Gainer, H., Flynn‐O’Brien, K. T., Leys, C. M., Gourlay, D. M., & Arendonk, K. J. V. (2022) · Surgery · doi:10.1016/j.surg.2022.06.053 · Cited by 11 · see citing works
Bias in the trauma bay: A multicenter qualitative study on team communication
Bankhead, B. K., Bichard, S. L., Seltzer, T., Thompson, L. A., Chambers, B., Davis, B. P., Knowlton, L. M., Tatebe, L. C., Vella, M. A., & Dumas, R. P. (2023) · The Journal of Trauma: Injury, Infection, and Critical Care · doi:10.1097/ta.0000000000003897 · Cited by 11 · see citing works
Bradby, H., Hamed, S., Thapar‐Björkert, S., & Ahlberg, B. M. (2021) · Scandinavian Journal of Public Health · doi:10.1177/14034948211040963 · Cited by 11 · see citing works
Equal Access Is Quality: an Update on the State of Disparities Research in Trauma
Udyavar, N. R., Perez, S. M., & Haider, A. H. (2018) · Current Trauma Reports · doi:10.1007/s40719-018-0114-6 · Cited by 11 · see citing works
Self-citationDisparities in Care Among Gunshot Victims: A Nationwide Analysis
Henry, R., Liasidis, P., Olson, B., Clark, D. H., Gomez, T. H., Ghafil, C. A., Ding, L., Matsushima, K., Schreiber, M. A., & Inaba, K. (2022) · Journal of Surgical Research · doi:10.1016/j.jss.2022.10.009 · Cited by 10 · see citing works
Merchant, A. A. H., Shaikh, N. Q., Afzal, N., Noorali, A. A., Rahim, K. A., Ahmad, R., Ahmer, A., Khan, A. A., Bakhshi, S. K., Mahmood, S. B. Z., et al. (2023) · PLoS ONE · doi:10.1371/journal.pone.0288549 · Cited by 10 · see citing works
Self-citationHarris, R. B., Cormack, D. M., Curtis, E., Jones, R., Stanley, J., & Lacey, C. J. (2016) · BMC Medical Education · doi:10.1186/s12909-016-0701-6 · Cited by 10 · see citing works
Renson, A., Schubert, F. D., & Bjurlin, M. A. (2018) · Medical Care · doi:10.1097/mlr.0000000000000986 · Cited by 10 · see citing works
Knowlton, L. M., Zakrison, T. L., Kao, L. S., McCrum, M. L., Agarwal, S., Bruns, B. R., Joseph, K.-A. P., & Berry, C. (2023) · Trauma Surgery & Acute Care Open · doi:10.1136/tsaco-2023-001098 · Cited by 9 · see citing works
Gender bias in surgery: A systematic review of qualitative studies
Lech, G. E., Goulart, L. B., Alves, C. H., Aguiar, C. P., Moraes, L. B. L., & Brandão, G. R. (2024) · The American Journal of Surgery · doi:10.1016/j.amjsurg.2024.115974 · Cited by 8 · see citing works
Hughes, T. M., Palmer, E. N., Capers, Q., Abdel‐Misih, S., Harzman, A. E., Beal, E. W., Woelfel, I. A., Noria, S. F., Agnese, D. M., Dillhoff, M. E., et al. (2018) · Annals of Surgical Oncology · doi:10.1245/s10434-018-6564-9 · Cited by 8 · see citing works
Obeid, S., Fanning, A., & Hultman, C. S. (2017) · Plastic & Reconstructive Surgery Global Open · doi:10.1097/gox.0000000000001469 · Cited by 8 · see citing works
Nasser, J. S., Fahmy, J. N., Song, Y., Wang, L., & Chung, K. C. (2023) · JAMA Network Open · doi:10.1001/jamanetworkopen.2023.25487 · Cited by 8 · see citing works
Racial disparities in surgical outcomes: Does the level of resident surgeon play a role?
Changoor, N. R., Ortega, G., Ekladios, M., Zogg, C. K., Cornwell, E. E., & Haider, A. H. (2015) · Surgery · doi:10.1016/j.surg.2015.03.046 · Cited by 8 · see citing works
Self-citationHollingshead, N. A., Matthias, M. S., Bair, M. J., & Hirsh, A. T. (2016) · Digital Scholarship - UNLV (University of Nevada Reno) · Cited by 8 · see citing works
Anastas, T., Wu, W., Burgess, D. J., Stewart, J. C., Salyers, M. P., Kroenke, K., & Hirsh, A. T. (2024) · Journal of Pain · doi:10.1016/j.jpain.2024.01.345 · Cited by 7 · see citing works
Humanizing Trayvon Martin: Racial Profiling, Implicit Biases, and Teacher Education
Desai, S. R. (2016) · Urban Education · doi:10.1177/0042085916646609 · Cited by 7 · see citing works
Racial Disparities in the Cost of Unplanned Hospitalizations after Breast Reconstruction
Nasser, J. S., Billig, J. I., Wang, C., Wang, L., & Chung, K. C. (2023) · Plastic & Reconstructive Surgery · doi:10.1097/prs.0000000000010200 · Cited by 7 · see citing works
Inpatient Trauma Mortality after Implementation of the Affordable Care Act in Illinois
Weygandt, P. L., Dresden, S. M., Powell, E. S., & Feinglass, J. M. (2018) · Western Journal of Emergency Medicine · doi:10.5811/westjem.2017.10.34949 · Cited by 7 · see citing works
- Authors
- Haider, A. H., Schneider, E. B., Sriram, N., Dossick, D. S., Scott, V. K., Swoboda, S. M., Losonczy, L., Haut, E. R., Efron, D. T., Pronovost, P. J., Freischlag, J. A., Lipsett, P. A., Cornwell, E. E., MacKenzie, E. J., & Cooper, L. A.
- Affiliations
- Howard University (US)
- ORCID
- Venue
- Journal of Trauma and Acute Care Surgery
- Published
- 2014-09
- Volume
- 77
- Issue
- 3
- Pages
- 409-416
- ISSN
- 2163-0755 (ISSN-L)
- OpenAlex
- W2123236160
- Cited by
- 147
- References
- 32
- Citations by year
- 2026: 5 · 2025: 11 · 2024: 10 · 2023: 16 · 2022: 19 · 2021: 12 · 2020: 13 · 2019: 10 · 2018: 13 · 2017: 13 · 2016: 18 · 2015: 6
- FWCI
- 31.22
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Trauma: Injury, Infection, and Critical Care (publishedVersion)
- PubMed (publishedVersion)
- eCommons - AKU (Aga Khan University) (submittedVersion)
- Funders
- National Institute of General Medical Sciences (K23GM093112)
- Topics
- Social Sciences › Gender Studies › Diversity and Career in Medicine
- Social Sciences › Sociology and Political Science › Social and Intergroup Psychology
- Social Sciences › Sociology and Political Science › Racial and Ethnic Identity Research
- Keywords
- implicit bias, racial bias, social class bias, trauma surgeons, acute care surgeons, clinical decision-making, clinical vignettes, Implicit Association Test, racial preferences
- MeSH terms
- Adult, Data Collection, Decision Making, Female, Humans, Male, Prejudice, Surveys and Questionnaires, Social Class, Traumatology, United States, Racial Groups, Healthcare Disparities, Racism
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
