Explicit Bias Toward High-Income-Country Research: A Randomized, Blinded, Crossover Experiment of English Clinicians
Abstract
Unconscious bias may interfere with the interpretation of research from some settings, particularly from lower-income countries. Most studies of this phenomenon have relied on indirect outcomes such as article citation counts and publication rates; few have addressed or proven the effect of unconscious bias in evidence interpretation. In this randomized, blinded crossover experiment in a sample of 347 English clinicians, we demonstrate that changing the source of a research abstract from a low- to a high-income country significantly improves how it is viewed, all else being equal. Using fixed-effects models, we measured differences in ratings for strength of evidence, relevance, and likelihood of referral to a peer. Having a high-income-country source had a significant overall impact on respondents' ratings of relevance and recommendation to a peer. Unconscious bias can have far-reaching implications for the diffusion of knowledge and innovations from low-income countries.
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Global research and innovation are skewed towards the West.
“Furthermore, global research and innovation are skewed towards the West [37].”
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Kola, L., Kohrt, B. A., Hanlon, C., Naslund, J. A., Sikander, S., Balaji, M., Benjet, C., Cheung, E. Y. L., Eaton, J., Gonsalves, P., et al. (2021) · The Lancet Psychiatry · doi:10.1016/s2215-0366(21)00025-0 · Cited by 835 · see citing works
Implicit bias in healthcare: clinical practice, research and decision making
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- Authors
- Harris, M., Marti, J., Watt, H., Bhatti, Y., Macinko, J., & Darzi, A. W.
- Affiliations
- Imperial College London (GB)
- University of California, Los Angeles (US)
- Venue
- Health Affairs
- Publisher
- Health Affairs Publishing, LLC
- Published
- 2017-11
- Volume
- 36
- Issue
- 11
- Pages
- 1997-2004
- ISSN
- 0278-2715 (ISSN-L)
- 1544-5208
- OpenAlex
- W2767709396
- Cited by
- 119
- References
- 5
- Citations by year
- 2026: 10 · 2025: 10 · 2024: 14 · 2023: 13 · 2022: 25 · 2021: 19 · 2020: 11 · 2019: 10 · 2018: 5 · 2017: 2
- FWCI
- 6.89
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Health Affairs (publishedVersion)
- PubMed (publishedVersion)
- Queen Mary Research Online (Queen Mary University of London) (submittedVersion)
- Spiral (Imperial College London) (submittedVersion)
- Funders
- National Institute for Health and Care Research (CL-2010-21-014)
- Topics
- Social Sciences › Decision Sciences › Statistics, Probability and Uncertainty › Meta-analysis and systematic reviews
- Social Sciences › Decision Sciences › Statistics, Probability and Uncertainty › scientometrics and bibliometrics research
- Social Sciences › Decision Sciences › Information Systems and Management › Academic Publishing and Open Access
- Keywords
- implicit bias, low-income countries, high-income countries, evidence interpretation, research relevance, peer referral, knowledge diffusion, clinician perceptions, citation bias
- MeSH terms
- Developing Countries, United Kingdom, Humans, Surveys and Questionnaires, Research, Review Literature as Topic, Publication Bias, Developed Countries
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