Effect of Physician Race and Gender on Simulated Patients' Ratings and Confidence in Their Physicians: A Randomized Trial
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 3,592
- 试验地点
- 2
- 主要终点
- Patient Confidence
研究概览
简要总结
The purpose of the study was to determine whether the race and gender of a simulated doctor affected analog patients' reported confidence and satisfaction in the simulated doctor's diagnosis and treatment plan. The study used two randomized patient analog experiments.
This study is complete and pre-analysis plans (PAPs) for each experiment were published prior to data collection. The PAPs are available at: http://aspredicted.org/blind.php?x=43xj25 (Study 1) and https://aspredicted.org/blind.php?x=369st7 (Study 2).
详细描述
Prior literature is unclear on whether patients display bias in their evaluations of physicians based on their race or gender. The investigators estimated the effects of physician race and gender using an online clinical vignette. Participants played the role of analog patients reporting to the Emergency Department (ED) with symptoms consistent with gastroenteritis. Participants were provided with a diagnosis of gastroenteritis by a simulated ED physician. The race (black or white) and gender (male or female) of the simulated physician was randomly assigned in a 2x2 factorial experiment. Simulated physicians provided a diagnosis of gastroenteritis and contradicted by an Online Symptom Checker. Following the physician's diagnosis and contradiction by the Online Symptom Checker, participants rated the simulated physician on survey measures of satisfaction and confidence in both the treatment plan and diagnosis. The main (null) hypothesis tested was that there were no differences across the four treatment arms (Black Female, Black Male, White Female, White Male). Participants for the first experiment (Study 1) were recruited from Amazon Mechanical Turk (MTurk) and participants for the second experiment (Study 2) were recruited from Lucid.
Primary Aim: To determine whether the race and gender of a simulated physician had a causal effect on participants' confidence and satisfaction in the physician's diagnosis and treatment plan in an ED setting.
Exploratory Aims: To determine whether the race and gender of a simulated physician had a casual effect on participants' perceptions of the warmth and competence of the physician, their willingness to sue or complain about the physician for an incorrect diagnosis, and their perceived fairness of the charge for the visit.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Factorial
- 主要目的
- Health Services Research
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •Adults over 18 years old
排除标准
- •Participants who reported current pregnancy
- •Participants who reported a current or prior diagnosis of cancer
- •Participants who reported a history of abdominal surgery
结局指标
主要结局
Patient Confidence
时间窗: Approximately 10 minutes
1. "How confident are you that this doctor made the correct diagnosis?" Study 1: \[not at all confident (0) to completely confident (100)\] Study 2: \[not at all confident (1) to completely confident (5)\]\* 2. "How confident are you that this doctor made the correct treatment plan?" Study 1: \[not at all confident (0) to completely confident (100)\] Study 2: \[not at all confident (1) to completely confident (5)\]\* * The Patient Confidence outcome for each study participant was the unweighted average of their ratings on questions a and b. In Study 1, this item was measured using 0-100 point scales. In Study 2, this outcome was measured using 5 point scales. For all analyses, these Patient Confidence outcomes from a and b were rescaled to match the 1-5 point range from Study 2.
Patient Satisfaction: scale
时间窗: Approximately 10 minutes
"What number would you use to rate your care during this emergency room visit?" Study 1: \[0 (worse possible care) to 100 (best possible care)\] Study 2: \[0 (worse possible care) to 10 (best possible care)\]\* \*In Study 1, the Patient Satisfaction was measured using a 0-100 point scale. In Study 2, this was measured using a 10 point scale. For all analyses, this Patient Satisfaction outcome from Study 1 was rescaled to match the 0-10 point range in Study 2.
Believed Symptom Checker over Doctor
时间窗: Approximately 10 minutes
"Which diagnosis do you think is more likely to be correct?" \[the doctor's diagnosis (0); online symptom checker (1)\]
Likelihood of Requesting more Tests
时间窗: Approximately 10 minutes
"Would you ask the doctor to perform additional diagnostic tests? (Such as the CT scan recommended by the Symptom Checker)." \[definitely not (1); probably not (2); might or might not (3); probably (4); definitely (5)\]
Likelihood to Recommend
时间窗: Approximately 10 minutes
"Would you recommend this doctor to your friends and family?" \[definitely not (1); probably not (2); might or might not (3); probably (4); definitely (5)\]
次要结局
- Fairness of the cost(Approximately 10 minutes)
- Warmth and Competence(Approximately 10 minutes)
- Willingness to sue or complain(Approximately 10 minutes)