Surgery Recommendations Vary by Race, Study Shows

Redefining Practice Through Quality and Evidence: What’s New

Monday

1:15 p.m. – 5:15 p.m.

Room 351DEF

Surgeons are more likely to recommend lung resection for black cancer patients than white cancer patients, according to a study that will be presented this afternoon.

The study showed that “patient race significantly influenced risk estimation and surgical recommendations. How these findings influence shared decision making and their association with treatment disparities require further investigation,” said Mark K. Ferguson, MD, of The University of Chicago, who is the lead author of “Patient Race Influences Risk Assessment and Recommendations for Lung Resection.”

For the study, surgeons read a clinical vignette and then viewed a video interview with either a black or white patient-actor. The participating surgeons recommended that 88% of black patients have lung surgery versus 75% of white patients. The patients were matched by age, body mass index, gait speed, and strength.

The 117 participating surgeons included 51 practicing surgeons and 66 trainees; 86 were white and 31 were in other self-identified racial categories; 96 were men and 21 were women.

“The literature suggests that black patients are less likely to be recommended to have surgery than white patients,” Dr. Ferguson said. “We found the opposite of that. I can’t explain why recommendations for surgery in other studies are less for blacks than for whites.”

The study, one in a series examining the use of video in making treatment recommendations, also suggests that videos influenced surgery recommendations more than the race-neutral clinical vignettes did. Because of the limited number of participating surgeons, more research is needed.

“I wouldn’t say that I could draw clear-cut conclusions from this. It seemed that the physicians—and this is both physicians of color and white physicians—had similar tendencies in terms of how they responded to the videos. Male and female physicians had some like tendencies in terms of how they responded to the videos,” Dr. Ferguson said. “It suggests that maybe physicians don’t see black patients in the same way they see white patients.”

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