Implicit Bias and Clinical Decision Making in Psoriasis Management Among Dermatology Residents: A Feasibility Study

Black and White individuals may not receive equal healthcare even when insurance status, income level, and access to health care are taken into account.1 Despite psoriasis having an established standard of care, the black race is associated with a lower likelihood of receiving biologics among Medicare beneficiaries.2 Implicit bias, which refers to subconscious ^beliefs may perpetuate ^{that individuals} disparities ^have by influencing ^{about other} physicians’ ^{identity groups,3} clinical ^Do No decision-making.⁴ This IRB approved feasibility study assesses ^Penalti the association between implicit race bias, race-compliance stereotyping, and psoriasis patient management in dermatology residents. Residents selected systemic, topical, and phototherapy at similar rates for both patient vignettes (P=0.99;Table 1).Though not statistically significant, biologics were chosen more often for the black patient (n=8, 50%) compared to the white patient (n=4, 28.6%, P=0.23; Table 1). Furthermore, Race IAT d-scores of residents assigned to the black patient show greater pro-^{Copy white} compared ^bias to ⁱⁿ non-biologics ^{residents who} (0.03±0.60, ^{chose biologics} P=0.22) ^(mean (Table ^0.32±0.25) 3). This ^Apply difference is more pronounced when comparing the Race-Compliance IAT d-score between residents who chose biologics (0.23±0.31) versus non-biologics (-0.21±0.30) in the same group (P=0.06;Table 3).