Evidence map›Paper›PMID 36127098›Full record

ArticleBMJ open2022

Disparities and implicit bias in the management of low-risk febrile infants: a mixed methods study protocol.

Colleen K Gutman, K Casey Lion, Paul Aronson, Carla Fisher, Carma Bylund, Antionette McFarlane, Xiangyang Lou, Mary D Patterson, Ahmed Lababidi, Rosemarie Fernandez

Open access · goldAbstract read
In one paragraph

Article in BMJ open, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.8field-weighted citation impact, top 28% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 3 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 4 institutions in 1 country.

Colleen K GutmanDepartment of Emergency Medicine, University of Florida, Gainesville, Florida, USA ckays21@ufl.edu.ORCID 0000-0002-6113-5799
K Casey LionDepartment of Pediatrics, University of Washington, Seattle, Washington, USA.
Paul AronsonDepartments of Emergency Medicine and Pediatrics, Yale University, New Haven, Connecticut, USA.
Carla FisherCollege of Journalism and Communications, University of Florida, Gainesville, Florida, USA.
Carma BylundDepartment of Health Outcomes and Biomedical Informatics, University of Florida, Gainesville, Florida, USA.
Antionette McFarlaneDepartment of Emergency Medicine, University of Florida, Gainesville, Florida, USA.
Xiangyang LouDepartment of Biostatistics, University of Florida, Gainesville, Florida, USA.
Mary D PattersonDepartment of Emergency Medicine, University of Florida, Gainesville, Florida, USA.
Ahmed LababidiDepartment of Pediatrics, University of Florida, Gainesville, Florida, USA.
Rosemarie FernandezDepartment of Emergency Medicine, University of Florida, Gainesville, Florida, USA.
University of Florida · USUniversity of Florida Health · USSeattle Children's Hospital · USYale University · US

Funding

Together: Transforming and Translating Discovery to Improve HealthKL2TR001429 · NCATS · UNIVERSITY OF FLORIDA · PI GUIRGIS, FAHEEM W, LEEUWENBURGH, CHRISTIAAN · 2015 to 2023
$5.5M
Development and pilot trial of a web-based tool to facilitate shared decision-making with parents of febrile infantsK08HS026006 · AHRQ · YALE UNIVERSITY · PI ARONSON, PAUL L · 2018 to 2020
$460k
AHRQ HHS K08 HS026006NCATS NIH HHS KL2 TR001429
6 · The paper itself

Abstract

introductionThe management of low-risk febrile infants presents a model population for exploring how implicit racial bias promotes inequitable emergency care for children who belong to racial, ethnic and language minority groups. Although widely used clinical standards guide the clinical care of febrile infants, there remains substantial variability in management strategies. Deviations from recommended care may be informed by the physician's assessment of the family's values, risk tolerance and access to supportive resources. However, in the fast-paced emergency setting, such assessments may be influenced by implicit racial bias. Despite significant research to inform the clinical care of febrile infants, there is a dearth of knowledge regarding health disparities and clinical guideline implementation. The proposed mixed methods approach will (1) quantify the extent of disparities by race, ethnicity and language proficiency and (2) explore the role of implicit bias in physician-patient communication when caring for this population. METHODS AND ANALYSIS: With 42 participating sites from the Pediatric Emergency Medicine Collaborative Research Committee, we will conduct a multicenter, cross-sectional study of low-risk febrile infants treated in the emergency department (ED) and apply multivariable logistic regression to assess the association between (1) race and ethnicity and (2) limited English proficiency with the primary outcome, discharge to home without lumbar puncture or antibiotics. We will concurrently perform an interpretive study using purposive sampling to conduct individual semistructured interviews with (1) minority parents of febrile infants and (2) paediatric ED physicians. We will triangulate or compare perspectives to better elucidate disparities and bias in communication and medical decision-making. ETHICS AND DISSEMINATION: This study has been approved by the University of Florida Institutional Review Board. All participating sites in the multicenter analysis will obtain local institutional review board approval. The results of this study will be presented at academic conferences and in peer-reviewed publications.

Indexed as

PhysiciansRacismAnti-Bacterial AgentsBias, ImplicitChildCross-Sectional StudiesEmergency Service, HospitalFeverHealthcare DisparitiesHumansInfantMulticenter Studies as TopicAnti-Bacterial Agentsaccident & emergency medicinepaediatric A&E and ambulatory carepaediatrics

Identifiers

PMID36127098
PMCPMC9490627
OpenAlexW4296519569

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.