Khadijah Breathett|Erika Yee|Natalie Pool|Megan Hebdon|Janice D. Crist|Shannon M. Knapp|Ashley Larsen|Sade Solola|Luis Luy|Kathryn Herrera?Theut|Leanne Zabala|Jeff Stone|Marylyn Morris McEwen|Elizabeth A. Calhoun|Nancy K. Sweitzer
Does Race Influence Decision Making for Advanced Heart Failure Therapies?
University of Arizona|University of Rochester|Banner - University Medical Center Tucson|University of Arizona|University of Rochester|Banner - University Medical Center Tucson|University of Arizona|University of Rochester|Banner - University Medical Center Tucson|University of Arizona|University of Rochester|Banner - University Medical Center Tucson|University of Arizona|University of Rochester|Banner - University Medical Center Tucson|University of Arizona|University of Rochester|Banner - University Medical Center Tucson|University of Arizona|University of Rochester|Banner - University Medical Center Tucson|University of Arizona|University of Rochester|Banner - University Medical Center Tucson|University of Rochester|University of Arizona|Banner - University Medical Center Tucson|Banner - University Medical Center Tucson|University of Arizona|University of Rochester|Banner - University Medical Center Tucson|University of Arizona|University of Rochester|University of Arizona|University of Rochester|Banner - University Medical Center Tucson|University of Arizona|University of Rochester|Banner - University Medical Center Tucson|University of Arizona|University of Rochester|Banner - University Medical Center Tucson|University of Arizona|University of Rochester|Banner - University Medical Center Tucson
background race influences medical decision making impact advanced heart failure therapy allocation unknown sought determine whether patient race influences allocation advanced heart failure therapies methods results members national heart failure organization randomized clinical vignettes varied patient race black white man blinded study objectives participants n422 completed likert scale surveys rating factors advanced therapy allocation thinkaloud interviews n44 survey results analyzed least absolute shrinkage selection operator multivariable regression identify factors influencing advanced therapy allocation including interactions vignette race participant demographics interviews analyzed using grounded theory surveys revealed differences overall racial ratings advanced therapies least absolute shrinkage selection operator regression selected interactions vignette race clinical factors important allocation however interactions participants aged 40 years black vignette negatively influenced heart transplant allocation modestly 058 95 ci 115 00002 adherence social history influential factors interviews revealed sequential decision making forming overall impression identifying urgency evaluating prior care appropriateness anticipating challenges evaluating trust making recommendations race influenced step avoiding discussing race believing photographs may contribute racial bias believing black man sicker compared white man developing greater concern trust adherence black man ultimately offering white man transplantation black man ventricular assist device implantation conclusions black race modestly influenced decision making heart transplant particularly conversations advanced therapy selection meetings conversations rather surveys allocation may vulnerable racial bias