Implicit gender bias in the diagnosis and treatment of type 2 diabetes: A randomized online study.

A Skvortsova, S H Meeuwis, R C Vos, H M M Vos, H van Middendorp, D S Veldhuijzen, A W M Evers

Journal: Diabetic medicine : a journal of the British Diabetic Association 2023;40(8):e15087

PMID: 36919798

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Abstract

AIMS

Implicit gender biases (IGBs) are unconscious evaluations about a person based on gender. IGBs of healthcare providers may affect medical decision making. This study investigated whether IGBs and genders of patients and general practitioners (GPs) influence diagnostics and treatment decisions in the context of diabetes type 2.

METHODS

Ninety-nine GPs participated in this randomized online study. Implicit Associations Tasks were used to measure two IGBs, related to lifestyle (women have a healthier lifestyle than men) and communication (men are less communicative than women). Clinical decisions regarding type 2 diabetes were measured with vignettes that included a fictional male or female patient case.

RESULTS

Female GPs exhibited a significant lifestyle IGB (p < 0.001). GPs of both genders exhibited a significant communication IGB (p < 0.001). Several associations between IGBs and clinical decisions were found. The gender of the vignette character affected several outcomes, for example GPs were less certain in the diabetes diagnosis when the character was a woman (p < 0.001).

CONCLUSION

We demonstrated that GPs have IGBs and these biases as well as patient's gender affect decisions of GP's when they are solving a diabetes vignette case. Future research is needed to understand the most important consequences of IGBs in the context of type 2 diabetes.

Address: Health, Medical and Neuropsychology Unit, Faculty of Social and Behavioural Sciences, Leiden University, Leiden, The Netherlands.; Department of Psychology, McGill University, Montreal, Quebec, Canada.; Institute of Psychology, Jagiellonian University, Kraków, Poland.; Department of Public Health and Primary Care/Health Campus The Hague, Leiden University Medical Center, Leiden, The Netherlands.; Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands.; Medical Delta, Leiden University, Technical University Delft and Erasmus University, Leiden, The Netherlands.

DOI: 10.1111/dme.15087

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MeSH Terms: Female, Humans, Male, Diabetes Mellitus, Type 2, General Practitioners, Healthy Lifestyle, Life Style, Sexism