PDF(Pubmed)
Abstract：
Bias in advanced heart failure therapy allocation results in inequitable outcomes for minoritized populations. The purpose of this study was to examine how bias is introduced during group decision-making with an interprofessional team using Breathett\'s Model of Heart Failure Decision-Making. This was a secondary qualitative descriptive analysis from a study focused on bias in advanced heart failure therapy allocation. Team meetings were recorded and transcribed from four heart failure centers. Breathett\'s Model was applied both deductively and inductively to transcripts (n = 12). Bias was identified during discussions about patient characteristics, clinical fragility, and prior clinical decision-making. Some patients were labeled as \"good citizens\" or as adherent/non-adherent while others benefited from strong advocacy from interprofessional team members. Social determinants of health also impacted therapy allocation. Interprofessional collaboration with advanced heart failure therapy allocation may be enhanced with the inclusion of patient advocates and limit of clinical decision-making using subjective data.
摘要：
高级心力衰竭治疗分配中的偏差导致少数群体的结果不公平。这项研究的目的是使用Breathett的心力衰竭决策模型，研究在跨专业团队的群体决策过程中如何引入偏见。这是一项针对晚期心力衰竭治疗分配偏倚的研究的次要定性描述性分析。团队会议从四个心力衰竭中心进行记录和转录。将Breathett模型演绎和归纳应用于转录本(n=12)。在讨论患者特征时发现了偏差，临床脆性，和事先的临床决策。一些患者被标记为“好公民”或“坚持/不坚持”，而另一些患者则受益于跨专业团队成员的大力倡导。健康的社会决定因素也影响了治疗分配。通过纳入患者倡导者和使用主观数据进行临床决策的限制，可以增强与高级心力衰竭治疗分配的跨专业合作。
