Doctors’ racial and gender biases affect heart failure treatment decisions, study finds

Clinicians appear to judge women harsher than men, particularly African American women, when deciding treatment recommendations, such as a heart transplant, for patients with advanced heart failure, according to an NHLBI-funded study. 

The  findings, published in JAMA Network Open, showed that neither patients’ gender nor race predicted the final treatment recommendations of advanced heart failure therapies. However, the researchers found evidence of biased assessment and use of irrelevant or inappropriate criteria, including appearance, support at home, number of children, and family dynamics. 

The doctors participating in the study received photos of the patients with terminal heart failure alongside their clinical histories. Many participants did not want to look at the photos and expressed concern that they knew the pictures would influence their assessment. 

Despite reaching similar conclusions regarding treatment options, the researchers and  accompanying editorial in the journal note that these biases could lead to delays in treatment referrals and lower allocation of advanced therapies.