Assessing the impact of weight status on pediatric decision-making and medical student awareness of its influence.

Abstract

The objective was to investigate the influence of pediatric patient and mother weight status on assessment/ treatment decisions of medical students, as well as student reaction to feedback about differential weightbased decision-making. Medical students (n = 120) viewed vignette scenes of a static virtual human pediatric patient presenting to a physician with back pain, accompanied by her mother. Cues of patient and mother weight (healthy, obesity) were manipulated across scenes. Participants provided ratings on likelihood to recommend pain assessment/treatment and perceptions about the dyad. Real-time individual-level analyses determined the influence of weight cues on decisions. Participants were informed about cue influence. Results show that 60% of participants were influenced by weight cues to make decisions, particularly when considering ordering imaging and physical therapy/psychology referrals. Patient obesity was equated with a higher likelihood to refer. Twenty-five percent of participants were influenced by weight cues when forming perceptions; patient and mother obesity was equated with lower anticipated treatment adherence and higher need for follow-up care. Participant awareness of weight cue influence was high and interest in participating in an obesity-related training was moderate. Results suggest that the weight status of pediatric patients and their mothers play a considerable role in medical students' pain-related decision-making. Such patterns in decision-making can be appropriate and contribute to necessary differences in care. They can also be inappropriate, such as inferring adherence based on weight status, and have harmful effects. This underscores need for evidence-based research at the intersection of pediatric obesity and pain and medical education in obesity.

Examining delays in diagnosis for slipped capital femoral epiphysis from a health disparities perspective

“…This correlation suggests that delays in care for SCFE PLOS ONE patients may be more complex than previous research has indicated. Current healthcare providers acknowledge that unfavorable views toward obese patients exist, and multiple metareview studies have indicated these negative perceptions have persisted for many decades in the healthcare field [67][68][69][70][71]. Obese patients have reported feeling dismissed by their healthcare provider regarding pain concerns [67,71,72].…”