Using Virtual Human Technology to Capture Dentists’ Decision Policies about Pain

Abstract

Healthcare professionals use race, gender, and age cues when making pain management decisions. Use of these demographic cues, therefore, is an important topic in the study of healthcare disparities. This study used virtual human (VH) technology to investigate the effects of VH patients' demographic cues on dentists' pain management decisions. Eighty-nine dentists viewed patients with different demographic cues. Analyses revealed that dentists rated pain intensity higher and were more willing to prescribe opioids to female, African-American, and younger patients than to their demographic counterparts. Results also found significant 2-way interactions between race and age for both pain assessment and treatment decisions. The interaction results suggest that the race difference (Caucasian < African American) was more pronounced for younger than for older patients. This is the first study to examine demographic cue use in dentists' decision-making for pain. The study found that dentists used demographic cues when making pain management decisions. Currently, there are no guidelines for decisionmaking practices for gender-, race-, or age-related pain. Since dentists see thousands of patients during their careers, the use of demographic cues could affect a substantial portion of the population. The findings could improve future training programs for dentists and dental students.KEY WORDS: gender, race, age, pain management, dentists, education. DOI: 10.1177/0022034513480802 Received September 19, 2011 Last revision February 6, 2013; Accepted February 6, 2013 A supplemental appendix to this article is published electronically only at http://jdr.sagepub.com/supplemental.

Using Virtual Human Technology to Provide Immediate Feedback About Participants′ Use of Demographic Cues and Knowledge of Their Cue Use

“…This finding is consistent with previous VH idiographic studies showing that pain expression is the most commonly used cue in pain management decisions. 8,18,19 However, also consistent with previous VH idiographic studies, sex, race, and age cue use were also significant, with age being the most commonly used of these demographic characteristics. 8 Although it was most common for participants to use two cues, including pain expression, our data suggest that a significant percentage of participants relied on additional patient characteristics in evaluating the VHs’ pain intensity and in making treatment decisions.…”

“…1,8,9,18,19 Limited focus, however, has been placed on whether individuals are aware of their use of cues, or how these individuals would respond to feedback about their potential use of cues in making judgments about another person’s pain. The current study used an experimental approach, VH technology, and LENS model analyses, to measure participants’ use of demographic cues in pain assessment and treatment.…”

The Interaction of Patient Race, Provider Bias, and Clinical Ambiguity on Pain Management Decisions

“…This innovative feature confers a higher level of experimental control and realism than is possible with typical approaches (e.g., retrospective chart reviews, paper-pencil vignettes). We successfully used, standardized, and validated these patient stimuli in previous studies, and previous participants have rated the stimuli as highly realistic and reflective of actual clinical situations [33–36,58,59]. …”

The influence of sex, race, and age on pain assessment and treatment decisions using virtual human technology: a cross-national comparison

“…Additional research has consistently shown that patient demographic characteristics such as sex, race, and age may influence the pain assessment and treatment decisions of health care trainees and professionals 8–14. Virtual human (VH) technology has been used to demonstrate that females are perceived as experiencing higher pain intensity8,9,12–15 and are more likely to be recommended medical treatment8,9,12–14 compared to males with the same clinical diagnoses.…”

“…Virtual human (VH) technology has been used to demonstrate that females are perceived as experiencing higher pain intensity8,9,12–15 and are more likely to be recommended medical treatment8,9,12–14 compared to males with the same clinical diagnoses. Furthermore, African American and older adult patients are considered to have greater pain and are recommended for medical management of their pain at a higher frequency than Caucasians and younger adults, respectively 8,9,12,13.…”