TY - JOUR
T1 - Health care practitioners’ confidence assessing lupus-related rashes in patients of color
AU - Kannuthurai, Vijay
AU - Murray, Jacob
AU - Chen, Ling
AU - Baker, Elizabeth A.
AU - Zickuhr, Lisa
N1 - Funding Information:
The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by the Washington University in St Louis Mentors in Medicine Program [grant number 2020].
Funding Information:
We thank Drs. Aisling Doyle, MD, Iris Lee, MD, Muithi Mwanthi, MD, PhD, and Andrea Ramirez-Gomez, MD for helping us develop our survey. We thank Drs. Dominique Cosco, MD, Heather Jones, MD, and Prabha Ranganathan, MD, MSCI for supporting survey distribution. The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by the Washington University in St Louis Mentors in Medicine Program [grant number 2020].
Publisher Copyright:
© The Author(s) 2021.
PY - 2021/11
Y1 - 2021/11
N2 - Background: Patients with skin of color (P-SOC) are disproportionately burdened by lupus and often have worse disease outcomes than white patients. This is partly because educational materials underrepresent P-SOC, thereby promoting unconscious bias and clinical deficiencies among practitioners. Purpose: We sought to measure providers' confidence in diagnosing the cutaneous manifestations of lupus (i.e., lupus-related rashes) in P-SOC and to assess which factors influenced their confidence. Research Design: We created and distributed a survey that gathered information about participants' personal characteristics, clinical specialty, training, and current practice as well as measuring their confidence assessing lupus-related rashes in various skin tones. Study Sample: Practitioners from the fields of rheumatology, dermatology, and internal medicine in the greater St. Louis area (Missouri, USA) participated in the survey. Analysis: We compared practitioners' mean confidence levels assessing lupus-related rashes in patients with fair skin and P-SOC with a linear mixed effects model and used univariate and multivariate linear regression models to determine if the aforementioned factors correlated with confidence. Results: Participants' mean confidence in diagnosing lupus-related rashes in P-SOC was significantly lower than assessing such findings in patients with fair skin (p =.009). Several factors correlated with confidence level at a univariate level; however, the multivariate model revealed experience as the only factor significantly associated with confidence (p =.001). Conclusions: Providers report significantly less confidence assessing lupus-related rashes in P-SOC than in patients with fair skin. Our analysis demonstrates that experience positively correlates with confidence and suggests that interventions which enhance practitioners' exposure to and experience with these rashes in P-SOC can improve clinical confidence as well as patient outcomes.
AB - Background: Patients with skin of color (P-SOC) are disproportionately burdened by lupus and often have worse disease outcomes than white patients. This is partly because educational materials underrepresent P-SOC, thereby promoting unconscious bias and clinical deficiencies among practitioners. Purpose: We sought to measure providers' confidence in diagnosing the cutaneous manifestations of lupus (i.e., lupus-related rashes) in P-SOC and to assess which factors influenced their confidence. Research Design: We created and distributed a survey that gathered information about participants' personal characteristics, clinical specialty, training, and current practice as well as measuring their confidence assessing lupus-related rashes in various skin tones. Study Sample: Practitioners from the fields of rheumatology, dermatology, and internal medicine in the greater St. Louis area (Missouri, USA) participated in the survey. Analysis: We compared practitioners' mean confidence levels assessing lupus-related rashes in patients with fair skin and P-SOC with a linear mixed effects model and used univariate and multivariate linear regression models to determine if the aforementioned factors correlated with confidence. Results: Participants' mean confidence in diagnosing lupus-related rashes in P-SOC was significantly lower than assessing such findings in patients with fair skin (p =.009). Several factors correlated with confidence level at a univariate level; however, the multivariate model revealed experience as the only factor significantly associated with confidence (p =.001). Conclusions: Providers report significantly less confidence assessing lupus-related rashes in P-SOC than in patients with fair skin. Our analysis demonstrates that experience positively correlates with confidence and suggests that interventions which enhance practitioners' exposure to and experience with these rashes in P-SOC can improve clinical confidence as well as patient outcomes.
KW - cutaneous lupus
KW - discoid lupus
KW - health equity
KW - medical education
KW - systemic lupus erythematosus
UR - http://www.scopus.com/inward/record.url?scp=85115055260&partnerID=8YFLogxK
U2 - 10.1177/09612033211045284
DO - 10.1177/09612033211045284
M3 - Article
C2 - 34528847
AN - SCOPUS:85115055260
SN - 0961-2033
VL - 30
SP - 1998
EP - 2002
JO - Lupus
JF - Lupus
IS - 12
ER -