INS NYC 2024 Program

Poster	Poster Session 06 Program Schedule 02/15/2024 04:00 pm - 05:15 pm Room: Shubert Complex (Posters 1-60) Poster Session 06: Aging \| MCI \| Neurodegenerative Disease - PART 2 Final Abstract #50 Is practitioner appraisal of facial expressivity in Parkinson’s disease affected by race? Shana Harris, The University of Iowa, Iowa City, United States Daniel Tranel, The University of Iowa, Iowa City, United States Category: Movement and Movement Disorders Keyword 1: Parkinson's disease Keyword 2: cross-cultural issues Keyword 3: multiculturalism Objective: Black people are diagnosed with Parkinson’s disease (PD) at half the rate as White people. The reasons for this large disparity in the prevalence of PD between these racial groups are not well understood. One unexplored possibility is that racial bias in practitioners, specifically when appraising motor signs of PD such as hypomimia (reduced facial expressivity), may cause delays or even errors in the diagnosis of PD in Black people versus White people. Specifically, practitioner bias surrounding facial expressivity in Black people versus White people may lead practitioners to appraise Black people with hypomimia as having higher levels of facial expressivity than their White counterparts. Furthermore, practitioner bias may impact their ability to appraise reduced facial expressivity as a medical sign, in Black versus White patients with hypomimia. Participants and Methods: The current study included 175 practitioners/primary care providers such as medical doctors, nurse practitioners and physician assistants. First, analyses were conducted to explore the association between practitioners’ demographic attributes such as race, gender, occupation and years of patient experience and their appraisal of facial expressivity, hypomimia, and pathology in Black versus White people with or without hypomimia. Hypomimia severity and medical history were similar in these Black and White people, within the same condition. Then, a multi-level modeling approach was used to compare the practitioners (1) appraisal of facial expressivity and (2) perception of pathology, in the same Black versus White people with and without hypomimia. Results: Firstly, preliminary correlational analyses revealed that as practitioners’ years of experience working with patients increases, their rating of likelihood of pathology in the Black actor with hypomimia also increases, r(168) = .164, p< .033. This demographic variable was included in the main multi-level model with pathology as the outcome variable. Next, the multi-level models showed that practitioners rated facial expressivity higher in Black versus White people with no hypomimia, t(500.170) = 8.916, p<.001, estimate = 13.352. Race did not influence practitioners rating of pathology, for Black and White people in the no hypomimia condition. In addition, race did not significantly impact practitioner’ ratings of facial expressivity or pathology, in Black versus White people with hypomimia. Further, hypomimia condition significantly predicted practitioners’ ratings for each outcome variable. Lastly, more years of patient experience were associated with higher pathology ratings by practitioners, for Black and White people with hypomimia, t(169.921) = 2.003, p<.05, estimate =0.008. Conclusions: These results suggest that patient race and practitioner demographic attributes, such as years of experience, can influence practitioners’ clinical evaluation of Black versus White people without and with hypomimia. In spite of these findings, practitioner racial bias does not appear to influence their ability to appraise people with more objective signs of hypomimia or to make important clinical decisions for these patients. Future researchers should investigate whether practitioners have a racial bias when evaluating less objective or milder symptoms of hypomimia or other motor signs of PD, while using measures that are validated to assess clinical appraisals and decision-making in primary care practitioners.

Poster

02/15/2024
04:00 pm - 05:15 pm
Room: Shubert Complex (Posters 1-60)

Poster Session 06: Aging | MCI | Neurodegenerative Disease - PART 2

Final Abstract #50

Is practitioner appraisal of facial expressivity in Parkinson’s disease affected by race?

Shana Harris, The University of Iowa, Iowa City, United States
Daniel Tranel, The University of Iowa, Iowa City, United States

Category: Movement and Movement Disorders

Keyword 1: Parkinson's disease
Keyword 2: cross-cultural issues
Keyword 3: multiculturalism

Objective:

Black people are diagnosed with Parkinson’s disease (PD) at half the rate as White people. The reasons for this large disparity in the prevalence of PD between these racial groups are not well understood. One unexplored possibility is that racial bias in practitioners, specifically when appraising motor signs of PD such as hypomimia (reduced facial expressivity), may cause delays or even errors in the diagnosis of PD in Black people versus White people. Specifically, practitioner bias surrounding facial expressivity in Black people versus White people may lead practitioners to appraise Black people with hypomimia as having higher levels of facial expressivity than their White counterparts. Furthermore, practitioner bias may impact their ability to appraise reduced facial expressivity as a medical sign, in Black versus White patients with hypomimia.

Participants and Methods:

The current study included 175 practitioners/primary care providers such as medical doctors, nurse practitioners and physician assistants. First, analyses were conducted to explore the association between practitioners’ demographic attributes such as race, gender, occupation and years of patient experience and their appraisal of facial expressivity, hypomimia, and pathology in Black versus White people with or without hypomimia. Hypomimia severity and medical history were similar in these Black and White people, within the same condition. Then, a multi-level modeling approach was used to compare the practitioners (1) appraisal of facial expressivity and (2) perception of pathology, in the same Black versus White people with and without hypomimia.

Results:

Firstly, preliminary correlational analyses revealed that as practitioners’ years of experience working with patients increases, their rating of likelihood of pathology in the Black actor with hypomimia also increases, r(168) = .164, p< .033. This demographic variable was included in the main multi-level model with pathology as the outcome variable. Next, the multi-level models showed that practitioners rated facial expressivity higher in Black versus White people with no hypomimia, t(500.170) = 8.916, p<.001, estimate = 13.352. Race did not influence practitioners rating of pathology, for Black and White people in the no hypomimia condition. In addition, race did not significantly impact practitioner’ ratings of facial expressivity or pathology, in Black versus White people with hypomimia. Further, hypomimia condition significantly predicted practitioners’ ratings for each outcome variable. Lastly, more years of patient experience were associated with higher pathology ratings by practitioners, for Black and White people with hypomimia, t(169.921) = 2.003, p<.05, estimate =0.008.

Conclusions:

These results suggest that patient race and practitioner demographic attributes, such as years of experience, can influence practitioners’ clinical evaluation of Black versus White people without and with hypomimia. In spite of these findings, practitioner racial bias does not appear to influence their ability to appraise people with more objective signs of hypomimia or to make important clinical decisions for these patients. Future researchers should investigate whether practitioners have a racial bias when evaluating less objective or milder symptoms of hypomimia or other motor signs of PD, while using measures that are validated to assess clinical appraisals and decision-making in primary care practitioners.