Removing bias from the treatment of heart disease

The University of Arizona Sarver Heart Center has unveiled a new project designed to decrease bias and eliminate barriers to the equitable treatment of advanced heart disease. By creating standardized training programs, the group hopes that they can help healthcare professionals provide better, more consistent patient care. 

“Using an evidence-based framework for behavior change, we developed a standardized protocol strategy, Seeking Objectivity in Allocation of Advanced Heart Failure (SOCIAL HF), that addresses three significant barriers to equity in advanced therapies,” said Khadijah Breathett, MD, MS, assistant professor of medicine in the division of cardiology at the University of Arizona College of Medicine, in a prepared statement.

Those three barriers? Bias, subjectivity in the evaluation of social support and adherence to medical advice, and poor group dynamics.

The research team recruited healthcare teams from around the country to work with the SOCIAL HF structure, which includes evidence-based bias training focused on heart failure, employing more objective evaluations of social support and adherence, and more. 

“Our goal is to assess real-world effectiveness and implement SOCIAL HF for the allocation of advanced heart failure therapies, such as heart transplant and ventricular-assist device implantation,” Breathett said.

As a way of testing the effectiveness of the SOCIAL HF strategy, the research team will assess its implementation across study sites and decide the best strategies for achieving equity.

In addition, they will gauge how SOCIAL HF impacts processes and outcomes important to advanced heart failure centers.

“This study proposes to implement evidence-based strategies that reduce bias, replace subjective evaluations with objective criteria, and improve group dynamics in a randomized cluster trial,” Breathett said. “Our rigorously designed trial will inform national guidelines for advanced heart failure therapy allocation. The data are likely to be generalizable to other organ replacement treatments and advanced chronic disease decision-making processes.”

The project is supported by the National Heart, Lung and Blood Institute, a division of the National Institutes of Health.

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