{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T23:21:04Z","timestamp":1761175264107,"version":"build-2065373602"},"reference-count":15,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2025,8,18]],"date-time":"2025-08-18T00:00:00Z","timestamp":1755475200000},"content-version":"vor","delay-in-days":17,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ACR Open Rheumatology"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Racial implicit bias may contribute to health disparities in juvenile idiopathic arthritis (JIA) outcomes by impacting provider medical decision\u2010making. Our study assessed racial and racial\u2013medical compliance implicit biases of an international pediatric rheumatology community and investigated whether their biases impact treatment recommendations for patients with JIA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A web\u2010based survey, which included a randomized vignette describing either a White or Black patient with JIA, was sent to pediatric rheumatology\u2009providers. Participants were prompted to select the best patient management option and to complete two implicit association tests (IATs): race and race compliance. Student's\n                      <jats:italic>t<\/jats:italic>\n                      \u2010tests or analysis of variance were used to compare IAT D\u2010scores between or across groups; all tests were two\u2010sided with\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.05 considered statistically significant. Logistic regression models were used to examine associations for two outcomes of interest: recommendation of either adequate (methotrexate monotherapy) or aggressive (methotrexate and adalimumab combination) treatment with each IAT D\u2010score by each vignette.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Overall, 165 pediatric rheumatologists completed the survey. Providers showed a slight pro\u2010White bias in the race IAT (mean D\u2010score \u00b1 SD 0.26 \u00b1 0.5) and race\u2013medical compliance IAT (mean D\u2010score \u00b1 SD 0.16 \u00b1 0.43). Although not statistically significant, a one\u2010point increase in IAT D\u2010scores was associated with a lower likelihood that providers would choose aggressive treatment versus adequate treatment in the Black vignette (odds ratio [OR] 0.55, 95% confidence interval [CI] 0.20\u20131.47;\n                      <jats:italic>P<\/jats:italic>\n                      = 0.23), and a greater likelihood that providers would choose aggressive treatment in the White vignette (OR 4.07, 95% CI 0.74\u201322.24;\n                      <jats:italic>P<\/jats:italic>\n                      = 0.11).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Implicit bias was not associated with treatment recommendations. Further studies are needed to better evaluate the impact of implicit bias.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/acr2.70082","type":"journal-article","created":{"date-parts":[[2025,8,18]],"date-time":"2025-08-18T09:36:20Z","timestamp":1755509780000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Racial Implicit Bias, Treatment Recommendations, and Perceived Compliance in the Care of Juvenile Idiopathic Arthritis"],"prefix":"10.1002","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-7650-8234","authenticated-orcid":false,"given":"Alisha","family":"Akinsete","sequence":"first","affiliation":[{"name":"Hospital for Special Surgery  New York New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Onjona B.","family":"Hossain","sequence":"additional","affiliation":[{"name":"Albert Einstein College of Medicine  Bronx New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6248-5790","authenticated-orcid":false,"given":"Ilir","family":"Agalliu","sequence":"additional","affiliation":[{"name":"Albert Einstein College of Medicine  Bronx New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0543-7805","authenticated-orcid":false,"given":"Dawn M.","family":"Wahezi","sequence":"additional","affiliation":[{"name":"Albert Einstein College of Medicine  Bronx New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ellen J.","family":"Silvers","sequence":"additional","affiliation":[{"name":"Albert Einstein College of Medicine  Bronx New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Irene","family":"Blanco","sequence":"additional","affiliation":[{"name":"Northwestern University Feinberg School of Medicine  Chicago Illinois"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8170-9377","authenticated-orcid":false,"given":"Tamar","family":"Rubinstein","sequence":"additional","affiliation":[{"name":"Albert Einstein College of Medicine  Bronx New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cristina","family":"Gonzalez","sequence":"additional","affiliation":[{"name":"NYU Grossman School of Medicine  New York New York"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,8,18]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.121147"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12969-020-00485-y"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2010.143347"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1177\/1368430216642029"},{"key":"e_1_2_6_6_1","unstructured":"Project Implicit.2021. Accessed October 2010.https:\/\/www.projectimplicit.net\/#:~:text=Project%20Implicit%20is%20a%20non group%2Dbased%20biases."},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1037\/0022-3514.74.6.1464"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.acap.2016.08.010"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-139-11-200312020-00009"},{"key":"e_1_2_6_10_1","unstructured":"2015 Workforce Study of Rheumatology Specialists in the United States. Accessed May 8 2022.https:\/\/www.rheumatology.org\/portals\/0\/files\/ACR-Workforce-Study-2015.pdf."},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr2.11573"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pec.2018.05.016"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2021.689462"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10903-021-01222-7"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1080\/19485565.2021.1991777"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.rdc.2021.09.014"}],"container-title":["ACR Open Rheumatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/acrjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/acr2.70082","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T08:22:20Z","timestamp":1761121340000},"score":1,"resource":{"primary":{"URL":"https:\/\/acrjournals.onlinelibrary.wiley.com\/doi\/10.1002\/acr2.70082"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8]]},"references-count":15,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2025,8]]}},"alternative-id":["10.1002\/acr2.70082"],"URL":"https:\/\/doi.org\/10.1002\/acr2.70082","archive":["Portico"],"relation":{},"ISSN":["2578-5745","2578-5745"],"issn-type":[{"type":"print","value":"2578-5745"},{"type":"electronic","value":"2578-5745"}],"subject":[],"published":{"date-parts":[[2025,8]]},"assertion":[{"value":"2024-04-28","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-09-11","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-08-18","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70082"}}