Do patients' faces influence General Practitioners' cancer suspicions? A test of automatic processing of sociodemographic information

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Abstract

Background: Delayed cancer diagnosis leads to poorer patient outcomes. During short consultations, General Practitioners (GPs) make quick decisions about likelihood of cancer. Patients’ facial cues are processed rapidly and may influence diagnosis.

Aim: To investigate whether patients’ facial characteristics influence immediate perception of cancer risk by GPs.

Design and setting: Web-based binary forced choice experiment with GPs from Northeast Scotland.

Method: GPs were presented with a series of pairs of face prototypes and asked to quickly select the patient more likely to have cancer. Faces were modified with respect to age, gender, and ethnicity. Choices were analysed using Chi-squared goodness-of-fit statistics with Bonferroni corrections.

Results: Eighty-two GPs participated. GPs were significantly more likely to suspect cancer in older patients. Gender influenced GP cancer suspicion, but this was modified by age: the male face was chosen as more likely to have cancer than the female face for young (72% of GPs;95% CI 61.0–87.0) and middle-aged faces (65.9%; 95% CI 54.7–75.5); but 63.4% (95% CI 52.2–73.3) decided the older female was more likely to have cancer than the older male (p = 0.015). GPs were significantly more likely to suspect cancer in the young Caucasian male (65.9% (95% CI 54.7, 75.5)) compared to the young Asian male (p = 0.004).

Conclusion: GPs’ first impressions about cancer risk are influenced by patient age, gender, and ethnicity. Tackling GP cognitive biases could be a promising way of reducing cancer diagnostic delays, particularly for younger patients.
Original languageEnglish
Article numbere0188222
Pages (from-to)1-13
Number of pages13
JournalPloS ONE
Volume12
Issue number11
DOIs
Publication statusPublished - 22 Nov 2017

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general practitioners
Automatic Data Processing
General Practitioners
neoplasms
Processing
Neoplasms
testing
Statistics
Experiments
nationalities and ethnic groups
gender
middle-aged adults
Delayed Diagnosis
Scotland
prototypes
Cues
Referral and Consultation
statistics

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Do patients' faces influence General Practitioners' cancer suspicions? A test of automatic processing of sociodemographic information. / Adam, Rosalind; Garau, Roberta; Raja, Edwin Amalraj; Jones, Benedict; Johnston, Marie; Murchie, Peter.

In: PloS ONE, Vol. 12, No. 11, e0188222, 22.11.2017, p. 1-13.

Research output: Contribution to journalArticle

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abstract = "Background: Delayed cancer diagnosis leads to poorer patient outcomes. During short consultations, General Practitioners (GPs) make quick decisions about likelihood of cancer. Patients’ facial cues are processed rapidly and may influence diagnosis.Aim: To investigate whether patients’ facial characteristics influence immediate perception of cancer risk by GPs.Design and setting: Web-based binary forced choice experiment with GPs from Northeast Scotland.Method: GPs were presented with a series of pairs of face prototypes and asked to quickly select the patient more likely to have cancer. Faces were modified with respect to age, gender, and ethnicity. Choices were analysed using Chi-squared goodness-of-fit statistics with Bonferroni corrections.Results: Eighty-two GPs participated. GPs were significantly more likely to suspect cancer in older patients. Gender influenced GP cancer suspicion, but this was modified by age: the male face was chosen as more likely to have cancer than the female face for young (72{\%} of GPs;95{\%} CI 61.0–87.0) and middle-aged faces (65.9{\%}; 95{\%} CI 54.7–75.5); but 63.4{\%} (95{\%} CI 52.2–73.3) decided the older female was more likely to have cancer than the older male (p = 0.015). GPs were significantly more likely to suspect cancer in the young Caucasian male (65.9{\%} (95{\%} CI 54.7, 75.5)) compared to the young Asian male (p = 0.004).Conclusion: GPs’ first impressions about cancer risk are influenced by patient age, gender, and ethnicity. Tackling GP cognitive biases could be a promising way of reducing cancer diagnostic delays, particularly for younger patients.",
author = "Rosalind Adam and Roberta Garau and Raja, {Edwin Amalraj} and Benedict Jones and Marie Johnston and Peter Murchie",
note = "Funding: Roberta Garau is a medical student who completed this project as part of a BSc (MedSci). She received financial support for this degree from The John & Gladys Colquhoun Trust Fund. No other specific funding was received.",
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AU - Johnston, Marie

AU - Murchie, Peter

N1 - Funding: Roberta Garau is a medical student who completed this project as part of a BSc (MedSci). She received financial support for this degree from The John & Gladys Colquhoun Trust Fund. No other specific funding was received.

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N2 - Background: Delayed cancer diagnosis leads to poorer patient outcomes. During short consultations, General Practitioners (GPs) make quick decisions about likelihood of cancer. Patients’ facial cues are processed rapidly and may influence diagnosis.Aim: To investigate whether patients’ facial characteristics influence immediate perception of cancer risk by GPs.Design and setting: Web-based binary forced choice experiment with GPs from Northeast Scotland.Method: GPs were presented with a series of pairs of face prototypes and asked to quickly select the patient more likely to have cancer. Faces were modified with respect to age, gender, and ethnicity. Choices were analysed using Chi-squared goodness-of-fit statistics with Bonferroni corrections.Results: Eighty-two GPs participated. GPs were significantly more likely to suspect cancer in older patients. Gender influenced GP cancer suspicion, but this was modified by age: the male face was chosen as more likely to have cancer than the female face for young (72% of GPs;95% CI 61.0–87.0) and middle-aged faces (65.9%; 95% CI 54.7–75.5); but 63.4% (95% CI 52.2–73.3) decided the older female was more likely to have cancer than the older male (p = 0.015). GPs were significantly more likely to suspect cancer in the young Caucasian male (65.9% (95% CI 54.7, 75.5)) compared to the young Asian male (p = 0.004).Conclusion: GPs’ first impressions about cancer risk are influenced by patient age, gender, and ethnicity. Tackling GP cognitive biases could be a promising way of reducing cancer diagnostic delays, particularly for younger patients.

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