Rizvi Zehra, Kunder Viktor, Stewart Hanna, Torres Paola, Moon Sana, Lingappa Nimisha, Kazaleh Mallory, Mallireddigari Varshini, Perez Julian, John Nigel, Sedani Anika, Jacobs Robin J
Osteopathic Medicine, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Fort Lauderdale, USA.
Medical and Behavioral Research; Health Informatics; Medical Education, Nova Southeastern University, Fort Lauderdale, USA.
Cureus. 2022 Nov 19;14(11):e31669. doi: 10.7759/cureus.31669. eCollection 2022 Nov.
Minorities, particularly non-White minorities, often encounter implicit biases from healthcare professionals that may impact their standard of care and quality of life. The study of dermatology has long been based on Whites, unintentionally affecting the treatment of non-White patients. Melanoma, although mostly curable, can become fatal in those presenting with advanced stages at diagnosis. Despite being rare in racial minorities, melanoma is associated with a worse prognosis among them compared to White populations. In light of this, the objective of this study was to determine the role of education in preventing biases and improving the diagnosis and treatment of melanoma in minority groups to improve patient outcomes. This study was designed as a scoping review to gather evidence on the impact of implicit bias and lack of education on the treatment of melanoma in people of color. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we searched for peer-reviewed studies involving melanoma, education, and treatment bias in people of color on the databases PubMed, Medline EBSCO, CINAHL, and Cochrane. The data were extracted pertaining to the following main aspects: (1) risk factors, (2) surveys of current knowledge, and 3) educational interventions. This scoping review identified socioeconomic factors, bias, and lack of education in minority populations as causes of increased mortality rates in melanoma. Moreover, because preventative dermatology is largely based on White skin types, incorporating darker skin tones into education will help dispel implicit bias. Additionally, there is evidence to indicate that current patient knowledge and understanding of skin cancer is inaccurate among many and can be significantly improved through educational interventions, such as brochures and videos. Further educational interventions may be beneficial to increase understanding of melanoma in populations of color to address health disparities in dermatological care.
少数群体，尤其是非白人少数群体，经常遭遇医疗保健专业人员的隐性偏见，这可能会影响他们的医疗标准和生活质量。长期以来，皮肤病学的研究一直以白人为基础，无意中影响了对非白人患者的治疗。黑色素瘤虽然大多可以治愈，但在诊断时处于晚期的患者中可能会致命。尽管黑色素瘤在少数族裔中很少见，但与白人相比，它在少数族裔中的预后更差。有鉴于此，本研究的目的是确定教育在预防偏见以及改善少数群体黑色素瘤的诊断和治疗以改善患者预后方面的作用。本研究设计为一项范围综述，以收集关于隐性偏见和缺乏教育对有色人种黑色素瘤治疗影响的证据。遵循系统评价和Meta分析的首选报告项目（PRISMA）指南，我们在PubMed、Medline EBSCO、CINAHL和Cochrane数据库中搜索了涉及有色人种黑色素瘤、教育和治疗偏见的同行评审研究。提取了与以下主要方面相关的数据：（1）风险因素，（2）当前知识调查，以及（3）教育干预措施。这项范围综述确定了少数族裔群体中的社会经济因素、偏见和缺乏教育是黑色素瘤死亡率上升的原因。此外，由于预防性皮肤病学主要基于白人皮肤类型，将深色皮肤纳入教育将有助于消除隐性偏见。此外，有证据表明，目前许多患者对皮肤癌的了解和认识不准确，通过宣传册和视频等教育干预措施可以显著改善这种情况。进一步的教育干预措施可能有助于提高有色人种对黑色素瘤的认识，以解决皮肤科护理中的健康差距问题。
