Implicit bias in surgical decision-making: a scoping review of recommendations, timing, and access to operative care.
4 affiliations
- 1Center for Medical Humanities, Compassionate Care, and Bioethics, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA. [email protected].
- 2Health Sciences Center Level 3 Suite 080 Stony Brook Medicine, Stony Brook, NY, 11794, USA. [email protected].
- 3Department of Physiology and Biophysics, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA.
- 4Center for Medical Humanities, Compassionate Care, and Bioethics, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA.
Abstract
Background
Surgical disparities are well documented, yet the extent to which implicit biases influence surgical decision-making remains incompletely characterized.Methods
A PRISMA-ScR-aligned scoping review of PubMed, Embase, CINAHL, PsycINFO, and Web of Science (2013-2025) with grey literature screening was conducted. Studies were included if they evaluated implicit bias in surgical decision-making, including operative recommendation, timing/prioritization of procedures, or candidacy for surgery.Results
A total of 1,849 records were identified with 1,613 remaining after duplicate removal. 36 articles underwent full-text review and 26 met inclusion criteria. Studies spanned multiple specialties and clustered into three decision domains: operative recommendation (n = 18), timing/prioritization of surgery (n = 5), and candidacy/access to surgery (n = 3). Disparities were frequently observed at points where clinical guidance was less explicit.Conclusions
Evidence suggests disparities cluster at discretionary surgical decision nodes, particularly in operative recommendation, timing, and access. Identifying these points may help guide measurement strategies and structural interventions to reduce care inequities.
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BibTeX
@article{merida2026implicit,
title = {{Implicit bias in surgical decision-making: a scoping review of recommendations, timing, and access to operative care.}},
author = {Josue Merida and Alexsandra Hernandez and Phyllis Migdal},
journal = {BMC surgery},
year = {2026},
month = aug,
doi = {10.1186/s12893-026-04116-3},
url = {https://europepmc.org/article/MED/42972317},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Implicit bias in surgical decision-making: a scoping review of recommendations, timing, and access to operative care.
AU - Josue Merida
AU - Alexsandra Hernandez
AU - Phyllis Migdal
PY - 2026
DA - 2026/08/06
JO - BMC surgery
DO - 10.1186/s12893-026-04116-3
UR - https://europepmc.org/article/MED/42972317
AB - Background Surgical disparities are well documented, yet the extent to which implicit biases influence surgical decision-making remains incompletely characterized.Methods A PRISMA-ScR-aligned scoping review of PubMed, Embase, CINAHL, PsycINFO, and Web of Science (2013-2025) with grey literature screening was conducted. Studies were included if they evaluated implicit bias in surgical decision-making, including operative recommendation, timing/prioritization of procedures, or candidacy for surgery.Results A total of 1,849 records were identified with 1,613 remaining after duplicate removal. 36 articles underwent full-text review and 26 met inclusion criteria. Studies spanned multiple specialties and clustered into three decision domains: operative recommendation (n = 18), timing/prioritization of surgery (n = 5), and candidacy/access to surgery (n = 3). Disparities were frequently observed at points where clinical guidance was less explicit.Conclusions Evidence suggests disparities cluster at discretionary surgical decision nodes, particularly in operative recommendation, timing, and access. Identifying these points may help guide measurement strategies and structural interventions to reduce care inequities.
SN - 1471-2482
ER -