Journal article
Is practitioner appraisal of facial expressivity and emotional engagement in simulated Parkinson’s disease affected by race?
Clinical parkinsonism & related disorders, Vol.13, 100356
2025
DOI: 10.1016/j.prdoa.2025.100356
PMCID: PMC12206039
PMID: 40584992
Abstract
•This study investigates racial differences in practitioners’ evaluation of simulated hypomimia in Black and White people.•The Black person was rated more expressive than the White person, with similar medical history (but no hypomimia).•Hypomimia severity, but not race, predicted practitioners’ appraisals/ratings of patients with hypomimia.•More years of training experience can lead to more accurate evaluations of patients with hypomimia by practitioners.
Black people are diagnosed with Parkinson’s disease (PD) at half the rate as White people. One unexplored possibility to explain this disparity is that practitioners have a racial bias, specifically when appraising motor signs of PD in Black versus White people.
The current study explores whether practitioners have a racial bias when appraising/evaluating Black versus White people with or without hypomimia (a motor sign of PD that results in reduced facial expressivity, which was simulated in this current study). Such bias may cause delays in the diagnosis of PD, which could explain the large racial disparity of the disease in Black versus White people.
A multi-level modeling approach was used to compare practitioners’ (N = 175) (1) appraisal of facial expressivity (2) perception of pathology and (3) impression of emotional engagement, in Black versus White people (paid actors) with or without simulated hypomimia. Additional analyses explored the association between these variables and practitioners’ demographics.
Results show that practitioners rated facial expressivity higher in Black versus White individuals with no hypomimia, t(500.170) = 8.916, p < 0.001, estimate = -13.352. Additionally, more years of patient experience was associated with higher pathology ratings by practitioners, for Black and White people with hypomimia.
Although this study did not find a racial bias in practitioners’ appraisal of Black versus White people with hypomimia, the results highlight that quantity (i.e., years of experience), and possibly, quality of training could lead to a more accurate evaluation of Black patients with signs of Parkinson’s disease, which is a feasible point of intervention.
Details
- Title: Subtitle
- Is practitioner appraisal of facial expressivity and emotional engagement in simulated Parkinson’s disease affected by race?
- Creators
- Shana Harris - Department of Neurology (Division of Neuropsychology and Cognitive Neuroscience), University of Iowa, 200 Hawkins Drive, Iowa City, IA 52242, USAHana-May Eadeh - Hennepin Healthcare Research InstituteDaniel Tranel - University of Iowa
- Resource Type
- Journal article
- Publication Details
- Clinical parkinsonism & related disorders, Vol.13, 100356
- Publisher
- Elsevier Ltd; AMSTERDAM
- DOI
- 10.1016/j.prdoa.2025.100356
- PMID
- 40584992
- PMCID
- PMC12206039
- ISSN
- 2590-1125
- eISSN
- 2590-1125
- Grant note
- Kiwanis Neuroscience Research FoundationEastern Star Society
This work was supported in part by grants from the Kiwanis Neuroscience Research Foundation and Eastern Star Society.
- Language
- English
- Date published
- 2025
- Academic Unit
- Neurology; Psychological and Brain Sciences; Iowa Neuroscience Institute
- Record Identifier
- 9984832082002771
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