Implicit Racial Bias in Evaluation of Neonatal Opiate Withdrawal Syndrome

Objective To assess implicit bias by administrating the Modified Finnegan Score (MFS) for quantifying neonatal opiate withdrawal and to evaluate risk of decreased opiate treatment of Black versus White infants.Study Design Study participants were nurses recruited from a large tertiary care center who received three clinical vignettes portraying withdrawing infants and were randomized to receive an accompanying photo of either a Black or White infant. MFS results were compared for identical vignettes based on race of infant photo.Results Out of 275 nurses, 70 completed the survey. In vignette 2, nurses aged <= 35 years scored Black infants lower than White infants (MFS=8.3 +/- 2 vs. 9.5 +/- 1.2, p=0.012). Nurses with <5 years of experience and <= 10 years of experience also scored Black infants lower for the same vignette (8.2 +/- 2.3 vs. 9.6 +/- 1.2, p=0.032 and 8.3 +/- 2 vs. 9.5 +/- 1.2, p=0.0083).Conclusion Implicit bias may contribute to the difference in opiate treatment.