News Release

Study aims to train advanced heart disease providers to remove bias from treatment decisions

Researchers at the University of Arizona Sarver Heart Center seek to reduce bias and remove barriers to equitable treatment for advanced heart disease through the implementation of standardized health care protocols

Business Announcement

University of Arizona Health Sciences

TUCSON, Ariz. — A clinical research project underway at the University of Arizona Sarver Heart Center seeks to reduce bias and remove barriers to equitable treatment for advanced heart disease through the implementation of standardized training programs for health care providers.

Studies have shown that physician bias creates disparities in advanced heart failure treatments. Standardized health care protocols can reduce the impact of implicit bias, but they have yet to be addressed for advanced heart disease therapies. 

Building on prior health disparities research that identified physician bias, Khadijah Breathett, MD, MS, FACC, FAHA, FHFSA, is leading a National Institutes of Health-funded study to launch and study the effectiveness of a training program that introduces standardized protocols to address significant barriers to equity and provide evidence-based bias training tailored for providers who specialize in advanced heart disease. 

“Using an evidence-based framework for behavior change, we developed a standardized protocol strategy, Seeking Objectivity in Allocation of Advanced Heart Failure (SOCIAL HF), that addresses three significant barriers to equity in advanced therapies,” said Dr. Breathett, assistant professor of medicine in the Division of Cardiology at the UArizona College of Medicine – Tucson. The barriers include bias, subjectivity in evaluation of social support and adherence to medical advice, and poor group dynamics. 

Dr. Breathett’s research team is recruiting health care teams around the U.S. who agree to work with the SOCIAL HF structure, which includes: 

  • evidence-based bias training tailored for heart failure treatment teams;
  • employing objective evaluations of social support and adherence; and, 
  • environmental restructuring to ensure an equitable voice for all members of the selection team.

“Our goal is to assess real-world effectiveness and implement SOCIAL HF for the allocation of advanced heart failure therapies, such as heart transplant and ventricular-assist device implantation,” said Dr. Breathett, who is a board-certified advanced heart disease and transplant cardiologist.

To test the effectiveness of the SOCIAL HF strategy, the research team will evaluate its implementation across study sites to determine the optimal strategies to achieve equity. They also will evaluate how SOCIAL HF affects processes and outcomes important to advanced heart failure centers. 

“This study proposes to implement evidence-based strategies that reduce bias, replace subjective evaluations with objective criteria, and improve group dynamics in a randomized cluster trial. Our rigorously designed trial will inform national guidelines for advanced heart failure therapy allocation,” Dr. Breathett said. “The data are likely to be generalizable to other organ replacement treatments and advanced chronic disease decision-making processes.” 

This research is supported by the National Heart, Lung and Blood Institute, a division of the National Institutes of Health (1R56HL159216-01). 

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About the University of Arizona Sarver Heart Center
The University of Arizona Sarver Heart Center's 165 members include faculty from cardiology, cardiothoracic surgery, pediatric cardiology, neurology, vascular surgery, radiology, endocrinology, emergency medicine, nursing, pharmacy and basic sciences. The UArizona Sarver Heart Center emphasizes a highly collaborative research environment, fostering innovative translational or "bench-to-bedside" research; dedicated to innovating lifesaving patient care. If you would like to give permission for Sarver Heart Center to contact you about heart research studies, please complete a Cardiology Research Registry Information Form. The academic mission of the Sarver Heart Center encompasses four fellowship programs in cardiovascular disease, interventional cardiology, advanced heart failure and transplant cardiology, and electrophysiology. For more information: (Follow us: Facebook | Twitter | YouTube | Instagram).

About the University of Arizona College of Medicine – Tucson
The University of Arizona College of Medicine – Tucson is shaping the future of medicine through state-of-the-art medical education programs, groundbreaking research and advancements in patient care in Arizona and beyond. Founded in 1967, the college boasts more than 50 years of innovation, ranking among the top medical schools in the nation for research and primary care. Through the university's partnership with Banner Health, one of the largest nonprofit health-care systems in the country, the college is leading the way in academic medicine. For more information: (Follow us: Facebook | Twitter | LinkedIn | Instagram).

About the University of Arizona Health Sciences
Located on campuses in Tucson and Phoenix, the University of Arizona Health Sciences is one of the top-ranked academic medical centers in the southwestern United States. UArizona Health Sciences includes the College of Medicine – Phoenix, College of Medicine – Tucson, College of Nursing, College of Pharmacy and the Mel and Enid Zuckerman College of Public Health. In addition, 12 UArizona Health Sciences centers and programs focus on cancer, neurodegenerative diseases, pain and addiction, and respiratory diseases; biomedical informatics, health technology innovation and simulation training; and precision health care and health disparities. A leader in next-generation education, biomedical research and public outreach, UArizona Health Sciences employs nearly 5,000 people, has approximately 4,000 students and 900 faculty members, and garners more than $200 million in research grants and contracts annually. For more information: (Follow us: Facebook | Twitter | YouTube | LinkedIn | Instagram).


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