Passage 6
With an increasing array of innovations and research emerging from low-income
countries there is a growing recognition that even high-income countries could
learn from these contexts. It is well known that the source of a product influences
perception of that product, but little research has examined whether this applies
also in evidence-based medicine and decision-making. In order to examine
likely barriers to learning from low-income countries, this study uses established
methods in cognitive psychology to explore whether healthcare professionals and
researchers implicitly associate good research with rich countries more so than
with poor countries.
[A] Computer-based Implicit Association Test (IAT) [was] distributed to healthcare
professionals and researchers. Stimuli representing Rich Countries were chosen
from OECD members in the top ten (>$36,000 per capita) World Bank rankings and
Poor Countries were chosen from the bottom thirty (<$1000 per capita) countries
by GDP per capita, in both cases giving attention to regional representation. Stimuli
representing Research were descriptors of the motivation (objective/biased), value
(useful/worthless), clarity (precise/vague), process (transparent/dishonest), and
trustworthiness (credible/unreliable) of research.
Three hundred twenty one tests were completed in a four-week period between
March and April 2015. The mean Implicit Association Test result…for the sample
was 0.57 (95% CI 0.52 to 0.61) indicating that on average our sample exhibited
moderately strong implicit associations between Rich Countries and Good
Research. People over 40 years of age were less likely to exhibit pro-poor implicit
associations, and being a peer reviewer contributes to a more pro-poor association.
The majority of our participants associate Good Research with Rich Countries,
compared to Poor Countries. Implicit associations such as these might disfavor
research from poor countries in research evaluation, evidence-based medicine and
diffusion of innovations.
Measuring the bias against low-income country research: an Implicit Association
Test. Adapted from Harris et al. (2017).
Based on the passage above, which of the following stereotypes about lowincome countries would be most likely to contribute to the observed results?
A) Assumptions that researchers from low-income countries are likely young,
and therefore lacking in the education or credentials necessary to generate
high-quality research
B) Beliefs that researchers from low-income countries are not well connected
to publishing bodies, and thus do not understand the common standards or
processes of the scientific method
C) Prejudiced beliefs that constitute a heuristic-like judgment on the value of
the data from low-income countries’ research
D) Oversimplifications regarding the English reading and writing skills of
researchers from low-income countries
Correct answer is C
Of the options presented, Answers A, C, and D are likely to play a possible role in the
study’s conclusion that individuals from rich countries are likely to view research
from poor countries as unreliable or of low-quality. All three are specifically
mentioned in the passage.
Answer C is correct because beliefs that researchers from low-income countries
are not well connected to publishing bodies, and thus do not understand the
common standards of the scientific method, are less likely to have played a role in
the study’s outcomes. The passage notes that “being a peer reviewer contributes
to a more pro-poor association” and thus it is plausible to hypothesize that those
who were more connected to publishing bodies (i.e. through their peer reviewing
positions) were likely to hold fewer biases against those who were not well
connected to publishing bodies, such as those from low-income countries.
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