| Disparities in physicians' interpretations of heart disease symptoms by patient gender: results of a video vignette factorial experiment. | |
| | |
MedLine Citation:
|
PMID: 19785567 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
BACKGROUND: Previous studies have documented the underdiagnosis of coronary heart disease (CHD) in women, but less is known about which alternate diagnoses take precedence and whether additional patient factors modify possible gender bias. Objective: To measure gender variation in clinical decision making, including (1) the number, types, and certainty levels of diagnoses considered and (2) how diagnoses vary according to patient characteristics, when patients have identical symptoms of CHD. METHODS: This was a factorial experiment presenting videotaped CHD symptoms, systematically altering patient gender, age, socioeconomic status (SES) and race, and physician gender and level of experience. The primary end point was physicians' most certain diagnosis. RESULTS: Physicians (n = 128) mentioned five diagnoses on average, most commonly heart, gastrointestinal, and mental health conditions. Physicians were significantly less certain of the underlying cause of symptoms among female patients regardless of age (p = 0.006), but only among middle-aged women were they significantly less certain of the CHD diagnosis (p < 0.001). Among middle-aged women, 31.3% received a mental health condition as the most certain diagnosis, compared with 15.6% of their male counterparts (p = 0.03). An interaction effect showed that females with high SES were most likely to receive a mental health diagnosis as the most certain (p = 0.006). CONCLUSIONS: Middle-aged female patients were diagnosed with the least confidence, whether for CHD or non-CHD conditions, indicating that their gender and age combination misled physicians, particularly toward mental health alternative diagnoses. Physicians should be aware of the potential for psychological symptoms to erroneously take a central role in the diagnosis of younger women. |
| | |
Authors:
|
Nancy N Maserejian; Carol L Link; Karen L Lutfey; Lisa D Marceau; John B McKinlay |
Related Documents
:
|
26247 - Gerontological aspects of hyperostosis frontalis interna. 21729957 - Seroprevalence of herpes simplex virus 2 among hispanics in the usa: national health an... 8138977 - Hla-antigens in oral submucous fibrosis. 8655887 - Association of skin test reactivity, specific ige, total ige, and eosinophils with nasa... 19850077 - Motor control and aging: links to age-related brain structural, functional, and biochem... 22859387 - Not all older adults have insight into their driving abilities: evidence from an on-roa... |
Publication Detail:
|
Type: Journal Article; Research Support, N.I.H., Extramural |
Journal Detail:
|
Title: Journal of women's health (2002) Volume: 18 ISSN: 1931-843X ISO Abbreviation: J Womens Health (Larchmt) Publication Date: 2009 Oct |
Date Detail:
|
Created Date: 2009-10-27 Completed Date: 2010-01-22 Revised Date: 2010-10-04 |
Medline Journal Info:
|
Nlm Unique ID: 101159262 Medline TA: J Womens Health (Larchmt) Country: United States |
Other Details:
|
Languages: eng Pagination: 1661-7 Citation Subset: IM |
Affiliation:
|
New England Research Institutes, Watertown, Massachusetts 02472, USA. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adult Aged Attitude of Health Personnel* Coronary Disease / diagnosis* Diagnosis, Differential Factor Analysis, Statistical Female Humans Male Middle Aged Outcome Assessment (Health Care) Patient-Centered Care / methods Physician's Practice Patterns / statistics & numerical data* Physician-Patient Relations* Sex Distribution Videotape Recording* |
| Grant Support | |
ID/Acronym/Agency:
|
AG16747/AG/NIA NIH HHS |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: The effect of water-based exercise on glucose and insulin response in overweight women: a pilot stud...
Next Document: Comparison of pitavastatin with simvastatin in primary hypercholesterolaemia or combined dyslipidaem...