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Women and men with coronary heart disease in three countries : are they treated differently?

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Bönte, Markus, Knesebeck, Olaf von dem, Siegrist, Johannes, Marceau, Lisa, Link, Carol, Arber, Sara, Adams, Ann and McKinlay, John B.. (2008) Women and men with coronary heart disease in three countries : are they treated differently? Women's Health Issues, Vol.18 (No.3). pp. 191-198. ISSN 1049-3867

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Official URL: http://dx.doi.org/10.1016/j.whi.2008.01.003

Abstract

Non-medical determinants of medical decision making were investigated in an international research project in the US, in the UK and in Germany. The key question in this paper is whether and to what extent doctors' diagnostic and therapeutic decisions in coronary heart disease (CHD) are influenced by the patients' gender. A factorial experiment with a videotaped patient consultation was conducted. Professional actors played the role of patients with symptoms of CHD. Several alternative versions were taped featuring the same script with patient-actors of different sex, age, race and socio-economic status. The videotapes were presented to a randomly selected sample of 128 primary care physicians in each country. Using an interview with standardized and open-ended questions, physicians were asked how they would diagnose and treat such a patient after they had seen the video. Results show gender differences in the diagnostic strategies of the doctors. Women were asked different questions, a CHD was mentioned more often as a possible diagnosis for men than for women, and physicians were less certain about their diagnosis with female patients. Moreover, results indicate that gender differences in management decisions (therapy and lifestyle advice) are less pronounced and less consistent than in diagnostic decisions. Magnitude of gender effect on doctors' decisions varies between countries with smaller influences in the US. Although patients with identical symptoms were presented, primary care doctors’ behavior differed by patients' gender in all three countries under study. These gender differences suggest that women may be less likely to receive an accurate diagnosis and appropriate treatment than men.

Item Type:	Journal Article
Alternative Title:
Subjects:	R Medicine > RC Internal medicine
Divisions:	Faculty of Medicine > Warwick Medical School > Mental Health and Wellbeing Faculty of Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH):	Sex discrimination in medicine, Coronary heart disease -- Diagnosis
Journal or Publication Title:	Women's Health Issues
Publisher:	Elsevier
ISSN:	1049-3867
Date:	3 May 2008
Volume:	Vol.18
Number:	No.3
Number of Pages:	8
Page Range:	pp. 191-198
Identification Number:	10.1016/j.whi.2008.01.003
Status:	Peer Reviewed
Publication Status:	Published
Access rights to Published version:	Open Access
Description:	Version accepted by publisher (post-print, after peer review, before copy-editing).
Funder:	National Institute on Aging (NIA)
Grant number:	AG 16747
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URI:	http://wrap.warwick.ac.uk/id/eprint/185