Women and men with coronary heart disease in three countries : are they treated differently?
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
WRAP_Adams_gender_3_countries_Revised_III_2.pdf - Draft Version
Official URL: http://dx.doi.org/10.1016/j.whi.2008.01.003
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|
|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|
|Official Date:||3 May 2008|
|Number of Pages:||8|
|Page Range:||pp. 191-198|
|Access rights to Published version:||Open Access|
Version accepted by publisher (post-print, after peer review, before copy-editing).
|Funder:||National Institute on Aging (NIA)|
|Grant number:||AG 16747|
Adams, A., Buckingham, C., Arber, S., McKinlay, J.B, Marceau, L., & Link, C. (2006). The influence of patient's age on clinical decision-making about coronary heart disease in the USA and the UK. Ageing and Society, 26, 303-321.
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