Gender bias in clinical decision making emerges when patients with coronary heart disease symptoms also have psychological symptoms
Gender bias in clinical decision making emerges when patients with coronary heart disease symptoms also have psychological symptoms
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DOI：
10.1016/j.hrtlng.2018.11.005
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发表时间：
2019-07-01
期刊：
影响因子：
2.8
通讯作者：
Orom, Heather
中科院分区：
文献类型：
--
作者：
Biddle, Caitlin;Fallavollita, James A.;Orom, Heather
背景：延迟治疗可能导致女性冠心病(CHD)相对较高的发病率和死亡率。方法：来自美国13所医学院的四年级医学生(N=225)被随机分配到四个试验性间歇期患者(男性或女性；有无抑郁和焦虑症状)中的一个进行临床决策(CHD风险判断、诊断、治疗建议)。结果：有心理症状的女性患者罹患冠心病的风险最低。与有心理症状的男性患者相比，对有心理症状的女性患者推荐去急诊科就诊、服药或接受营养或运动建议的可能性较低。结论：当患者同时有心理症状时，冠心病患者的临床决策存在性别偏见。(C)2018 Elsevier Inc.保留所有权利。
Background: Delayed treatment may contribute to women's relatively higher morbidity and mortality from coronary heart disease (CHD). We tested whether disparities in treatment may be due to bias in diagnosis and treatment recommendations for women with psychological symptoms.Methods: Fourth year medical students (N = 225) from 13 U.S. medical schools were randomly assigned to make clinical decisions (CHD risk judgments, diagnosis, treatment recommendations) about one of four experimental vignette patients (male or female; with symptoms of depression and anxiety or without). Vignettes were presented as text via an online survey platform.Results: The female patient with psychological symptoms was perceived to be at lowest risk for CHD. Perceptions of risk partly mediated lower likelihood of recommending the female patient with psychological symptoms be seen in an emergency department, take medication, or receive nutrition or exercise advice relative to the male patient with psychological symptoms.Conclusions: There was a gender bias in CHD clinical decision-making when patients had concurrent psychological symptoms. (C) 2018 Elsevier Inc. All rights reserved.