Gendered uncertainty and variation in physicians' decisions for coronary heart disease: the double-edged sword of "atypical symptoms".
Gendered uncertainty and variation in physicians' decisions for coronary heart disease: the double-edged sword of "atypical symptoms".
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DOI：
10.1177/0022146512456026
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发表时间：
2012-09
影响因子：
5
通讯作者：
Grace M
中科院分区：
文献类型：
--
作者：
Welch LC;Lutfey KE;Gerstenberger E;Grace M
Nonmedical factors and diagnostic certainty contribute to variation in clinical decision making, but the process by which this occurs remains unclear. We examine how physicians’ interpretations of patient sex/gender affect diagnostic certainty and, in turn, decision making for coronary heart disease (CHD). Data are from a factorial experiment of 256 physicians who viewed one of 16 video vignettes with different patient-actors presenting the same CHD symptoms. Physician participants completed a structured interview and provided a narrative about their decision-making processes. Quantitative analysis showed that diagnostic uncertainty reduces the likelihood that physicians will order tests and medications appropriate for an urgent cardiac condition in particular. Qualitative analysis revealed that a subset of physicians applied knowledge that women have “atypical symptoms” as a generalization, which engendered uncertainty for some. Findings are discussed in relation to social-psychological processes that underlie clinical decision making and the social framing of medical knowledge.
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影响因子：
6
作者：
Galvao, M;Kalman, J;Moskowitz, RM
通讯作者：
Moskowitz, RM
影响因子：
2.8
作者：
Chen, W;Woods, SL;Puntillo, KA
通讯作者：
Puntillo, KA
影响因子：
4.4
作者：
Faulkner, J;Schaller, M;Duncan, LA
通讯作者：
Duncan, LA
DOI：
10.1097/00043798-200212000-00002
发表时间：
2002-12-01
期刊：
JOURNAL OF CARDIOVASCULAR RISK
影响因子：
--
作者：
Charney, P
通讯作者：
Charney, P
影响因子：
3.2
作者：
Bird, Chloe E.;Fremont, Allen M.;Escarce, Jose J.
通讯作者：
Escarce, Jose J.