Background Epidemiologic studies have reported differences in the use of cardiovascular procedures according to the race and sex of the patient.
Whether the differences stem from differences in the recommendations of physicians remains uncertain.
Methods We developed a computerized survey instrument to assess physicians'recommendations for managing chest pain.
Actors portrayed patients with particular characteristics in scripted interviews about their symptoms.
A total of 720 physicians at two national meetings of organizations of primary care physicians participated in the survey.
Each physician viewed a recorded interview and was given other data about a hypothetical patient.
He or she then made recommendations about that patient's care.
We used multivariate logistic-regression analysis to assess the effects of the race and sex of the patients on treatment recommendations, while controlling for the physicians'assessment of the probability of coronary artery disease as well as for the age of the patient, the level of coronary risk, the type of chest pain, and the results of an exercise stress test.
Results The physicians'mean (±SD) estimates of the probability of coronary artery disease were lower for women (probability, 64.1±19.3 percent, vs. 69.2±18.2 percent for men ; P<0.001), younger patients (63.8±19.5 percent for patients who were 55 years old, vs. 69.5±17.9 percent for patients who were 70 years old ; P<0.001), and patients with non-anginal pain (58.3±19. (...)
Mots-clés Pascal : Angine poitrine, Epidémiologie, Traitement, Cathétérisme, Critère décision, Sexe, Race, Recommandation, Traitement informatique, Questionnaire, Homme, Etats Unis, Amérique du Nord, Amérique, Appareil circulatoire pathologie, Cardiopathie coronaire, Traitement instrumental
Mots-clés Pascal anglais : Angina pectoris, Epidemiology, Treatment, Catheterization, Decision criterion, Sex, Race, Recommendation, Computerized processing, Questionnaire, Human, United States, North America, America, Cardiovascular disease, Coronary heart disease, Instrumentation therapy
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0152807
Code Inist : 002B26E. Création : 16/11/1999.