ArticleJournal of women's health (2002)2009
Disparities in physicians' interpretations of heart disease symptoms by patient gender: results of a video vignette factorial experiment.
Article in Journal of women's health (2002), 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers, 2 of them syntheses that pooled it.
What it found
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
35 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Social disparities in patient safety in primary care: a systematic review.International journal for equity in health · 2018Pooled it
- Implicit bias in healthcare professionals: a systematic review.BMC medical ethics · 2017Pooled it
- Sex disparities in the presentation, management and outcomes of patients with acute coronary syndrome: insights from the ACS QUIK trial.Open heart · 2021Trial
- Implicit Gender Bias and the Use of Cardiovascular Tests Among Cardiologists.Journal of the American Heart Association · 2017Trial
- Neurologic Manifestations of Long COVID Affect Adult Females More Severely Than Males.Annals of clinical and translational neurology · 2026Article
- From perimenopause to neuroinflammation: Rethinking a case of late-onset mania.PCN reports : psychiatry and clinical neurosciences · 2026Article
- Gender differences in Myasthenia Gravis in a neuromuscular reference center in Belgium.Acta neurologica Belgica · 2026Article
- Bias and discrimination in healthcare through the eyes of future professionals: a qualitative study of student observations.BMC medical education · 2026Article
- Striving for LGBTQI+ Health Equity in Arthroplasty.Arthroplasty today · 2026Article
- Joint Hypermobility: An Under-Recognised Cause of Palpitations, Dizziness, and Syncope in Young Females.Journal of clinical medicine · 2025Article
- A comparison of social drivers of health identification and intervention rates by sex among patients receiving primary care.Biology of sex differences · 2025Article
- The Relationships Between Healthcare Access, Gender, and Psychedelics and Their Effects on Distress.Healthcare (Basel, Switzerland) · 2025Article
- Gender Differences in Clinical Practice Regarding Coronary Heart Disease: A Systematic Review.Journal of clinical medicine · 2025Review
- Artificial intelligence: Applications in cardio-oncology and potential impact on racial disparities.American heart journal plus : cardiology research and practice · 2024Article
- Documenting Race and Gender Biases in Pain Assessment and a Novel Intervention Designed to Reduce Biases.The journal of pain · 2024Article
- Reinvestigating the performance of artificial intelligence classification algorithms on COVID-19 X-Ray and CT images.iScience · 2024Article
- Primary care clinicians' perspectives on interacting with patients with gynaecological conditions: a systematic review.BJGP open · 2024Article
- Review
- Gender Bias in Diagnosis, Prevention, and Treatment of Cardiovascular Diseases: A Systematic Review.Cureus · 2024Review
- Does Biological Sex Matter in Lyme Disease? The Need for Sex-Disaggregated Data in Persistent Illness.International journal of general medicine · 2023Article
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
backgroundPrevious studies have documented the underdiagnosis of coronary heart disease (CHD) in women, but less is known about which alternate diagnoses take precedence and whether additional patient factors modify possible gender bias.
objectiveTo measure gender variation in clinical decision making, including (1) the number, types, and certainty levels of diagnoses considered and (2) how diagnoses vary according to patient characteristics, when patients have identical symptoms of CHD.
methodsThis was a factorial experiment presenting videotaped CHD symptoms, systematically altering patient gender, age, socioeconomic status (SES) and race, and physician gender and level of experience. The primary end point was physicians' most certain diagnosis.
resultsPhysicians (n = 128) mentioned five diagnoses on average, most commonly heart, gastrointestinal, and mental health conditions. Physicians were significantly less certain of the underlying cause of symptoms among female patients regardless of age (p = 0.006), but only among middle-aged women were they significantly less certain of the CHD diagnosis (p < 0.001). Among middle-aged women, 31.3% received a mental health condition as the most certain diagnosis, compared with 15.6% of their male counterparts (p = 0.03). An interaction effect showed that females with high SES were most likely to receive a mental health diagnosis as the most certain (p = 0.006).
conclusionsMiddle-aged female patients were diagnosed with the least confidence, whether for CHD or non-CHD conditions, indicating that their gender and age combination misled physicians, particularly toward mental health alternative diagnoses. Physicians should be aware of the potential for psychological symptoms to erroneously take a central role in the diagnosis of younger women.
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