Observational studyBMJ open2019
Are there gender disparities in symptom presentation or triage of patients with chest discomfort at primary care out-of-hours services? An observational study.
Observational study in BMJ open, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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
8 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Diagnostic accuracy of signs and symptoms in acute coronary syndrome and acute myocardial infarction.Scandinavian journal of primary health care · 2025Pooled it
- Difficult calls to emergency medical dispatch centres - a mixed method study.BMC emergency medicine · 2025Article
- Sex differences in chest pain presentation, triage assessment, and outcomes in urgent primary care: findings from the TRACE cohort study.Primary health care research & development · 2025Article
- Gender-stratified analyses of symptoms associated with life-threatening events in patients calling out-of-hours primary care for shortness of breath.BMC primary care · 2025Article
- Article
- Gender-stratified analyses of symptoms associated with acute coronary syndrome in telephone triage: a cross-sectional study.BMJ open · 2021Article
- Call Characteristics of Patients Suspected of Transient Ischemic Attack (TIA) or Stroke During Out-of-Hours Service: A Comparison Between Men and Women.Frontiers in neurology · 2021Article
- Accuracy of telephone triage in primary care patients with chest discomfort: a cross-sectional study.Open heart · 2020Article
Corrections and comments
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Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesPrevious hospital-based studies have suggested delayed recognition of acute coronary syndrome (ACS) in women. We wanted to assess differences in symptom presentation or triage among women and men who contacted primary care out-of-hours services (OHS) for chest discomfort.
designRetrospective observational study.
settingPrimary care OHS.
participants276 women and 242 men with chest discomfort who contacted a primary care OHS in the Netherlands in 2013 and 2014.
main outcome measuresDifferences between women and men regarding symptom presentation and urgency allocation.
results8.4% women and 14.0% men had ACS. Differences in symptoms between patients with and without ACS were in general small, for both women and men. In women with ACS compared with women without ACS, mean duration of telephone calls was discriminative; 5.22 (SD 2.53) vs 7.26 (SD 3.11) min, p value=0.003. In men, radiation of pain (89.3% vs 54.9%, p value=0.011) was discriminative for ACS, and stabbing chest pain (3.7% vs 24.0%, p value=0.014) for absence of ACS . Women and men with chest discomfort received similar high urgency allocation (crude and adjusted OR after correction for ACS and age; 1.03 (95% CI 0.72 to 1.48) and 1.04 (95% CI 0.72 to 1.52), respectively). Women with ACS received a high urgency allocation in 22/23 (95.7%) and men with ACS in 30/34 (88.2%), p value=0.331.
conclusionsDiscriminating ACS in patients with chest discomfort who contacted primary care OHS is difficult in both women and men. Women and men with chest discomfort received similar high urgency allocation.
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