Evidence map›Paper›PMID 34083391›Full record

ArticleOpen heart2021

Sex-based inequalities in contemporary UK hospital management of stable chest pain.

Gareth Morgan-Hughes, Michelle Claire Williams, Margaret Loudon, Carl A Roobottom, Stelios Iacovides, Franchesca Wotton, Alice Veitch, Russel Bull

Erratum issuedAbstract readMulticenter Study
In one paragraph

Article in Open heart, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors.

Gareth Morgan-HughesCardiology, University Hospitals Plymouth NHS Trust, Plymouth, UK garethmh@me.com.ORCID 0000-0001-8568-6440
Michelle Claire WilliamsRadiology, Edinburgh Napier University, Edinburgh, UK.ORCID 0000-0003-3556-2428
Margaret LoudonCardiology, University Hospitals Plymouth NHS Trust, Plymouth, UK.ORCID 0000-0001-7249-2647
Carl A RoobottomRadiology, University Hospitals Plymouth NHS Trust, Plymouth, UK.
Stelios IacovidesCardiology, University Hospitals Plymouth NHS Trust, Plymouth, UK.
Franchesca WottonRadiology, University Hospitals Plymouth NHS Trust, Plymouth, UK.
Alice VeitchSalisbury Hospital NHS Foundation Trust, Salisbury, Wiltshire, UK.
Russel BullRadiology, Royal Bournemouth Hospital, Bournemouth, UK.

Funding

British Heart Foundation FS/ICRF/20/26002
6 · The paper itself

Abstract

objectiveWe surveyed UK practice of National Institute for Health and Care Excellence (NICE) "Recent onset chest pain" guidance (CG95, 2016), stratified by sex. We looked for sex-related differences in referral to computed tomographic coronary angiography (CTCA) and subsequent functional imaging (FI), invasive coronary angiography (ICA) and revascularisation.

methodsThis was a prospective analysis of CTCA practice in 8 UK centres between 2018 and 2020. Coronary artery disease (CAD) was recorded with the CAD-reporting and data system. Local electronic records/archiving/communication systems were used to collect data regarding subsequent FI, ICA and revascularisation.

results2301 women, 2326 men underwent CTCA; women were older (58±11 vs 55±12 years, p<0.001) but more likely to have normal coronary arteries (46% (1047) vs 29% (685); p<0.001) and less likely to have severe stenosis (7% (169) vs 13% (307); p<0.001). FI was used less for 4% (93) women, 5% (108) men; ICA was also used less for women (8% (182) vs 14% (321)), as was revascularisation (4% (83) vs 8% (177), p<0.001 for all), including those with ≥moderate CTCA stenosis undergoing ICA (53% (79) vs 61% (166); p<0.001).

conclusionsWomen referred for a NICE CG95 (2016) CTCA are more likely to have normal coronary arteries and men more likely to have CAD. More men than women will then undergo ICA and revascularisation even after adjustments for CTCA disease severity. Raised awareness of these inequalities may improve contemporary chest pain care.

Indexed as

HospitalsAdolescentAdultAgedAged, 80 and overChest PainComputed Tomography AngiographyCoronary AngiographyCoronary Artery DiseaseFemaleHumansIncidenceMaleMiddle AgedPredictive Value of TestsProspective Studieschest paincomputed tomography angiographyquality of health care

Identifiers

PMID34083391
PMCPMC8174516

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.