Key result
Female patients were less likely than men to have their cardiovascular risk assessed using the French scale (OR 0.64; 95% CI 0.5-0.8) or SCORE scale, particularly when seen by male physicians.
Why the study?
Does patient and physician gender influence the frequency of cardiovascular risk assessment in primary prevention?
Observational (n=3,640)
Yes
Does patient and physician gender influence the frequency of cardiovascular risk assessment in primary prevention?
Odds Ratio: 0.64 (95% CI 0.5–0.8)
Women receive less frequent cardiovascular risk assessment for primary prevention than men, a disparity that is exacerbated when the treating physician is male.
Male GPs showed greater gender disparities in CV risk assessment; leaves open whether training mitigates bias in primary prevention.
OBJECTIVE: Our objective was to analyse general practitioner (GP) cardiovascular risk assessment of patients for primary prevention while considering the gender of both the GP and the patient. METHODS: This study consisted of an observational survey of GPs who were internship supervisors in the Paris metropolitan area. Each of 52 volunteer GPs completed a self-administered questionnaire regarding their own characteristics and randomly selected 70 patients from their patient list. Dependent variables from the patient files included the presence of information about risk factors necessary to assess the patient's cardiovascular risk according to the French scale and the Systematic COronary Risk Evaluation (SCORE) scale. Analyses used mixed logistic models with a random intercept and adjusted for patient and physician characteristics. RESULTS: Both cardiovascular risk scales could be assessed less frequently in women than in men (odds ratio (OR) = 0.64 (95% confidence interval (CI): 0.5-0.8) for the French scale and OR = 0.63 (95% CI: 0.5-0.8) for the SCORE scale). These gender differences were less substantial when the patients were seen by female (for the SCORE scale OR = 0.72 (95% CI: 0.5-1.01)) compared with male physicians (OR = 0.56 (95% CI: 0.4-0.7)). The patients who were least well assessed for cardiovascular risk were women seen by male physicians. CONCLUSION: Even before the onset of cardiovascular disease, women patients receive less satisfactory preventative management than men do, and these differences are even more marked when the physician is a man. More attention to the influence of gender stereotypes is needed in medical training in order to combat the inequalities that they cause.
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Delpech et al. (2016) conducted an observational in Cardiovascular risk assessment (n=3,640). Female patient gender vs. Male patient gender was evaluated on Presence of information necessary to assess cardiovascular risk according to the French scale (OR 0.64, 95% CI 0.5-0.8). Female patients were less likely than men to have their cardiovascular risk assessed using the French scale (OR 0.64; 95% CI 0.5-0.8) or SCORE scale, particularly when seen by male physicians.
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