Endovascular treatment decision in acute stroke: does physician gender matter? Insights from UNMASK EVT, an international, multidisciplinary survey.


Journal

Journal of neurointerventional surgery
ISSN: 1759-8486
Titre abrégé: J Neurointerv Surg
Pays: England
ID NLM: 101517079

Informations de publication

Date de publication:
Mar 2020
Historique:
received: 28 05 2019
revised: 08 07 2019
accepted: 12 07 2019
pubmed: 1 8 2019
medline: 5 8 2020
entrez: 1 8 2019
Statut: ppublish

Résumé

Differences in the treatment practice of female and male physicians have been shown in several medical subspecialties. It is currently not known whether this also applies to endovascular stroke treatment. The purpose of this study was to explore whether there are differences in endovascular treatment decisions made by female and male stroke physicians and neurointerventionalists. In an international survey, stroke physicians and neurointerventionalists were randomly assigned 10 case scenarios and asked how they would treat the patient: (A) assuming there were no external constraints and (B) given their local working conditions. Descriptive statistics were used to describe baseline demographics, and the adjusted OR for physician gender as a predictor of endovascular treatment decision was calculated using logistic regression. 607 physicians (97 women, 508 men, 2 who did not wish to declare) participated in this survey. Physician gender was neither a significant predictor for endovascular treatment decision under assumed ideal conditions (endovascular therapy was favored by 77.0% of female and 79.3% of male physicians, adjusted OR 1.03, P=0.806) nor under current local resources (endovascular therapy was favored by 69.1% of female and 76.9% of male physicians, adjusted OR 1.03, P=0.814). Endovascular therapy decision making between male and female physicians did not differ under assumed ideal conditions or under current local resources.

Sections du résumé

BACKGROUND AND PURPOSE OBJECTIVE
Differences in the treatment practice of female and male physicians have been shown in several medical subspecialties. It is currently not known whether this also applies to endovascular stroke treatment. The purpose of this study was to explore whether there are differences in endovascular treatment decisions made by female and male stroke physicians and neurointerventionalists.
METHODS METHODS
In an international survey, stroke physicians and neurointerventionalists were randomly assigned 10 case scenarios and asked how they would treat the patient: (A) assuming there were no external constraints and (B) given their local working conditions. Descriptive statistics were used to describe baseline demographics, and the adjusted OR for physician gender as a predictor of endovascular treatment decision was calculated using logistic regression.
RESULTS RESULTS
607 physicians (97 women, 508 men, 2 who did not wish to declare) participated in this survey. Physician gender was neither a significant predictor for endovascular treatment decision under assumed ideal conditions (endovascular therapy was favored by 77.0% of female and 79.3% of male physicians, adjusted OR 1.03, P=0.806) nor under current local resources (endovascular therapy was favored by 69.1% of female and 76.9% of male physicians, adjusted OR 1.03, P=0.814).
CONCLUSION CONCLUSIONS
Endovascular therapy decision making between male and female physicians did not differ under assumed ideal conditions or under current local resources.

Identifiants

pubmed: 31363043
pii: neurintsurg-2019-015003
doi: 10.1136/neurintsurg-2019-015003
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

256-259

Informations de copyright

© Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.

Déclaration de conflit d'intérêts

Competing interests: None declared.

Auteurs

Johanna Maria Ospel (JM)

Division of Neuroradiology, Clinic of Radiology and Nuclear Medicine, University Hospital Basel, Basel, Switzerland.
Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada.

Nima Kashani (N)

Diagnostic Imaging, University of Calgary, Calgary, Alberta, Canada.

Alexis T Wilson (AT)

Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada.

Urs Fischer (U)

Department of Neurology, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland.

Bruce C V Campbell (BCV)

Department of Medicine, University of Melbourne, Parkville, VIctoria, Australia.
Department of Neurology, Royal Melbourne Hospital, Melbourne, Victoria, Australia.

Pillai N Sylaja (PN)

Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India.

Shinichi Yoshimura (S)

Department of Neurosurgery, Hyogo College of Medicine, Nishinomiya, Japan.

Alejandro A Rabinstein (AA)

Department of Neurology, Mayo Clinic, Rochester, Minnesota, United States.

Francis Turjman (F)

Department of Interventional Neuroradiology, Centre Hospitalier Universitaire de Lyon, Lyon, France.

Peter Mitchell (P)

Department of Radiology, Royal Melbourne Hospital, Melbourne, Australia.

Byung Moon Kim (BM)

Department of Radiology, Yonsei University College of Medicine, Seoul, South Korea.

Mathew P Cherian (MP)

Radiology, Kovai Medical Center, Coimbatore, Tamil Nadu, India.

Ji Hoe Heo (JH)

Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea.

Blaise W Baxter (BW)

University of Tennessee, College of Medicine, Chattanooga, Tennessee, United States.

Anna Podlasek (A)

Neuroscience and Vascular Simulation, Anglia Ruskin University, Chelmsford, UK.

Mona Foss (M)

Bootstrap Analytics, Calgary, Alberta, Canada.

Bijoy K Menon (BK)

Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada.
Diagnostic Imaging, University of Calgary, Calgary, Alberta, Canada.

Mohammed A Almekhlafi (MA)

Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada.
Diagnostic Imaging, University of Calgary, Calgary, Alberta, Canada.

Andrew M Demchuk (AM)

Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada.
Diagnostic Imaging, University of Calgary, Calgary, Alberta, Canada.

Michael D Hill (MD)

Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada.
Diagnostic Imaging, University of Calgary, Calgary, Alberta, Canada.

Gustavo Saposnik (G)

Division of Neurology, Department of Medicine, St Michael's Hospital, University of Toronto Faculty of Medicine, Toronto, Ontario, Canada.

Mayank Goyal (M)

Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada.
Diagnostic Imaging, University of Calgary, Calgary, Alberta, Canada.

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Classifications MeSH