Abstract 16545: Gender Attitudes and the Use of Angiography Among Cardiologists
Background: Physician bias may contribute to gender disparities in the use of angiography. We performed the first study using the Implicit Association Test (IAT) to examine gender biases and their associations with angiography decisions.
Methods: Cardiology physicians were emailed a web-based survey that included 2 gender-IATs and a two-part clinical vignette randomized by patient gender. The IATs measured attitudes about men versus women on strength and risk-taking. The vignette represented an intermediate likelihood of CAD regardless of gender; part-1 described a patient with symptoms of CAD and part-2 described an abnormal stress test. Physicians rated the likelihood of CAD and their agreement with the usefulness of angiography for that patient. We examined the association between gender attitudes and rated usefulness of angiography for the male and female patient, adjusting for the perceived likelihood of CAD.
Results: Of the 503 cardiologists who responded, over half associated strength and willingness to take risks with males. For both parts of the case, cardiologists’ estimated the likelihood of CAD similarly by patient gender; yet, cardiologists’ more often rated the usefulness of angiography as “high” for the male versus female patient (Part-1: 19.7% vs. 9.8%; Part-2: 73.7% vs. 64.3%; p<0.05 for both). These differences varied by gender attitudes; those with higher male-risk bias or male-strength bias rated angiography as more useful for men than for women. (Figure) After adjustment, only the relationship with male-risk bias and higher angiography rating for male patients persisted (p=0.01 for interaction).
Conclusions: Despite similar estimates of CAD likelihood, cardiology physicians rated the usefulness of angiography higher for a standardized male than female patient. This difference significantly varied by gender-risk bias suggesting the concept of riskiness influenced decisions about angiography differently in women and male patients.
Author Disclosures: S.L. Daugherty: Research Grant; Significant; NHLBI K08. I.V. Blair: None. E.P. Havranek: None. A. Furniss: None. M. Dickinson: None. D.S. Main: None. E. Karimkhani: None. F.A. Masoudi: None.
- © 2015 by American Heart Association, Inc.