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急性脑卒中血管内治疗决策:医生性别是否重要?来自 UNMASK EVT 的国际多学科调查的见解。

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

机构信息

Division of Neuroradiology, Clinic of Radiology and Nuclear Medicine, University Hospital Basel, Basel, Switzerland.

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

出版信息

J Neurointerv Surg. 2020 Mar;12(3):256-259. doi: 10.1136/neurintsurg-2019-015003. Epub 2019 Jul 30.

Abstract

BACKGROUND AND PURPOSE

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

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

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

Endovascular therapy decision making between male and female physicians did not differ under assumed ideal conditions or under current local resources.

摘要

背景与目的

在多个医学亚专科领域已经显示出女性和男性医生在治疗实践方面存在差异。目前尚不清楚这是否也适用于血管内卒中治疗。本研究的目的是探讨女性和男性卒中医生和神经介入医生在血管内治疗决策方面是否存在差异。

方法

在一项国际调查中,卒中医生和神经介入医生被随机分配了 10 个病例场景,并被问及他们将如何治疗患者:(A)假设没有外部限制,(B)考虑其当地工作条件。使用描述性统计数据描述基线人口统计学特征,并使用逻辑回归计算医生性别作为血管内治疗决策预测因子的调整比值比。

结果

共有 607 名医生(97 名女性,508 名男性,2 名不愿透露性别)参与了这项调查。在假设理想条件下,医生的性别既不是血管内治疗决策的显著预测因素(77.0%的女性和 79.3%的男性医生倾向于血管内治疗,调整比值比 1.03,P=0.806),也不是在当前当地资源条件下的显著预测因素(69.1%的女性和 76.9%的男性医生倾向于血管内治疗,调整比值比 1.03,P=0.814)。

结论

在假设的理想条件下或当前的当地资源条件下,男性和女性医生的血管内治疗决策没有差异。

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