Akbarshahi Hamid, Ahmadi Zainab, Currow David C, Sandberg Jacob, Vandersman Zac, Shanon-Honson Aaron, Ekström Magnus
Dept of Clinical Sciences, Division of Respiratory Medicine and Allergology, Lund University, Lund, Sweden.
IMPACCT, Faculty of Health, University of Technology Sydney, Ultimo, Australia.
ERJ Open Res. 2020 Nov 10;6(4). doi: 10.1183/23120541.00342-2020. eCollection 2020 Oct.
COPD is a major cause of morbidity and mortality. The prevalence, morbidity and mortality of COPD among females have increased. Previous studies indicate a possible gender bias in the diagnosis and management of COPD. The present study aims to determine if there is gender bias in the management of COPD in Sweden.
This was a double-blind, randomised (1:1), controlled, parallel-group, web-based trial using the hypothetical case scenario of a former smoker (40 pack-years and quit smoking 3 years ago) who was male or female. The participants were blind to the randomisation and the purpose of the trial. The case progressively revealed more information with associated questions on how the physician would manage the patient. Study participants chose from a list of tests and treatments at each step of the case scenario.
In total, 134 physicians were randomised to a male (n=62) or a female (n=72) case. There was no difference in initial diagnosis (61 (98%) male cases and 70 (97%) female cases diagnosed with COPD) and planned diagnostic procedures between the male and female cases. Spirometry was chosen by all the physicians as one of the requested diagnostic tests. The management of the hypothetical COPD case did not differ by sex of the responding physician.
In Sweden, diagnosis and management of a hypothetical patient with COPD did not differ by the gender of the patient or physician.
慢性阻塞性肺疾病（COPD）是发病和死亡的主要原因。女性COPD的患病率、发病率和死亡率均有所上升。先前的研究表明，COPD的诊断和管理可能存在性别偏见。本研究旨在确定瑞典在COPD管理方面是否存在性别偏见。
这是一项双盲、随机（1:1）、对照、平行组、基于网络的试验，使用一名曾经吸烟（40包年，3年前戒烟）的男性或女性的假设病例。参与者对随机分组和试验目的不知情。病例逐步揭示更多信息，并伴有关于医生如何管理患者的相关问题。研究参与者在病例场景的每个步骤中从一系列检查和治疗中进行选择。
总共134名医生被随机分配到男性病例组（n = 62）或女性病例组（n = 72）。男性病例和女性病例在初始诊断（61例（98%）男性病例和70例（97%）女性病例被诊断为COPD）和计划诊断程序方面没有差异。所有医生都选择肺活量测定作为所需的诊断测试之一。对假设的COPD病例的管理不因应答医生的性别而有所不同。
在瑞典，假设的COPD患者的诊断和管理不因患者或医生的性别而有所不同。
