Practitioner Gender and Quality of Care in Ambulatory Cardiology Practices: A Report From the National Cardiovascular Data Practice Innovation and Clinical Excellence (PINNACLE) Registry.
Dipti Gupta, Fengming Tang, Frederick A Masoudi and 3 others
PMID 28816774WHAT IT FOUND
Practitioner gender showed little consistent difference in prescribing once practitioner type and visit number were considered: 3 of 7 measures were similar, and 4 were higher for male practitioners.
Key findings
01After adjustment, male practitioners had higher adherence for four of seven measures, including antiplatelet therapy, beta-blocker therapy, and lipid-lowering therapy for CAD, and oral anticoagulant therapy for AF.
02Among eligible AF patients, oral anticoagulant adherence was 57.4% for male practitioners and 49.2% for female practitioners.
03For eligible LVSD patients, beta-blocker use was 90.8% with male practitioners and 91.3% with female practitioners, with no significant difference.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study was observational, so it cannot show that practitioner gender caused the differences in adherence. Participation in the registry was voluntary, so highly motivated practices may have been over represented. Patients seen by male and female practitioners differed at baseline, including age, sex, smoking, coronary artery disease, diabetes, and hypertension, which may have confounded the results. Only 300 of 1,493 practitioners were women, and only 131 of those were physicians, so the study may be underpowered for gender differences and could not examine whether differences varied by practitioner type. The study measured prescribing adherence to performance measures, not patient outcomes.
Declared interests
The supplied metadata lists NIH extramural and non-U.S. government research support. The article text provided does not include an author conflict-of-interest statement.
The easy way to misread this
Do not conclude that practitioner gender caused the differences in prescribing. The study is observational, the adjusted differences were small, and only 300 of 1,493 practitioners were women.