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Women Die More From Heart Attacks Than Men -- Unless the ER Doc Is Female (scientificamerican.com)
Women who suffer from heart attacks may be at a higher risk of death in the emergency room if they see a male physician rather than a female one, a new study suggests. The study doesn't jump to conclusions, but doctors and cardiologists have a few theories. There could be a systematic bias where male physicians are not listening to female patients' complaints as readily as [those of] a man, or there could be a bias that favors men in the medical literature, leading to misdiagnoses in women. It may also be that female doctors do a better job than their male counterparts. "In the new study everyone was more likely to survive if they saw a female physician, and a study published last year [...] indicated all patients of female physicians had lower mortality and hospital readmission rates," reports Scientific American. From the report: Heart disease is the number-one killer of both men and women, but the latter are significantly less likely to survive heart attacks. According to 2016 American Heart Association statement, 26 percent of women will die within a year of a heart attack compared with just 19 percent of men. The gap widens with time: By five years after a heart attack almost half of women die, compared with 36 percent of men. The reason has eluded researchers for years, but the authors of the new study point to the disparity in male and female representation in emergency doctors as a potential source of answers. The researchers analyzed a Florida Agency for Health Care Administration database containing every heart attack case from every ER in the state (excluding Veterans Affairs hospitals) between 1991 and 2010.
The researchers divided 500,000-plus cases into four categories: male doctors treating men; male doctors treating women; female doctors treating men; and female doctors treating women. "All of those are statistically indistinguishable except for male doctor -- female patient," says Brad Greenwood, an author on the study and a data scientist at the University of Minnesota. If a heart attack patient is a woman and her emergency physician is a man, he says, her risk of death suddenly rises by about 12 percent. Put another way, a heart attack patient dies in the ER about 11.9 percent of the time overall -- but the research team found women with heart attacks will die about 12.4 percent of the time if their cases are handled by male doctors. This means approximately one out of every 66 women with heart attacks dies in the emergency room if she sees a male doctor rather than a female one.
The researchers divided 500,000-plus cases into four categories: male doctors treating men; male doctors treating women; female doctors treating men; and female doctors treating women. "All of those are statistically indistinguishable except for male doctor -- female patient," says Brad Greenwood, an author on the study and a data scientist at the University of Minnesota. If a heart attack patient is a woman and her emergency physician is a man, he says, her risk of death suddenly rises by about 12 percent. Put another way, a heart attack patient dies in the ER about 11.9 percent of the time overall -- but the research team found women with heart attacks will die about 12.4 percent of the time if their cases are handled by male doctors. This means approximately one out of every 66 women with heart attacks dies in the emergency room if she sees a male doctor rather than a female one.
Same way men will lie about their problems so as not to appear lesser. Nothing says women don't have pride.
Have all doctors identify as women and all patients identify as men.
From the abstract: "We further find that male physicians with more exposure to female patients and female physicians have more success treating female patients."
http://www.pnas.org/content/early/2018/07/31/1800097115
Just seems like people with more experience in treating females are better at treating females.
No? The TFS sure as hell does!
I tend to rant.
(from the referenced paper in the article, page 918 left side):
Women are often older when they present with their first AMI, at an average age of 71.8 years compared with 65 years for men.
(with AMI meaning Acute Myocardial Infarction)
Now, could it be that the shorter long term survival rate has more to do with age than gender?
Also, there is a very interesting graph on the previous page depicting the AMI-related deaths for both sexes, with female deaths due to cardiovascular faults being in sharp decline since 2000. So either something happened around that time that made women less susceptible to dying from a heart attack, or something else took over as the big lady killer.
We used to have a Bill of Rights. Now, with the rights gone, all we have left is the bill.
First proposition:
In the new study everyone was more likely to survive if they saw a female physician
Second proposition:
The researchers divided 500,000-plus cases into four categories: male doctors treating men; male doctors treating women; female doctors treating men; and female doctors treating women. " All of those are statistically indistinguishable except for male doctor -- female patient ," says Brad Greenwood, an author on the study
Since the second is apparently from an author, I'd tend to guess the first is "journalistic flair" (ahem) from someone carrying around a gender hammer. Unfortunately can't look at the study itself to confirm -- the link in TFS is actually to the AHA 2016 statement and the actual study is paywalled.
I'd bet most ERs only have one cardiologist available at any given time.
I bet a lot of the smaller ones have none present at times and rely on on-call when needed.
It could also be the female cardiologists are less experienced, less senior or less competent. Therefore they are only assigned the easier, more routine, lower-risk cases.
Does Tokyo Medical University approve of their admissions staff posting on Slashdot during working hours?
It could also be the female cardiologists are less experienced, less senior or less competent. Therefore they are only assigned the easier, more routine, lower-risk cases.
If this was the case, then the disparity would show up for both male and female patients. Yet according to TFA, the survival difference for male patients was not statistically significant.
For the paper what seem to have happen is two fold.
First they had an open question, wanted to see if patients had different outcomes from male and female doctors, this is a prime example on how to poke the data until something came out, you just look at every combination until something presents a statistical significant value, I bet that if they do this study again they will get different findings.
Second, the difference was not that big, 0,5% less on the outcome of both cases, mortality and readmission, (or about 4% in relative terms) when treated by a woman, when the biggest difference in outcome, according the numbers by SciAm, was the gender itself, 26% of women will die within a year of a heart attack compared with 19% of men.
The researches say they adjusted for several factors, but I wonder if differences in choices of time or location of work between men and women may cause the difference, if it is actually real.
And by the way, the mean age of patients in the study is 80 years old, and almost 2/3 were women.
For the SciAm article, they seem to not report on the paper, but on part of the raw data in the paper, which is likely not adjusted for confounding factors and the report also seem very biased and sensationalist.
It's odd that you don't see that it would still be the same study. Men survive more than women if the doctor is male, and women survive more than men if the doctor is female. There's plenty for both party's fanatics to be butt-hurt about, I guess you just decided to pick one.
No it doesn't.
[...] a heart attack patient dies in the ER about 11.9 percent of the time overall -- but the research team found women with heart attacks will die about 12.4 percent of the time if their cases are handled by male doctors.
That's more like a 4% rise, not a 12% rise. Overstating threefold much?
A common mistake on /., conflating increase in risk with increase in occurrence probability.
CPR is not used for mycoardial infarction. The heart stopping, such as from atrial tachycardia, is treatable with CPU. CPR is quite dangerous, it tends to break ribs and is not that efficient. The mortality rate for CPR is also quite high: if you ever perform CPR in the field, it's important not to blame yourself personally if it fails, even if you made small mistakes. Only roughly 1/3 of CPR patients survive.
Myocardial Infarctions are tissue death in the heart, caused by a blockage. They're typically painful because muscle tissue in the heart is _dying_. Many people have survived numerous small infarctions. ECG's, however, electro cardiograms, where electrodes are placed on the chest and a few elsewhere on the body to monitor heart activity, does involve at least opening up the shirt and exposing the chest.
Also, many patients are quite frightened in the emergency room. I can easily picture a frightened, older female patient, who grew up more than 50 years ago, being less frightened and less reluctant to share their full medical information with a male physician, and their family or caregivers less able to communicate with a male physician.
Just remove this meaningless social construct that is gender from the study and the problem goes away.
I am armed because I am free. I am free because I am armed.
They already did, some time ago.
Google "BBC health gap" and prepare to be horrified (it's a series of articles written by some dickless man calling himself a doctor) . Somehow even though women live 8 yrs longer, are healthier, die less at work (93:7), die less from suicide (3:1) there is a health gap, a systematic war against women of which the whole medical profession (where women are the majority) is complicit.
The best I have ever heard is that women are smaller and weaker than men because we systematically and deliberately underfed them throughout the whole of history. I wonder why female chimps are smaller and weaker (and just about every other animal); that patriarchy goes a long way it seems!
BTW, according to Wikipedia there was a society that gave poorer food to women and in this society women did live shorter than men. Guess which society was that? Athens. The city state, that is. Yes, the fathers of democracy. The Spartans had better eugenics program --> they did not allow teenage pregnancy which was an amazing insight for those times. They'd also allow, in exceptional cases, polygamy in light of the numerous young widows among the warrior class. But then, there were other issues in their society (e.g. slavery) that were not so great...
It is absolutely ridiculous that the most privilege group of people in history (white western women) who are surrounded by endless invisible walls of protection and comfort (provided mostly my men), who rubbed their backsides on the banks of the best universities never seen a day of hardship, while their peers in the rest of the world were working full time jobs (sometimes more than one) and rising a family (just ask what my mother or grandmothers think about those screeching harpies...be prepared for the c-word to be mentioned repeatedly) are now declaring the world to the most horrific of places, their position to be one of victimhood and oppression while opening the doors (and legs) to cultures that are decades behind the West in terms of equal treatment of different people (who are the greatest homophobes in the world - Africans and Arabs! The stories I have heard from white, gay South Africans...wow man, just wow!).
In my worst nightmares I could not imagine that the West would come to this. All those years I am here (17), among you, I was worried about the rednecks, the ultra-religious creationists, the "foking banksters", the 1%, the mafia that is the energy industry (oil, gas), food, medicine, cosmetics and so on....anyone can see my /. post history.....and now my own people (the left, don't blame me, I can't help it, no way you can be conservative with extrovert and openness score in the 95 percentile range) betrayed me and became anti-science, anti-free speech, anti-reality for fuck's sake! I am ashamed of myself, that I missed that transformation for many years (yes, I did have horrendous personal problems so I let everything else slide, including political analysis, but still....) and repeated for a while the bulshit without checking the facts...well we live and learn I guess.
I am well aware where the division in groups and the oppressed-oppressor narrative lead. So, westerners, pick your ultimate destiny --> fascist labor camps, or communist Gulags. You don't have a third option since the silent majority happily/docilly allowed the nutters from both sides to hijack the political discourse, the mainstream media, the educational system and so on...now 2 generations have been screwed already. We will harvest what we sow. Good luck!
That's not what it says.
It says "In the new study everyone was more likely to survive if they saw a female physician"
Which means that men seeing female doctors survive better too. Sometimes you have to be careful with reports, because male doctors kill more women is true. but male doctors kill more of everyone is MORE true.
So - basically the study is implying that there is something about male doctos that increases mortality.
The study concludes:
"Sex differences occur in the pathophysiology and clinical pre-sentation of MI and affect treatment delays. Recommended perfusion therapies for AMI in women are similar to those in men, yet bleeding risks and other complications remain greater in women. Women are undertreated with guideline-based recommendations, leading to worse outcomes and increased rates of readmission, reinfarction, and deaths in the first year after MI."
So it seems like some doctors are failing to diagnose the issue as quickly in women as they do in men, because of the different ways that the condition presents. Furthermore they undertreat women.
Also,
"To further compound undertreatment, womenâ(TM)s adherence to these evidence-based recommendations is sub-optimal. There is a need for continued public health messages and interventions to target racial and ethnic minority women"
So when they are treated women from certain backgrounds are somewhat less likely to stick to the treatments. I kind of wonder if cost is a factor there.
The difference in outcomes between male and female doctors treating women is statistically significant but small in comparison to these bigger issues.
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SJW, n: "Someone I don't like, and by the way I'm a fuckwit" - AC
How about:
(1) male physicians are bigger risk takers and take on harder cases
(2) male physicians are taking a longer view picture and don't waste resources on patients that may not die in the emergency room but will die within a few days
(3) male physicians do, in fact, listen more to their patients, about 20% of whom have do not resuscitate orders, and more who may express a verbal preference against extraordinary measures or a life with severe mental disability
(4) there are differences in reporting between male and female physicians
A partner of mine suffered from agoraphobia terribly, sometimes suffering anxiety and tachycardia with HR over 220 for extended periods. Counseling, medication, nothing seemed to be effective, and she was a highly-skilled RN, just adding to her frustration. It ruined our relationship long before it became so debilitating she was considering changing her career.
One attack landed her in the ER and in front of the new-in-town cardiologist fresh from residency in a well-known hospital. According to the ER nurse he took a two minute look at the EKG, ordered tests stat, another two minute read, and was on the phone back to his residency hospital, booking air evac, and sending her to his mentor.
She had a conduction defect. Not merely undetected for her entire life, but actually ruled out by more than one cardiologist previously, certain she was just having panic attacks. Yes, this caused a few uncomfortable discussions, and this fresh new cardiologist left the area and joined a big-city practice, for he had stumbled into a nice, quiet city that loved its doctors, and did not appreciate having them called out as having missed one diagnosis.
Why? Well, first, women were once considered 'hysterical' beings, prone to problems that were psychological and not physical. This is hard to overcome, even generations later. And much heart disease is, even today, considered a male problem, as if women all eat well, suffer less stress, and are not physically active.
How many have died needlessly?
deleting the extra space after periods so i can stay relevant, yeah.
Might be a problem...but not "a real problem in our society." We have bigger fish to fry than figuring out how to enhance the privilege of the ultra-privileged.
I object to power without constructive purpose. --Spock
I'd like to see better statistics. On average, a first heart attack strikes men at age 65; women, 72. A 72 year old is simply more likely to die of a heart attack than a 65 year old one; age matters. There's no surprise that women are more likely to die, and although women are more likely to die of their heart attack, men still, on the average, die earlier of heart attacks.
The difference between male and female doctors is interesting, but note that the difference is actually small: according to the article, a heart attack patient dies in the ER about 11.9 percent of the time, versus 12.4 percent with female doctors-- the difference is one part in two hundred. So I agree with the caution suggested by an outside researcher about this study: "Emergency doctors and cardiologists, however, are wary of jumping to conclusions just yet. It is a little early to say male physicians have trouble treating female heart attack patients based on these data alone, says Michelle O’Donoghue, a cardiologist at Brigham and Women’s Hospital and Harvard Medical School who did not work on the new study." Right: let's look at confounding effects first.
The big confounding effect here is age in doctors, not just patients: on the average, female doctors are younger than male doctors, and thus more recently educated and presumably up to date on the most modern techniques. I'd like to see that effect accounted for.
They already did, some time ago. Google "BBC health gap" and prepare to be horrified (it's a series of articles written by some dickless man calling himself a doctor) . Somehow even though women live 8 yrs longer, are healthier, die less at work (93:7), die less from suicide (3:1) there is a health gap, a systematic war against women of which the whole medical profession (where women are the majority) is complicit....
Yes, an interesting point. Men die earlier. How is this effect accounted for?
Some of these cases may be heart attacks, but I suspect most are actually just female hysteria.
Most chest pain in the ER turns out to be non-serious.
Still, it's to be careful as the serious cases are doozies.
Actually it's much simpler than that.
Their claim that their groups seperate out other infractions is not even basically correct.
All it takes is two biases.
For example if women having attacks are more likely to die (which they are add women tend to have them later in life) and male doctors are more likely to be given more difficult cases (which they are, as they tend to be more senior due to a longer time in the system) then we would see exactly this distribution.
How on earth a statistical paper can be published without even a basic understanding of statistics is ridiculous.
Of course the reason it can be is it's conclusion is politically motivated and happily accepted of course.
But it is not science.
It's odd that you don't see that it would still be the same study. Men survive more than women if the doctor is male, and women survive more than men if the doctor is female.
If you had bothered to read all the way too the 4th sentence of the summary, you would have seen this:
It may also be that female doctors do a better job than their male counterparts. "In the new study everyone was more likely to survive if they saw a female physician, and a study published last year [...] indicated all patients of female physicians had lower mortality and hospital readmission rates," reports Scientific American
But why actually read what you're commenting on, right? Total waste of time.
There's plenty for both party's fanatics to be butt-hurt about, I guess you just decided to pick one.
Judging by the fact that I got modded "troll" while the jackass who couldn't even be bothered to read the fucking summary got modded "+5 insightful", I guess we know which fanatics managed to get their grubby little mitts on mod points today.
Okay, prove it, pick a race and provide a fixed definition without resorting to subjective identification by oneself or others... 1. 2. 3 go.
You'll fail. There are things we tend to group with loose general and incorrect perceptions of the definition of a race that are real, things like national or regional origin and culture; as well as common highly visible traits like skin color, eye shape, dna ancestry, etc. None of these define a race and at this point the genetics and nationalities are so blended in our society that if they once did it no longer matters. The truth is we have sets of characteristics we tend to lump under race categories and people just go along with what everyone around them has said when they grew up.
Legally your race is defined by self-identification because we have no way to define it. Right now we play so fast and loose with that word that it is meaningless. There are certain medical factors that go along with genetic race but the utility of considering that is no different than screening for any of the millions of genetic illnesses that don't have a high correlation to racial identification. The DNA ancestry and culture angle is highly in congruent with the way most are defining these things. For example here in the states everyone who is black is treated like a former slave and those who are former slaves are that this point genetically as much or more like their slave owner ancestors than their slave ancestors and you can't from a genetic standpoint claim one more than the other. Almost every disadvantage associated with being one of them that can actually objectively be proven can be solved in a single generation by moving outside of neighborhoods that group others with the same label together, integrating with general american culture, and hard work. In other words, those problems have to do with neighborhoods and cultures and not genetic history.