Patient gender bias on the diagnosis of idiopathic pulmonary fibrosis.
Thorax
; 75(5): 407-412, 2020 05.
Article
em En
| MEDLINE
| ID: mdl-32054644
ABSTRACT
BACKGROUND:
Patient sex has clinical and prognostic implications in idiopathic pulmonary fibrosis (IPF). It is not known if sex-related and gender-related discrepancies exist when establishing a diagnosis of IPF. The aim was to determine how patient gender influences the diagnosis of IPF and the physician's diagnostic confidence.METHODS:
This study was performed using clinical cases compiled from a single centre, then scored by respiratory physicians for a prior study. Using clinical information, physicians were asked to provide up to five diagnoses, together with their diagnostic confidence. Logistic regression was used to assess the odds of receiving a diagnosis of IPF based on patient gender. Prognostic discrimination between IPF and non-IPF was used to assess diagnostic accuracy with Cox proportional hazards modelling.RESULTS:
Sixty cases were scored by 404 physicians. IPF was diagnosed more frequently in men compared with women (37.8% vs 10.6%; p<0.0001), and with greater mean diagnostic confidence (p<0.001). The odds of a male patient receiving an IPF diagnosis was greater than that of female patients, after adjusting for confounders (OR=3.05, 95% CI 2.81 to 3.31), especially if the scan was not definite for the usual interstitial pneumonia pattern. Mortality was higher in women (HR=2.21, 95% CI 2.02 to 2.41) than in men with an IPF diagnosis (HR=1.26, 95% CI 1.20 to 1.33), suggesting that men were more often misclassified as having IPF.CONCLUSION:
Patient gender influences diagnosis of IPF women may be underdiagnosed and men overdiagnosed with IPF.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Fibrose Pulmonar Idiopática
/
Pneumologistas
Tipo de estudo:
Diagnostic_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Adult
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Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Thorax
Ano de publicação:
2020
Tipo de documento:
Article
País de afiliação:
Canadá