title: Gender and noninvasive diagnosis of coronary artery disease in women and men.
abstract: OBJECTIVE
  The purpose of this prospective study was to investigate the impact of the gender of physicians and patients on the accuracy of diagnosing coronary artery disease (CAD) based on the patient history only.
  
  
  METHODS
  Screening involved 1082 consecutive patients undergoing coronary angiography for suspected CAD. Known CAD was an exclusion criterion. The inclusion criteria were met by 144 patients (47 females). All patients were inverviewed by both an experienced male cardiologist (n=6) and an experienced female cardiologist (n=5), who had to state before coronary angiography if CAD was present relying solely on the patient interview. Eligible subjects also answered a questionnaire. Diagnostic performance to assess the presence or absence of CAD by history taking by male and female cardiologists, exercise testing, patient self-assessment, and the questionnaire were compared.
  
  
  RESULTS
  Coronary angiography showed significant CAD in 20 females (43%) and 70 males (72%). Diagnostic accuracy was not different between male (79%) and female (79%) cardiologists and comparable to the results of exercise testing (74%) but better than self-assessment by the patients (65%, p=0.01) or a questionnaire (68%, p=0.01). The accuracy of female physicians was better in men than in women (85% vs. 66%, p=0.01). The specificity of male physicians tended to be better in women than in men (74% vs. 59%, p=0.25). Female cardiologists overestimated the presence of CAD in women (specificity 48% vs. 74%, p=0.04).
  
  
  CONCLUSIONS
  The female cardiologists did not assess women more accurately than did their male colleagues. The diagnostic accuracy of these male and female cardiologists was quite good. However, both tend to assess patients of the opposite gender more specifically. There may be an impact of the gender of the physician on the accuracy of diagnosis of CAD by history taking.
authors.affiliation: Division of Cardiology, University Hospital, Zurich, Switzerland.
authors.forename: Barbara
authors.initials: B
authors.lastname: Bürgi Wegmann
authors.forename: Gabor
authors.initials: G
authors.lastname: Sütsch
authors.forename: Hans
authors.initials: H
authors.lastname: Rickli
authors.forename: Burkhardt
authors.initials: B
authors.lastname: Seifert
authors.forename: Jörg
authors.initials: J
authors.lastname: Muntwyler
authors.forename: Thomas F
authors.initials: TF
authors.lastname: Lüscher
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Kiowski
authors.forename: Christine H
authors.initials: CH
authors.lastname: Attenhofer Jost
mesh_terms: D002983:Clinical Competence; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000175:diagnosis*; D005080:Exercise Test; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012737:Sex Factors; D013557:Switzerland