title: Does medical specialty influence the treatment of asymptomatic carotid stenosis? a Belgian multidisciplinary survey.
abstract: OBJECTIVE
  The aim of this study was to supplement the few data that exist regarding the potential effect of the referring medical specialty on the proposed treatment for asymptomatic carotid stenosis.
  
  
  METHODS
  In a web survey, we presented Belgian cardiologists, neurologists and vascular surgeons with two fairly uncomplicated case vignettes on asymptomatic carotid stenosis differing only in the degree of stenosis (70-80% in case 1 and >80% in case 2).
  
  
  RESULTS
  In both cases the suggested therapies were different per medical specialty (P<0.000002 and P<0.00002, respectively). Cardiologists were more conservative and vascular surgeons were more aggressive. Preferred therapies for both cases differed statistically significantly (odds ratio 8.63; 95% confidence interval 5.11-14.58). Suggesting a different therapy or not for case 1 and case 2 was also different per medical specialty (P<0.035). Cardiologists were most inclined to suggest a different therapy and vascular surgeons the least. Nobody switched to a more conservative treatment. Younger physicians suggested a more conservative approach (P<0.014).
  
  
  CONCLUSIONS
  Different medical specialties prefer different treatments for asymptomatic carotid stenosis. Also, younger physicians seem more conservative. We elaborate on the different reasons that could explain these findings.
authors: Department of Neurology, Leuven University Hospitals, Belgium. maarten.schrooten@uzleuven.be
authors: M
authors: M
authors: Schrooten
authors: I
authors: I
authors: Fourneau
authors: V
authors: V
authors: Thijs
authors: P
authors: P
authors: Verhamme
authors: A
authors: A
authors: Nevelsteen
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D017130:Angioplasty / Q000295:instrumentation / Q000706:statistics & numerical data; D058070:Asymptomatic Diseases; D001530:Belgium; D002309:Cardiology; D002317:Cardiovascular Agents / Q000627:therapeutic use*; D016893:Carotid Stenosis / Q000628:therapy*; D016009:Chi-Square Distribution; D016894:Endarterectomy, Carotid / Q000706:statistics & numerical data; D005260:Female; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D020407:Internet; D008297:Male; D008511:Medicine / Q000706:statistics & numerical data; D008875:Middle Aged; D009462:Neurology; D016017:Odds Ratio; D018579:Patient Selection; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012720:Severity of Illness Index; D015607:Stents; D014656:Vascular Surgical Procedures
chemical_list: D002317:Cardiovascular Agents