Sex inequalities in ischaemic heart disease in primary care

doi:10.1136/bmj.323.7309.400/a

BMJ 2001;323:400 ( 18 August )

Letters

Sex inequalities in ischaemic heart disease in primary care

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Clinical decision making is not necessarily guided by prejudice

The first 150 words of the full text of this article appear below.

EDITOR $---$ The paper by Hippisley-Cox et al makes an important contribution to the literature on sex differences in health serviceuse.¹ Primary care physicians act as gatekeepers to specialisthealth services, yet this critical role in the healthcare systemhas been largely ignored by researchers in this field.²

Hippisley-Cox et al said that their findings suggest a systematic bias towards men in terms of secondary prevention of ischaemicheart disease. Such a conclusion is premature. The results mayreflect biased decision making, but they may also have been determinedby patient preferences or mutual agreement between doctor andpatient. In common with other research in this area, the chargeof biased decision making has been made as a result of a processof exclusion. Once it has been shown that clinical need (in thiscase a diagnosis of ischaemic heart disease) cannot account forthe finding that women are . . . [Full text of this article]

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Relevant Article

Sex inequalities in ischaemic heart disease in general practice: cross sectional survey: Julia Hippisley-Cox, Mike Pringle, Nicola Crown, Andy Meal, and Alison Wynn
BMJ 2001 322: 832. [Abstract] [Full Text] [PDF]

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Rapid Responses:

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Sex and secondary prevention: Mike Banning
bmj.com, 24 Aug 2001 [Full text]
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