Endovascular treatment decision in acute stroke: does physician gender matter? Insights from UNMASK EVT, an international, multidisciplinary survey.

Ospel, Johanna Maria; Kashani, Nima; Wilson, Alexis T; Fischer, Urs; Campbell, Bruce C V; Sylaja, Pillai N; Yoshimura, Shinichi; Rabinstein, Alejandro A; Turjman, Francis; Mitchell, Peter; Kim, Byung Moon; Cherian, Mathew P; Heo, Ji Hoe; Baxter, Blaise W; Podlasek, Anna; Foss, Mona; Menon, Bijoy K; Almekhlafi, Mohammed A; Demchuk, Andrew M; Hill, Michael D; ... (2020). Endovascular treatment decision in acute stroke: does physician gender matter? Insights from UNMASK EVT, an international, multidisciplinary survey. Journal of neurointerventional surgery, 12(3), pp. 256-259. BMJ Publishing Group 10.1136/neurintsurg-2019-015003

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BACKGROUND AND PURPOSE

Differences in the treatment practice of female and male physicians have been shown in several medical subspecialties. It is currently not known whether this also applies to endovascular stroke treatment. The purpose of this study was to explore whether there are differences in endovascular treatment decisions made by female and male stroke physicians and neurointerventionalists.

METHODS

In an international survey, stroke physicians and neurointerventionalists were randomly assigned 10 case scenarios and asked how they would treat the patient: (A) assuming there were no external constraints and (B) given their local working conditions. Descriptive statistics were used to describe baseline demographics, and the adjusted OR for physician gender as a predictor of endovascular treatment decision was calculated using logistic regression.

RESULTS

607 physicians (97 women, 508 men, 2 who did not wish to declare) participated in this survey. Physician gender was neither a significant predictor for endovascular treatment decision under assumed ideal conditions (endovascular therapy was favored by 77.0% of female and 79.3% of male physicians, adjusted OR 1.03, P=0.806) nor under current local resources (endovascular therapy was favored by 69.1% of female and 76.9% of male physicians, adjusted OR 1.03, P=0.814).

CONCLUSION

Endovascular therapy decision making between male and female physicians did not differ under assumed ideal conditions or under current local resources.

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