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Angell AM, Varma DS, Deavenport-Saman A, Yin L, Solomon O, Bai C, Zou B. Effects of Sex, Race, and Ethnicity on Primary and Subspecialty Healthcare Use by Autistic Children in Florida: A Longitudinal Retrospective Cohort Study (2012-2018). RESEARCH IN AUTISM SPECTRUM DISORDERS 2022; 94:101951. [PMID: 35498508 PMCID: PMC9053730 DOI: 10.1016/j.rasd.2022.101951] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Affiliation(s)
- Amber M. Angell
- Department of Occupational Therapy at University of Florida, PO Box 100165, Gainesville, FL 32610
| | - Deepthi S. Varma
- Department of Epidemiology at University of Florida, 2004 Mowry Road, Gainesville, FL, 32610
| | - Alexis Deavenport-Saman
- Keck School of Medicine at University of Southern California, 1975 Zonal Ave, Los Angeles, CA 90033
- Children’s Hospital Los Angeles, 4650 Sunset Blvd, Los Angeles, CA 90027
| | - Larry Yin
- Keck School of Medicine at University of Southern California, 1975 Zonal Ave, Los Angeles, CA 90033
- Children’s Hospital Los Angeles, 4650 Sunset Blvd, Los Angeles, CA 90027
- Mrs. T. H. Chan Division of Occupational Science and Occupational Therapy at University of Southern California, 1540 Alcazar St, Los Angeles, CA 90089
| | - Olga Solomon
- Keck School of Medicine at University of Southern California, 1975 Zonal Ave, Los Angeles, CA 90033
- Children’s Hospital Los Angeles, 4650 Sunset Blvd, Los Angeles, CA 90027
| | - Chen Bai
- Department of Biostatistics at University of Florida, 2004 Mowry Road, Gainesville, FL, 32610
| | - Baiming Zou
- Department of Biostatistics at University of North Carolina at Chapel Hill, 170 Rosenau Hall, CB #7400, 135 Dauer Drive, Chapel Hill, NC, 27599
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Morais R, Bernardes S, Verdonk P. What is gender awareness in health? A scoping review of the concept, its operationalization, and its relation to health outcomes. Women Health 2022; 62:181-204. [PMID: 35220903 DOI: 10.1080/03630242.2022.2041150] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Gender awareness emerged in the 1990s and aimed to provide awareness and sympathy toward the needs of women, measuring health-care providers' attitudes toward them and understand if providers possessed the knowledge for appropriate care. According to Miller et al.'s seminal model, gender awareness incorporates three sub-dimensions: gender sensitivity, gender ideology, and knowledge. Gender awareness has the potential to minimize gender bias in health care, improving the ecological validity of research. This scoping review provides an analysis of how gender awareness has been conceptualized, operationalized, and investigated in its relationship with health-related outcomes. A search was conducted on PubMed, PsycINFO, and ERIC. The relevance of 2.589 articles was assessed and 14 empirical studies were selected and included. Difficulties conceptualizing gender awareness were found and gender awareness and gender sensitivity were often presented as interchangeable. Most papers aimed to measure and compare levels of gender awareness among health professionals and the relationship between gender awareness and relevant health-related outcomes was not studied. Drawing upon a critical analysis of our findings, a proposal for a revised gender awareness conceptualization and operationalization is put forth as to inform novel research on its association with gender bias in health and health care.
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Affiliation(s)
- Rita Morais
- Instituto Universitário de Lisboa (ISCTE-IUL), Lisbon, Portugal.,Centro de Investigação e Intervenção Social (CIS-IUL), Lisbon, Portugal
| | - Sónia Bernardes
- Instituto Universitário de Lisboa (ISCTE-IUL), Lisbon, Portugal.,Centro de Investigação e Intervenção Social (CIS-IUL), Lisbon, Portugal
| | - Petra Verdonk
- Department Ethics, Law & Humanities, APH Research Institute, Amsterdam UMC-VUmc, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
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Kalff MC, Wagner AD, Verhoeven RHA, Lemmens VEPP, van Laarhoven HWM, Gisbertz SS, van Berge Henegouwen MI. Sex differences in tumor characteristics, treatment, and outcomes of gastric and esophageal cancer surgery: nationwide cohort data from the Dutch Upper GI Cancer Audit. Gastric Cancer 2022; 25:22-32. [PMID: 34365540 PMCID: PMC8732809 DOI: 10.1007/s10120-021-01225-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 07/27/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Sex differences in clinicopathological characteristics, treatment, and postoperative outcomes of gastric and esophageal cancer are largely undefined. This study aimed to compare tumor and treatment characteristics and outcomes of gastric and esophageal cancer surgery between male and female patients. METHODS Patients after elective surgery for primary esophageal (EAC) or gastric adenocarcinoma (GAC) registered in the Dutch Upper GI Cancer Audit between 2011 and 2016 were included. The primary endpoint, 5-year relative survival with relative excess risk (RER), i.e., adjusted for the normal life expectancy, was compared between male and female patients with EAC and GAC. RESULTS In total, 4937 patients were included (75% male) with a mean age of 66 years. cT and cN-stages showed a similar distribution in male and female patients. In females, antrum GAC was more frequent (47% vs. 38%, p < 0.001). Female patients with EAC less frequently received neo-adjuvant treatment (OR = 0.60, 95% CI 0.38-0.96, p = 0.033). For GAC, less postoperative morbidity (33% vs. 38% p = 0.017) and less re-interventions (12% vs. 16%, p = 0.008) were observed in females, although they had inferior 5-year relative survival (49% vs. 56%, RER = 1.31, 95% CI 1.09-1.58, p = 0.004). No differences in relative survival of EAC were observed. CONCLUSIONS In addition to significant sex differences in tumor location, female patients with esophageal adenocarcinoma less frequently received neo-adjuvant therapy, and female patients with gastric adenocarcinoma had inferior relative survival. Further consideration and exploration of sex differences in surgical treatment and outcomes are necessary to improve tailored treatment and outcomes.
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Affiliation(s)
- Marianne C. Kalff
- Department of Surgery, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Anna D. Wagner
- Department of Oncology, Lausanne University Hospital (CHUV), University of Lausanne (UNIL), Lausanne, Switzerland
| | - Rob H. A. Verhoeven
- Department of Research, Netherlands Comprehensive Cancer Organization (IKNL), Utrecht, the Netherlands ,Department of Medical Oncology, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Valery E. P. P. Lemmens
- Department of Research, Netherlands Comprehensive Cancer Organization (IKNL), Utrecht, the Netherlands ,Department of Public Health, Erasmus University Medical Centre, Rotterdam, the Netherlands
| | - Hanneke W. M. van Laarhoven
- Department of Medical Oncology, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Suzanne S. Gisbertz
- Department of Surgery, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Mark I. van Berge Henegouwen
- Department of Surgery, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
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Obenson K. Commentary on: Dror IE, Melinek J, Arden JL, Kukucka J, Hawkins S, Carter J, et al. Cognitive bias in forensic pathology decisions. J Forensic Sci. https://doi.org/10.1111/1556-4029.14697. Epub 2021 Feb 20. J Forensic Sci 2021; 66:2582-2584. [PMID: 34499354 DOI: 10.1111/1556-4029.14855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 07/19/2021] [Indexed: 11/26/2022]
Affiliation(s)
- Ken Obenson
- Dalhousie Medical School New Brunswick and the Horizon Health Network, Department of Laboratory Medicine, Saint John Regional Hospital, Saint John, Canada
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Ross AB, Kalia V, Chan BY, Li G. The influence of patient race on the use of diagnostic imaging in United States emergency departments: data from the National Hospital Ambulatory Medical Care survey. BMC Health Serv Res 2020; 20:840. [PMID: 32894129 PMCID: PMC7487740 DOI: 10.1186/s12913-020-05698-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 08/31/2020] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND An established body of literature has shown evidence of implicit bias in the health care system on the basis of patient race and ethnicity that contributes to well documented disparities in outcomes. However, little is known about the influence of patient race and ethnicity on the decision to order diagnostic radiology exams in the acute care setting. This study examines the role of patient race and ethnicity on the likelihood of diagnostic imaging exams being ordered during United States emergency department encounters. METHODS Publicly available data from the National Hospital Ambulatory Medical Care Survey Emergency Department sample for the years 2006-2016 was compiled. The proportion of patient encounters where diagnostic imaging was ordered was tabulated by race/ethnicity, sub-divided by imaging modality. A multivariable logistic regression model was used to evaluate the influence of patient race/ethnicity on the ordering of diagnostic imaging controlling for other patient and hospital characteristics. Survey weighting variables were used to formulate national-level estimates. RESULTS Using the weighted data, an average of 131,558,553 patient encounters were included each year for the 11-year study period. Imaging was used at 46% of all visits although this varied significantly by patient race and ethnicity with white patients receiving medical imaging at 49% of visits and non-white patients at 41% of visits (p < 0.001). This effect persisted in the controlled regression model and across all imaging modalities with the exception of ultrasound. Other factors with a significant influence on imaging use included patient age, gender, insurance status, number of co-morbidities, hospital setting (urban vs non-urban) and hospital region. There was no evidence to suggest that the disparate use of imaging by patient race and ethnicity changed over the 11-year study time period. CONCLUSION The likelihood that a diagnostic imaging exam will be ordered during United States emergency department encounters differs significantly by patient race and ethnicity even when controlling for other patient and hospital characteristics. Further work must be done to understand and mitigate what may represent systematic bias and ensure equitable use of health care resources.
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Affiliation(s)
- Andrew B Ross
- Department of Radiology, School of Medicine and Public Health, University of Wisconsin, 600 Highland Ave, Madison, WI, 53792, USA.
| | - Vivek Kalia
- Department of Radiology, University of Michigan Health System, 1500 E Medical Center Dr, Ann Arbor, MI, 48109, USA
| | - Brian Y Chan
- Department of Radiology, School of Medicine, University of Utah, 30 N. 1900 E., Salt Lake City, UT, 84132, USA
| | - Geng Li
- Department of Biostatistics and Medical Informatics, School of Medicine and Public Health, University of Wisconsin, 600 Highland Ave, Madison, WI, 53792, USA
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Mattocks K, Casares J, Brown A, Bean-Mayberry B, Goldstein KM, Driscoll M, Haskell S, Bastian L, Brandt C. Women Veterans’ Experiences with Perceived Gender Bias in U.S. Department of Veterans Affairs Specialty Care. Womens Health Issues 2020; 30:113-119. [DOI: 10.1016/j.whi.2019.10.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 09/20/2019] [Accepted: 10/07/2019] [Indexed: 12/20/2022]
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Frigerio M, Carugo S, Voltolini A. Of hearts, minds, and guts: difficulties in diagnosing heart failure in the young. Eur J Heart Fail 2019; 22:8-11. [DOI: 10.1002/ejhf.1544] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Revised: 04/24/2019] [Accepted: 06/04/2019] [Indexed: 12/28/2022] Open
Affiliation(s)
- Maria Frigerio
- 2nd Section of Cardiology, Heart Failure and Cardiac Transplant Unit, De Gasperis Cardio CenterNiguarda Hospital Milan Italy
| | - Stefano Carugo
- Cardiology Unit, San Paolo Hospital, Department of Health SciencesUniversity of Milan Milan Italy
| | - Alessandra Voltolini
- Clinical Psychology Service, Department of Mental HealthNiguarda Hospital Milan Italy
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