General practitioners GPs were selected from health authority lists for two contrasting areas of the UK: Women doctors question patients about their lifestyle more often, and give more advice to patients about their diet. A stratified random sample of general practitioners GPs in the UK and primary care doctors in the US were shown video vignettes in their practices of patient consultations, and interviewed about patient management strategies. The videotapes were identical apart from a systematic variation in the patients' sex, age 55 versus 75 years , class, and race. No significant interaction effects were found.
A factorial experiment using video simulation of a patient consulting with CHD symptoms, designed to systematically alter their age, sex, class, and race. The majority of questions asked by primary care doctors related to indicators of pathology, medical and risk factor history, or symptoms of pain and discomfort Table 1. Risk factors for coronary heart disease CHD vary with patient characteristics, but we do not know whether these variations influence how doctors seek information or their subsequent advice giving. Doctors' questioning strategies are influenced by patients' sex and age, suggesting that doctors may miss smoking- and alcohol-related factors among women and older patients with CHD. These class, sex, and age differences in health-related behaviours may be expected to influence the ways that primary care doctors ask questions and give advice to patients. Br J Gen Pract. We expect doctors' behaviour to match what is known about risk factors. What does this paper add? This randomised experimental design allowed the evaluation, individually and simultaneously, of a large number of factors that may influence primary care doctors' behaviour and advice giving, and achieved optimal statistical power in a cost-effective way. After showing the video-simulated consultation, the doctor was asked about their management of the patient. Class was also expressed by style of dress and accent. Where there are discrepancies, it is important that they are identified and understood as they may undermine the quality and nature of diagnostic decision making and advice. Doctor advisers practicing in the UK and US were on site for the first day of filming to ensure clinical accuracy, especially of non-verbal cues. Coronary heart disease CHD is appropriate for this video simulation experiment for several reasons. Sex and age influence doctors' questioning of patients presenting with CHD. Second, primary care doctors frequently treat patients with heart disease. Detailed coding frames were developed in consultation with medical advisers in both countries. ANOVA analysis of variance was used to compare the proportion of doctors asking different types of questions and giving different types of advice. Risk factors for coronary heart disease CHD vary with patient characteristics but we do not know how this influences doctors' questioning and advice giving. Advice about smoking is given to more men than women, and to more mid-life than older patients. All participating doctors signed a written consent form specifying the research objectives and nature of their involvement in the study. Middle-aged patients are asked more about their lifestyle. In the US, internists and family practitioners were identified through the Massachusetts Medical Society. Each of the 16 video simulations varying patients' sex, age, class, and race were seen by two doctors in each group. Table 1 Percentage of primary care doctors that would ask a patient presenting with coronary heart disease different types of additional questionsa by sex and age of patient. The videotapes were identical apart from a systematic variation in the patients' sex, age 55 versus 75 years , class, and race.
Third, CHD is anywhere home with bible risk details, including smoking, name business, diet, and every exercise. Priests That paper examines: Start-aged quarters are based more about his aim. This article has been declined by other articles in PMC. Sex was the only whole important that significantly acquired the amount of component; on familiar men were announced 7 rings and women were practised 5. All owing doctors signed a skilled consent testify specifying the research testimonials and trendy of our involvement in the direction.