Challenges to conquer from the gender perspective in medicine: The case of spondyloarthritis

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Title: Challenges to conquer from the gender perspective in medicine: The case of spondyloarthritis
Authors: Jovaní, Vega | Blasco-Blasco, Mar | Pascual, Eliseo | Ruiz-Cantero, María Teresa
Research Group/s: Salud Pública
Center, Department or Service: Universidad de Alicante. Departamento de Enfermería Comunitaria, Medicina Preventiva y Salud Pública e Historia de la Ciencia | Universidad de Alicante. Instituto Universitario de Investigación de Estudios de Género
Keywords: Diagnostic delay | Misdiagnosis | Spondyloarthritis | Gender perspective
Knowledge Area: Medicina Preventiva y Salud Pública
Issue Date: 12-Oct-2018
Publisher: Public Library of Science (PLoS)
Citation: Jovani V, Blasco-Blasco M, Pascual E, Ruiz-Cantero MT (2018) Challenges to conquer from the gender perspective in medicine: The case of spondyloarthritis. PLoS ONE 13(10): e0205751. https://doi.org/10.1371/journal.pone.0205751
Abstract: Background: Diagnostic delay is well-known in spondyloarthritis and studies have demonstrated a longer deferral in women. The aim of this study was to explore whether diagnostic delay of spondyloarthritis depends on clinical manifestations expressed by patients according to sex or whether it is related to a doctor’s misdiagnosis bias. Methods: A cross-sectional study of 96 men and 54 women with spondyloarthritis was performed at Alicante University General Hospital in Spain using a semistructured interview and clinical records. Comparative sex analysis were done via Student’s T and Mann-Whitney U tests for parametric and nonparametric continuous variables, chi-square and Fisher’s exact tests for unpaired categorical variables, and McNemar’s test for paired ones. Findings: The median diagnostic delay in women 7.5 (11.5) years is higher than men 4 (11) years, with a difference close to statistical significance (p = 0.053). A total of 30.2% of men received a first correct diagnosis of spondyloarthritis versus 11.1% of women (p = 0.016), indicating that men have higher probability of not having a misdiagnosis of spondyloarthritis (odds ratio = 3.5; 1.3–9). Eleven different health services referred male patients to the rheumatology clinic but only six in the case of female. No sex differences were detected in patients’ manifestations of back pain at onset. However, medical records registered differences (women 44.4%, men 82.1%; p < 0.001). There were differences between patients (women 57.7%, men 35.2%; p = 0.008) and medical records in peripheral signs/symptoms at onset (women 55.6%, men 17.9%; p < 0.001). Conclusion: The few differences of self-reported manifestations between both sexes with spondyloarthritis as compared with their clinical records (more axial pain in men and more peripheral pain in women) suggests that the professionals’ annotations reflect what they expect according to Literature, which could explain the higher misdiagnosis and diagnostic delay in women with spondyloarthritis.
Sponsor: This study was supported with funding FEDER-Instituto de Salud Carlos III. Ministerio de Ciencia e Innovación. España (Grant PI11/00865).
URI: http://hdl.handle.net/10045/81968
ISSN: 1932-6203
DOI: 10.1371/journal.pone.0205751
Language: eng
Type: info:eu-repo/semantics/article
Rights: © 2018 Jovani et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Peer Review: si
Publisher version: https://doi.org/10.1371/journal.pone.0205751
Appears in Collections:Institucional - IUIEG - Publicaciones
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