Gender Disparity Observed in Myocardial Perfusion Imaging

Primary care physicians more likely to order inappropriate MPIs for women

TUESDAY, June 14 (HealthDay News) -- The majority of inappropriate and uncertain studies for myocardial perfusion imaging (MPI) are ordered for women by primary care physicians (PCPs), according to a study published online April 23 in the Journal of Nuclear Cardiology.

Aarti Gupta, M.D., from the Miriam and Rhode Island Hospital in Providence, and colleagues investigated whether gender disparity was evident in MPI tests categorized by appropriate use criteria (AUC) and whether the specialty of the ordering doctor was responsible for this disparity. Baseline data were compared with gender reversed data in 314 MPIs.

The investigators found that MPI was ordered appropriately in 263 studies, inappropriately in 34 studies, and 17 studies were considered uncertain according to the AUC criteria. Women were significantly more likely to receive inappropriate (68 percent) and uncertain (82 percent) MPI studies. MPI studies for women which were ordered by cardiologists were significantly more appropriate than those ordered by PCPs. There was a higher percentage of appropriate studies ordered for men than women, irrespective of whether they were ordered by cardiologists (96 versus 86 percent; P = 0.05), or by PCPs (86 versus 71 percent; P = 0.03). Reversal of gender demonstrated disparity in the AUC tool with 46 studies not correlating.

"When the AUC were applied, cardiologists were better able to appropriately order single-photon emission computed tomography MPI tests in both men and women, while PCPs used MPI testing more inappropriately in women," the authors write.

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