Impact of physician’s sex/gender on processes of care, and clinical outcomes in cardiac operative care: a systematic review

Objectives This systematic review aimed to assess the role of physician’s sex and gender in relation to processes of care and/or clinical outcomes within the context of cardiac operative care.Design A systematic review.Data sources Searches were conducted in PsycINFO, Embase and Medline from incepti...

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Main Authors: Louise Y Sun, Sylvain Boet, Amy Johnston, Katina Zheng, Mimi Deng, Fadi Mansour, Hussein Said, Cole Etherington
Format: Article
Language:English
Published: BMJ Publishing Group 2020-09-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/10/9/e037139.full
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author Louise Y Sun
Sylvain Boet
Amy Johnston
Katina Zheng
Mimi Deng
Fadi Mansour
Hussein Said
Cole Etherington
author_facet Louise Y Sun
Sylvain Boet
Amy Johnston
Katina Zheng
Mimi Deng
Fadi Mansour
Hussein Said
Cole Etherington
author_sort Louise Y Sun
collection DOAJ
description Objectives This systematic review aimed to assess the role of physician’s sex and gender in relation to processes of care and/or clinical outcomes within the context of cardiac operative care.Design A systematic review.Data sources Searches were conducted in PsycINFO, Embase and Medline from inception to 6 September 2018. The reference lists of relevant systematic reviews and included studies were also searched.Eligibility criteria for selecting studies Quantitative studies of any design were included if they were published in English or French, involved patients of any age undergoing a cardiac surgical procedure and specifically assessed differences in processes of care or clinical patient outcomes by physician’s sex or gender. Studies were screened in duplicate by two pairs of independent reviewers.Outcome measures Processes of care, patient morbidity and patient mortality.Results The search yielded 2095 publications after duplicate removal, of which two were ultimately included. These studies involved various types of surgery, including cardiac. One study found that patients treated by female surgeons compared with male surgeons had a lower 30-day mortality. The other study, however, found no differences in patient outcomes by surgeon’s sex. There were no studies that investigated anaesthesiologist’s sex/gender. There were also no studies investing physician’s sex or gender exclusively in the cardiac operating room.Conclusions The limited data surrounding the impact of physician’s sex/gender on the outcomes of cardiac surgery inhibits drawing a robust conclusion at this time. Results highlight the need for primary research to determine how these factors may influence cardiac operative practice, in order to optimise provider’s performance and improve outcomes in this high-risk patient group.
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spelling doaj-art-981bf3df316d45c180cf8d9533444f9f2025-01-08T04:35:13ZengBMJ Publishing GroupBMJ Open2044-60552020-09-0110910.1136/bmjopen-2020-037139Impact of physician’s sex/gender on processes of care, and clinical outcomes in cardiac operative care: a systematic reviewLouise Y Sun0Sylvain Boet1Amy Johnston2Katina Zheng3Mimi Deng4Fadi Mansour5Hussein Said6Cole Etherington7School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, CanadaSubaquatic and Hyperbaric Medicine Unit, Emergency Service, Acute Medicine Department, Geneva University Hospitals, Geneva, Switzerland5 School of Nursing, Midwifery, and Social Work, University of Queensland—St Lucia Campus, Brisbane, Queensland, AustraliaDivision of Cardiac Anesthesiology, Department of Anesthesiology and Pain Medicine, University of Ottawa Heart Institute, Ottawa, Ontario, CanadaDepartment of Anaesthesiology and Pain Medicine, The Ottawa Hospital, Ottawa, Ontario, CanadaDepartment of Anaesthesiology and Pain Medicine, The Ottawa Hospital, Ottawa, Ontario, CanadaRespiratory Medicine, NHS Highland, Inverness, Highland, UKClinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, CanadaObjectives This systematic review aimed to assess the role of physician’s sex and gender in relation to processes of care and/or clinical outcomes within the context of cardiac operative care.Design A systematic review.Data sources Searches were conducted in PsycINFO, Embase and Medline from inception to 6 September 2018. The reference lists of relevant systematic reviews and included studies were also searched.Eligibility criteria for selecting studies Quantitative studies of any design were included if they were published in English or French, involved patients of any age undergoing a cardiac surgical procedure and specifically assessed differences in processes of care or clinical patient outcomes by physician’s sex or gender. Studies were screened in duplicate by two pairs of independent reviewers.Outcome measures Processes of care, patient morbidity and patient mortality.Results The search yielded 2095 publications after duplicate removal, of which two were ultimately included. These studies involved various types of surgery, including cardiac. One study found that patients treated by female surgeons compared with male surgeons had a lower 30-day mortality. The other study, however, found no differences in patient outcomes by surgeon’s sex. There were no studies that investigated anaesthesiologist’s sex/gender. There were also no studies investing physician’s sex or gender exclusively in the cardiac operating room.Conclusions The limited data surrounding the impact of physician’s sex/gender on the outcomes of cardiac surgery inhibits drawing a robust conclusion at this time. Results highlight the need for primary research to determine how these factors may influence cardiac operative practice, in order to optimise provider’s performance and improve outcomes in this high-risk patient group.https://bmjopen.bmj.com/content/10/9/e037139.full
spellingShingle Louise Y Sun
Sylvain Boet
Amy Johnston
Katina Zheng
Mimi Deng
Fadi Mansour
Hussein Said
Cole Etherington
Impact of physician’s sex/gender on processes of care, and clinical outcomes in cardiac operative care: a systematic review
BMJ Open
title Impact of physician’s sex/gender on processes of care, and clinical outcomes in cardiac operative care: a systematic review
title_full Impact of physician’s sex/gender on processes of care, and clinical outcomes in cardiac operative care: a systematic review
title_fullStr Impact of physician’s sex/gender on processes of care, and clinical outcomes in cardiac operative care: a systematic review
title_full_unstemmed Impact of physician’s sex/gender on processes of care, and clinical outcomes in cardiac operative care: a systematic review
title_short Impact of physician’s sex/gender on processes of care, and clinical outcomes in cardiac operative care: a systematic review
title_sort impact of physician s sex gender on processes of care and clinical outcomes in cardiac operative care a systematic review
url https://bmjopen.bmj.com/content/10/9/e037139.full
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