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Is certainty more important than diagnosis for understanding race and gender disparities?: An experiment using coronary heart disease and depression case vignettes

  • Lutfey, Karen E.
  • Link, Carol L.
  • Grant, Richard W.
  • Marceau, Lisa D.
  • McKinlay, John B.
Registered author(s):

    Objectives To (1) examine the influence of patient and provider attributes on physicians' diagnostic certainty and (2) assess the effect of diagnostic certainty on clinical therapeutic actions.Methods Factorial experiment of 128 generalist physicians using identical clinically authentic videotaped vignettes depicting patients with coronary heart disease (CHD) or depression.Results For CHD, physicians were least certain for Black patients (p=.003) and for younger female patients (p=.013). For depression, average certainty was higher than for the CHD presentation (74.0 vs. 57.9 on of scale of 0-100, p

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    Article provided by Elsevier in its journal Health Policy.

    Volume (Year): 89 (2009)
    Issue (Month): 3 (March)
    Pages: 279-287

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    Handle: RePEc:eee:hepoli:v:89:y:2009:i:3:p:279-287
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    1. Balsa, Ana I. & McGuire, Thomas G., 2003. "Prejudice, clinical uncertainty and stereotyping as sources of health disparities," Journal of Health Economics, Elsevier, vol. 22(1), pages 89-116, January.
    2. van Ryn, Michelle & Burke, Jane, 2000. "The effect of patient race and socio-economic status on physicians' perceptions of patients," Social Science & Medicine, Elsevier, vol. 50(6), pages 813-828, March.
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