• Acad Emerg Med · Oct 2024

    Multicenter Study Observational Study

    Emergency physician gender and head computed tomography orders for older adults who have fallen.

    • Rhys Kraft, Mathew Mercuri, Natasha Clayton, Andrew Worster, Eric Mercier, Marcel Emond, Catherine Varner, Shelley L McLeod, Debra Eagles, Ian Stiell, David Barbic, Judy Morris, Rebecca Jeanmonod, Yoan K Kagoma, Ashkan Shoamanesh, Paul T Engels, Sunjay Sharma, Alexandra Papaioannou, Sameer Parpia, Ian Buchanan, Mariyam Ali, and de WitKerstinK0000-0003-2763-6474Department of Medicine, McMaster University, Hamilton, Ontario, Canada.Department of Emergency Medicine, Queen's University, Kingston, Ontario, Canada.Department of Health Research Methods, Evidence, and Impact, McMaster U.
    • Department of Biomedical and Molecular Sciences, Queen's University, Kingston, Ontario, Canada.
    • Acad Emerg Med. 2024 Oct 1; 31 (10): 100610131006-1013.

    ObjectivePhysicians vary in their computed tomography (CT) scan usage. It remains unclear how physician gender relates to clinical practice or patient outcomes. The aim of this study was to assess the association between physician gender and decision to order head CT scans for older emergency patients who had fallen.MethodsThis was a secondary analysis of a prospective observational cohort study conducted in 11 hospital emergency departments (EDs) in Canada and the United States. The primary study enrolled patients who were 65 years and older who presented to the ED after a fall. The analysis evaluated treating physician gender adjusted for multiple clinical variables. Primary analysis used a hierarchical logistic regression model to evaluate the association between treating physician gender and the patient receiving a head CT scan. Secondary analysis reported the adjusted odds ratio (OR) for diagnosing intracranial bleeding by physician gender.ResultsThere were 3663 patients and 256 physicians included in the primary analysis. In the adjusted analysis, women physicians were no more likely to order a head CT than men (OR 1.26, 95% confidence interval 0.98-1.61). In the secondary analysis of 2294 patients who received a head CT, physician gender was not associated with finding a clinically important intracranial bleed.ConclusionsThere was no significant association between physician gender and ordering head CT scans for older emergency patients who had fallen. For patients where CT scans were ordered, there was no significant relationship between physician gender and the diagnosis of clinically important intracranial bleeding.© 2024 Society for Academic Emergency Medicine.

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