Wednesday, August 07, 2024

Sex bias: Physicians in emergency rooms take women’s pain less seriously than men’s in the US and Israel. Really!

Perhaps a good reason for some women to become transgender men? Pardon my bad joke!

I bet this study was driven by a particular sex bias on part of the scientists involved!

It appears this already celebrated and viral study is deeply flawed, because it focused exclusively on non-specific pain complaints. A pain category traditionally and usually more associated with women than with men. May we call this another case of junk science?

It is also characteristic for deliberate disinformation when important facts like this study relied solely on emergency room data are omitted from headlines!  The reporting about this study and the study itself is curiously silent whether the nurses and doctors involved were male or female. It it not be interesting to learn whether female nurses and doctors came to the same conclusions as their male counterparts. This study is a failure!

Emergency room doctors in many cases have to act and judge very fast.  and they are usually not able to spend much time with each individual patient. So if a patient with non-specific pain complaints arrive in the emergency room doctor this patient irrespective of the sex will probably not receive a prescription for pain medication.

Of course, patients with non-specific pain and no other serious condition will wait longer in emergency rooms. This has little to do with sex bias!!!

There persistent and long held rumors and anecdotal evidence that more women are plaintive than men when it comes to pain. Maybe it is more than just a rumor! Women are different from men perhaps also with respect to pain and perhaps this is a fact and not a bias!

"... “Women are viewed as exaggerating or hysterical and men are viewed as more stoic when they complain of pain,” says co-author Alex Gileles-Hillel, a physician-scientist at Hadassah-Hebrew University Medical Center in Jerusalem. ...
They analysed more than 20,000 discharge notes of patients who had come in with ‘non-specific’ pain complaints — those without a clear underlying cause — such as headaches. ..."
The analysis found that, when first arriving at hospital, women were 10% less likely than men to have a recorded pain score — a number from 1 to 10, given by the patient, that helps to inform physicians about the severity of pain. After the initial assessment, women waited an average of 30 minutes longer than men to see a physician, and were less likely than men to receive pain medication. ..."

From the significance and abstract:
"Pain treatment must be provided adequately and impartially. Here, we conduct an analysis of archival datasets of pain management decisions as well as a controlled experiment, testing whether pain management differs by patients’ sex. We present robust evidence showing that physicians’ and nurses’ pain management decisions in emergency departments disfavor female patients compared to male patients. Notably, female patients are less likely than males to be prescribed pain-relief medications for the same complaints. We argue that female patients receive less pain treatment than they should, which may adversely impact their health. The findings underscore the critical need to address psychological biases in healthcare settings to ensure fair and efficient treatment for all.
Abstract
In the pursuit of mental and physical health, effective pain management stands as a cornerstone. Here, we examine a potential sex bias in pain management. Leveraging insights from psychological research showing that females’ pain is stereotypically judged as less intense than males’ pain, we hypothesize that there may be tangible differences in pain management decisions based on patients’ sex. Our investigation spans emergency department (ED) datasets from two countries, including discharge notes of patients arriving with pain complaints (N = 21,851). Across these datasets, a consistent sex disparity emerges. Female patients are less likely to be prescribed pain-relief medications compared to males, and this disparity persists even after adjusting for patients’ reported pain scores and numerous patient, physician, and ED variables. This disparity extends across medical practitioners, with both male and female physicians prescribing less pain-relief medications to females than to males. Additional analyses reveal that female patients’ pain scores are 10% less likely to be recorded by nurses, and female patients spend an additional 30 min in the ED compared to male patients. A controlled experiment employing clinical vignettes reinforces our hypothesis, showing that nurses (N = 109) judge pain of female patients to be less intense than that of males. We argue that the findings reflect an undertreatment of female patients’ pain. We discuss the troubling societal and medical implications of females’ pain being overlooked and call for policy interventions to ensure equal pain treatment."

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Study: Female ER patients get less pain meds than needed "Researchers found significant disparities between male and female patients, even those who reported identical levels of pain."

Data reveal how doctors take women’s pain less seriously than men’s (no public access) "A study of hospital emergency departments suggests that women have more limited access to painkillers and medical care."

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