Sex differences in incidence of respiratory symptoms and management by general practitioners

Abstract

Background Differences between women and men play an important role in lung physiology and epidemiology of respiratory diseases, but also in the health care processes. Objective To analyse sex differences in patients encountering their general practitioner (GP) with respiratory symptoms with regard to incidence, GP’s management and final diagnoses. Methods Retrospective cohort study, using data of the Dutch Practice Based Research Network. All patients who encountered their GP from 01-07-2013 until 30-06-2018 with a new episode of care starting with a reason for encounter in the respiratory category (R) of the ICPC-2 classification were included (n = 16 773). Multi-level logistic regression was used to analyse influence of patients’ sex on management of GPs with adjustment for possible confounders. Results We found a significant higher incidence of respiratory symptoms in women than in men: 230/1000 patient years [95% confidence interval (CI) 227–232] and 186/1000 patient years (95% CI 183–189), respectively. When presenting with cough, GPs are more likely to perform physical examination [odds ratio (OR) 1.22; 95% CI 1.11–1.35] and diagnostic radiology (OR 1.25; 95% CI 1.08–1.44), but less likely to prescribe medication (OR 0.88; 95% CI 0.82–0.95) in men. When visiting the GP with dyspnoea, men more often undergo diagnostic imaging (OR 1.32; 95% CI 1.05–1.66) and are more often referred to a specialist (OR 1.35; 95% CI 1.13–1.62). Conclusions Women encounter their GP more frequently with respiratory symptoms than men and GPs perform more diagnostic investigations in men. We suggest more research in general practice focussing on sex differences and possible confounders.

Sex and Gender-Related Differences in COVID-19 Diagnoses and SARS-CoV-2 Testing Practices During the First Wave of the Pandemic: The Dutch Lifelines COVID-19 Cohort Study

“…In health care workers, this pattern was fully revised with male health care workers being at significantly higher odds of SARS-CoV-2 testing than female health care workers. Several studies argue that sex- and gender-related factors associate with male-biased patterns of access to diagnostic measures, 30 , 31 which is in line with our study. We identified more testing in male than female health care workers, which might be related to symptoms being possibly more pronounced in males than in females.…”

Contrastive learning of heart and lung sounds for label-efficient diagnosis

“…See also Table S1. We speculate that these factors are either correlated with presence of disease (age and sex 17 ) or can provide insight into spatial information for improved learning (recording location 18 ).…”

“…The available metadata consist of whether the patient is a child or adult (which we refer to as "age"), the patient’s sex, and the recording location (trachea, anterior left, anterior right, posterior left, posterior right, lateral left, or lateral right). We speculate that these factors are either correlated with presence of disease (age and sex 17 ) or can provide insight into spatial information for improved learning (recording location 18 ).…”

Impact of Social, Economic, and Healthcare Factors on the Regional Structure of Antibiotic Consumption in Primary Care in Poland (2013–2017)

“…The authors of the meta-analysis consider macrolides as a group of drugs mainly used for the treatment of respiratory tract infections (RTI) (17). One of the recent Dutch studies also showed a higher incidence of respiratory symptoms in women than men (18). Observation indicates high clarithromycin consumption by the female gender.…”