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Lutfey KE, Eva KW, Gerstenberger E, et al. Physician cognitive processing as a source of diagnostic and treatment disparities in coronary heart disease: results of a factorial priming experiment. J Health Soc Behav. 2010;51(1):16-29doi: 10.1177/0022146509361193.
Lutfey, K. E., Eva, K. W., Gerstenberger, E., Link, C. L., & McKinlay, J. B. (2010). Physician cognitive processing as a source of diagnostic and treatment disparities in coronary heart disease: results of a factorial priming experiment. Journal of health and social behavior, 51(1), 16-29. https://doi.org/10.1177/0022146509361193
Lutfey, Karen E, et al. "Physician cognitive processing as a source of diagnostic and treatment disparities in coronary heart disease: results of a factorial priming experiment." Journal of health and social behavior vol. 51,1 (2010): 16-29. doi: https://doi.org/10.1177/0022146509361193
Lutfey KE, Eva KW, Gerstenberger E, Link CL, McKinlay JB. Physician cognitive processing as a source of diagnostic and treatment disparities in coronary heart disease: results of a factorial priming experiment. J Health Soc Behav. 2010 Mar;51(1):16-29. doi: 10.1177/0022146509361193. PMID: 20420292; PMCID: PMC3120017.
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J Health Soc Behav. 2010 Mar;51(1):16-29. doi: 10.1177/0022146509361193.

Physician cognitive processing as a source of diagnostic and treatment disparities in coronary heart disease: results of a factorial priming experiment.

Journal of health and social behavior

Karen E Lutfey, Kevin W Eva, Eric Gerstenberger, Carol L Link, John B McKinlay

Affiliations

  1. New England Research Institutes, 9 Galen Street,Watertown, MA 02472, USA. [email protected]

PMID: 20420292 PMCID: PMC3120017 DOI: 10.1177/0022146509361193

Abstract

Literature on health disparities documents variations in clinical decision-making across patient characteristics, physician attributes, and among health care systems. Using data from a vignette-based factorial experiment of 256 primary care providers, we examine the cognitive basis of disparities in the diagnosis and treatment of coronary heart disease (CHD). We explore whether previously observed disparities are due to physicians (1) not fully considering CHD for certain patients or (2) considering CHD but then discounting it. Half of the physicians in the experiment were primed with explicit directions to consider a CHD diagnosis, and half were not. Relative to their unprimed counterparts, primed physicians were more likely to order CHD-related tests and prescriptions. However, the main effects for patient gender and age remained, suggesting that physicians treated these demographic variables as diagnostic features indicating lower risk of CHD for these patients. This finding suggests that physician appeals to perceived base rates have the potential to contribute to the further reification of socially constructed health statistics.

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