New research from the University of St Andrews has found that women are less like than men with the same medical condition to be offered active management such as surgery, a stent or a strong painkiller.
The findings, published today (16 September) in PLOS One come from a review that sifted 1,112 published studies down to those that directly compared the care given to male and female patients. Of the 38 that analysed patient records, 33 reported a significant difference in the treatment men and women received.
Researchers from the University of St Andrews School of Medicine found that almost none of those studies pointed to any guideline recommending different treatment by sex, leaving open whether this reflects sound clinical judgement or unequal care.
Dr Andrew O'Malley, who co-led the study, said: "For clinicians, the findings are a prompt to check whether treatment is being offered on clinical grounds rather than assumption. For example, one study found that when the teams deciding who receives advanced heart failure therapy functioned poorly, women were less likely to be selected. Other work shows doctors more often attribute women's symptoms to anxiety and make more diagnostic errors with female patients, even when test results are positive.
Dr Miriam Veenhuizen, Honorary Lecturer in the School of Medicine, said: "While the direction of the findings was not a surprise the consistency was. The same pattern appeared in cardiology, surgery, transplant medicine and emergency care, and it survived statistical adjustment in most studies. It's not entirely clear why this is happening, but it is likely because women were under-represented in clinical trials until recent decades, so many guidelines rest on data from men."
Dr Veenhuizen added: "What struck us most was the imbalance in attention. Over the same period, 551 studies examined sex inequality affecting doctors and other health professionals. Only 41 examined what happens to patients."
The researchers now intend to test whether the same patterns appear in the outputs of generative AI systems, which are trained on this literature and on clinical records, and which could entrench these differences at scale if left unchecked.
