Monday, August 18, 2008

Sex, race, and ICDs

Two studies published last year in The Journal of the American Medical Association (JAMA) found some serious disparities between men and women regarding implant rates of ICDs for primary prevention of sudden death.

One study (JAMA. 2007;298(13):1517-1524) found that among Medicare patients, men were about 2-3 times more likely than women to receive an implantable cardioverter-defibrillator (ICD) for the prevention of sudden cardiac death.

The second study (JAMA. 2007;298(13):1525-1532) concluded that the rate of ICD use among eligible black female patients (28.2 percent) were significantly lower than that of white male patients (43.6 percent).

We need to understand why women (and particularly African-American women) are less likely to receive a needed ICD.

It's hard to believe that sex and race still influence a doctor's decision on whether to offer an ICD to an eligible patient.


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