Article Figures & Data
Figures
- Figure 1.
Relative frequency of the performed interventions in female and male episodes of care related to common somatic symptoms (*P < .001, χ2 test). Abbreviation: EoC, episode of care.
Tables
Characteristic Female Male P Value Patients, n 10,541 (57.1%) 7,915 (42.9%) Patients' age in years, mean (SD) 43.4 (23.1) 42.3 (23.9) <0.001§ Patient years,* n 78,954 (52.3%) 75,734 (47.7%) Unique EoC, n 21,025 (61.4%) 13,243 (38.6%) EoC with intervention No intervention 3,218 (15.3%) 1,827 (13.8) ≥1 intervention 17,807 (84.7%) 11,416 (86.2%) <0.001† EoC with final diagnosis Disease diagnosis 7,470 (35.5%) 4,924 (37.2%) 0.002† Symptom diagnosis 13,555 (64.5%) 8,319 (62.8%) Encounters within an EoC 1 encounter 13,619 (64.8%) 8,697 (65.7%) 0.090† >1 encounter 7,406 (35.2%) 4,546 (34.3%) RFE per EoC 1 RFE 14,739 (70.1%) 9,839 (74.3%) <0.001† >1 RFE 6,286 (29.9%) 3,404 (25.7%) EoC with comorbidities, n 8,282 (39.4%) 5,295 (43.7%) 0.271† Cardiovascular disease 5,741 (27.3%) 3,827 (28.9%) 0.001† Asthma and/or COPD 3,106 (14.8%) 1,998 (15.1%) 0.427† Malignancies 1,684 (8.0%) 979 (7.4%) 0.038† - Table 2.
Adjusted Associations Between Diagnostic Interventions and Disease Diagnoses in Episodes of Care Starting with Common Somatic Symptoms, Stratified by Sex
Odds Ratio (95%CI)* Independent Variables Total EoC (n = 34,268) Female EoC (n = 21,025) Male EoC (n = 13,243) Physical examination 2.32 (2.17-2.49) 2.33 (2.14-2.54) 2.32 (2.07-2.60) Laboratory diagnostics† 0.50 (0.47-0.54) 0.47 (0.44-0.52) 0.56 (0.50-0.62) Imaging 0.96 (0.86-1.06) 0.92 (0.81-1.06) 1.00 (0.85-1.17) Referral to a specialist† 1.38 (1.27-1.49) 1.29 (1.17-1.43) 1.50 (1.33-1.69) Abbreviations: EoC, episode of care; RFE, reason for encounter; CI, confidence interval.
↵* Adjusted for patients' sex (total EoC), patients' age, presence of comorbidities at the start of an EoC, number of contacts within an EoC, type of consult, and type of RFE.
↵† The interaction term between the patient's sex and the respective diagnostic intervention was statistically significant.
- Table 3.
Adjusted Odds Ratios and Significant Intervention-by-Female-Sex Interaction Terms for the Association Between Diagnostic Interventions and Disease Diagnosis, Stratified by Reason for Encounter
OR* (95% CI) Headache (n = 3,411) Dizziness (n = 2,709) Heart Pain (n = 660) (Lower) Back Pain (n = 5,962) Physical examination 2.07 (1.74-2.47) 2.12 (1.68-2.67) 0.98 (0.59-1.64) 1.35 (1.11-1.63)† Laboratory diagnostics 0.59 (0.47-0.74) 0.30 (0.25-0.37) 0.94 (0.56-1.58) 1.49 (1.18-1.88) Imaging 0.67 (0.37-1.22) 0.43 (0.14-1.36) 0.51 (0.12-2.23) 0.87 (0.70-1.07)† Specialist referral 0.77 (0.60-0.98) 1.11 (0.84-1.46) 1.14 (0.73-1.77)† 2.78 (2.18-3.55)† OR* (95% CI) Nausea (n = 1,222) Muscle Pain (n = 554) Shortness of Breath (n = 3,593) Chills (n = 132) Physical examination 1.93 (1.46-2.56) 1.19 (0.71-2.01) 2.58 (2.02-3.31) 3.35 (1.23-9.11) Laboratory diagnostics 0.49 (0.35-0.68) 0.71 (0.41-1.23) 0.78 (0.65-0.92) 0.81 (0.29-2.28) Imaging 0.57 (0.26-1.21) 0.30 (0.06-1.39) 0.49 (0.38-0.64) 0.69 (0.02-19.9) Specialist referral 1.25 (0.82-1.90) 0.66 (0.27-1.59) 1.07 (0.87-1.31) 0.57 (0.19-1.74) OR* (95% CI) Tingling in Fingers, Feet, and/or Toes (n = 609) Swallowing/Throat Symptoms (n = 4,961) Weakness/General Tiredness (n = 5,608) Arm and/or Leg Symptoms (n = 4,847) Physical examination 1.16 (0.72-1.87) 5.42 (4.56-6.44) 2.57 (2.14-3.09) 1.70 (1.40-2.06) Laboratory diagnostics 0.40 (0.25-0.64)† 0.97 (0.80-1.18) 0.20 (0.18-0.24)† 0.51 (0.41-0.63)† Imaging 0.47 (0.11-2.06) 0.40 (0.23-0.72) 1.62 (1.14-2.32) 1.11 (0.93-1.32) Specialist referral 1.72 (1.05-2.81) 0.64 (0.51-0.81) 1.25 (0.99-1.58) 1.86 (1.55-2.23)† Abbreviations: EoC, episode of care; OR, odds ratio; CI, confidence interval.
↵* Adjusted for the patients' age at diagnosis, comorbidities, number of contacts per EoC, and sex. †Significant intervention-by-female-sex interaction term.
