Country differences in the diagnosis and management of coronary heart disease – a comparison between the US, the UK and Germany
2008

Country Differences in Treating Heart Disease

Sample size: 384 publication Evidence: moderate

Author Information

Author(s): Olaf von dem Knesebeck, Markus Bönte, Johannes Siegrist, Lisa Marceau, Carol Link, Sara Arber, Ann Adams, John McKinlay

Primary Institution: University Medical Center Hamburg-Eppendorf

Hypothesis

Are doctors' diagnostic and therapeutic decisions influenced by the health care system in which they practice?

Conclusion

Doctors in the US and UK show similar decision-making patterns for coronary heart disease, while German doctors exhibit significant differences in their approach.

Supporting Evidence

  • 90% of UK and US doctors identified coronary heart disease as a possible diagnosis.
  • German physicians ordered fewer tests and prescribed fewer medications compared to US and UK doctors.
  • US physicians asked more questions during patient consultations than their German counterparts.

Takeaway

Doctors in different countries treat heart disease differently, with US and UK doctors being more proactive than their German counterparts.

Methodology

The study used videotaped patient scenarios shown to primary care physicians to assess their diagnostic and management decisions.

Potential Biases

Physicians may have altered their responses due to the test-like nature of the study.

Limitations

The study's external validity may be limited as physicians might behave differently in real-life situations compared to the experimental setup.

Participant Demographics

Physicians from the US, UK, and Germany, stratified by gender and years of experience.

Statistical Information

Statistical Significance

p<0.05

Digital Object Identifier (DOI)

10.1186/1472-6963-8-198

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