Endovascular treatment decision in acute stroke: Does physician gender matter? Insights from UNMASK EVT, an international, multidisciplinary survey

Johanna Maria Ospel, Nima Kashani, Alexis T. Wilson, Urs Fischer, Bruce C.V. Campbell, Pillai N. Sylaja, Shinichi Yoshimura, Alejandro A. Rabinstein, Francis Turjman, Peter Mitchell, Byung Moon Kim, Mathew P. Cherian, Ji Hoe Heo, Blaise W. Baxter, Anna Podlasek, Mona Foss, Bijoy K. Menon, Mohammed A. Almekhlafi, Andrew M. Demchuk, Michael D. HillGustavo Saposnik, Mayank Goyal

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)


Background and purpose Differences in the treatment practice of female and male physicians have been shown in several medical subspecialties. It is currently not known whether this also applies to endovascular stroke treatment. The purpose of this study was to explore whether there are differences in endovascular treatment decisions made by female and male stroke physicians and neurointerventionalists. Methods In an international survey, stroke physicians and neurointerventionalists were randomly assigned 10 case scenarios and asked how they would treat the patient: (A) assuming there were no external constraints and (B) given their local working conditions. Descriptive statistics were used to describe baseline demographics, and the adjusted OR for physician gender as a predictor of endovascular treatment decision was calculated using logistic regression. Results 607 physicians (97 women, 508 men, 2 who did not wish to declare) participated in this survey. Physician gender was neither a significant predictor for endovascular treatment decision under assumed ideal conditions (endovascular therapy was favored by 77.0% of female and 79.3% of male physicians, adjusted OR 1.03, P=0.806) nor under current local resources (endovascular therapy was favored by 69.1% of female and 76.9% of male physicians, adjusted OR 1.03, P=0.814). Conclusion Endovascular therapy decision making between male and female physicians did not differ under assumed ideal conditions or under current local resources.

Original languageEnglish
Pages (from-to)256-259
Number of pages4
JournalJournal of NeuroInterventional Surgery
Issue number3
Publication statusPublished - 2020 Mar 1

Bibliographical note

Funding Information:
1Division of neuroradiology, clinic of radiology and nuclear Medicine, University hospital Basel, Basel, switzerland 2clinical neurosciences, University of calgary, calgary, alberta, canada 3Diagnostic imaging, University of calgary, calgary, alberta, canada 4Department of neurology, inselspital, Bern University hospital and University of Bern, Bern, switzerland 5Department of Medicine, University of Melbourne, Parkville, Victoria, australia 6Department of neurology, royal Melbourne hospital, Melbourne, Victoria, australia 7sree chitra Tirunal institute for Medical sciences and Technology, Thiruvananthapuram, Kerala, india 8Department of neurosurgery, hyogo college of Medicine, nishinomiya, Japan 9Department of neurology, Mayo clinic, rochester, Minnesota, United states 10Department of interventional neuroradiology, centre hospitalier Universitaire de lyon, lyon, France 11Department of radiology, royal Melbourne hospital, Melbourne, australia 12Department of radiology, Yonsei University college of Medicine, seoul, south Korea 13radiology, Kovai Medical center, coimbatore, Tamil nadu, india 14Department of neurology, Yonsei University college of Medicine, seoul, south Korea 15University of Tennessee, college of Medicine, chattanooga, Tennessee, United states 16neuroscience and Vascular simulation, anglia ruskin University, chelmsford, UK 17Bootstrap analytics, calgary, alberta, canada 18Division of neurology, Department of Medicine, st Michael’s hospital, University of Toronto Faculty of Medicine, Toronto, Ontario, canada Acknowledgements The authors are most grateful to all physicians participating in the study and thank the Dr. Walter und luise Freundlich Foundation for support in the form of a travel grant.

Publisher Copyright:
© Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.

All Science Journal Classification (ASJC) codes

  • Surgery
  • Clinical Neurology


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