Perceived Disease Activity in Rheumatoid Arthritis: When the Physician's Gender Matters.

Area of Science:

• Rheumatology
• Clinical assessment
• Gender studies

Background:

• Rheumatoid arthritis (RA) often has a worse prognosis in females.
• The impact of physician gender on RA activity assessment is not well understood.

Purpose of the Study:

• To examine differences in RA disease activity assessment between male and female physicians.
• To compare patient and physician perceptions of disease activity and global health (GH).

Main Methods:

• 154 RA patients were evaluated by one female and one male rheumatologist.
• Data collected included tender/swollen joint counts, GH, evaluator global assessment (EGA), and patient global assessment (PGA).
• Disease activity scores (DAS28, CDAI, SDAI) were calculated; differences and agreement were statistically analyzed.

Main Results:

• Global health, PGA, and DAS28 scores were higher when assessed by the female physician.
• Male EGA was higher; male patients reported higher PGA with the female examiner.
• Disease activity assessment was not dependent on physician gender, but physician-patient agreement was higher with the female physician.

Conclusions:

• Subjective RA disease activity measures vary between male and female rheumatologists.
• Patients generally report higher disease activity than physicians perceive.
• Female physicians may foster a more empathetic environment, leading to better physician-patient agreement.