Table_2_Gender-based time discrepancy in diagnosis of coronary artery disease based on data analytics of electronic medical records.CSV

BackgroundWomen continue to have worse Coronary Artery Disease (CAD) outcomes than men. The causes of this discrepancy have yet to be fully elucidated. The main objective of this study is to detect gender discrepancies in the diagnosis and treatment of CAD.
MethodsWe used data analytics to risk stratify ~32,000 patients with CAD of the total 960,129 patients treated at the UCSF Medical Center over an 8 year period. We implemented a multidimensional data analytics framework to trace patients from admission through treatment to create a path of events. Events are any medications or noninvasive and invasive procedures. The time between events for a similar set of paths was calculated. Then, the average waiting time for each step of the treatment was calculated. Finally, we applied statistical analysis to determine differences in time between diagnosis and treatment steps for men and women.
ResultsThere is a significant time difference from the first time of admission to diagnostic Cardiac Catheterization between genders (p-value = 0.000119), while the time difference from diagnostic Cardiac Catheterization to CABG is not statistically significant.
ConclusionWomen had a significantly longer interval between their first physician encounter indicative of CAD and their first diagnostic cardiac catheterization compared to men. Avoiding this delay in diagnosis may provide more timely treatment and a better outcome for patients at risk. Finally, we conclude by discussing the impact of the study on improving patient care with early detection and managing individual patients at risk of rapid progression of CAD.

背景：相较于男性，女性冠状动脉疾病（Coronary Artery Disease, CAD）患者的预后始终更差，而这种差异的成因尚未完全阐明。本研究的核心目标是探究CAD诊疗过程中存在的性别差异。
方法：本研究针对加州大学旧金山分校医学中心（UCSF Medical Center）8年间收治的960129例患者中的约32000例CAD患者开展数据分析以进行风险分层。我们搭建了多维度数据分析框架，对患者从入院至接受治疗的全流程进行追踪，以构建事件路径。此处的事件涵盖各类药物治疗、无创操作及有创操作。我们计算了同类事件路径中各操作间的时间间隔，并进一步测算各诊疗步骤的平均等待时长。最终通过统计学分析，对比男女患者在CAD诊断与各治疗步骤间的时间差异。
结果：不同性别患者从首次入院至诊断性心脏导管术（Cardiac Catheterization）的时间间隔存在显著差异（p值=0.000119）；而从诊断性心脏导管术至冠状动脉旁路移植术（Coronary Artery Bypass Grafting, CABG）的时间差异则无统计学意义。
结论：相较于男性，女性首次因疑似CAD就诊至首次接受诊断性心脏导管术的间隔时间显著更长。规避此类诊断延误，可为高危患者提供更及时的治疗，进而改善其预后。最后，本研究将探讨该成果对提升CAD早期检出相关临床诊疗质量、管理存在快速进展风险的个体患者的影响。