{'fraction_non_alphanumeric': 0.01766953199617956, 'fraction_numerical': 0.002387774594078319, 'mean_word_length': 5.253731343283582, 'pattern_counts': {'":': 0, '<': 0, '<?xml version=': 0, '>': 0, 'https://': 0, 'lorem ipsum': 0, 'www.': 0, 'xml': 0}, 'pii_count': 0, 'substrings_counts': 0, 'word_list_counts': {'cursed_substrings.json': 0, 'profanity_word_list.json': 0, 'sexual_word_list.json': 0, 'zh_pornsignals.json': 0}}
Gender, cardiology, and optimal medical care.

EVEN at its scientific best, the practice of medicine relies on the assumption that generalized notions of diseases and their detection and treatment can be individualized. Thus, large multicenter studies are interpreted as providing meaningful guidelines for treating a single patient; we assume that the patient will respond in a manner similar to the majority of the study group. The usefulness of such assumptions is limited, of course, but in daily practice physicians have no better basis for management decisions other than what is in the literature. This is especially true in rapidly changing, technologically oriented specialties such as cardiology. Gender is one of the most obvious ways in which an individual patient may differ from the population presented in the literature. We readily accept that diseases may have different prevalences in men and women and even that disease processes may differ as well. However, it is not often appreciated that the interpretation of diagnostic tests or the successful application of therapeutic modalities may depend on the patient's sex. Given the epidemiology of most forms of heart disease, it is not surprising that most of the descriptions of cardiac diagnostic testing, risk factors for disease, and even expected therapeutic outcomes are determined largely, if not exclusively, by studies of male patients. Because relatively fewer women are studied, any possible differences between the sexes may be overlooked. For example, of the three most cited studies examining the role of coronary artery bypass grafting in atherosclerotic coronary artery disease, the Veterans Administration Cooperative Study1 and the European Coronary Surgery Study2 included only men, while the population of the Coronary Artery Surgery Study (CASS) was only 19% female.3 Yet the results of these studies are used daily to justify coronary surgery in women. If the outcomes in both sexes were similar, the composition of the study populations would not matter. However, the CASS study found that the operative