P184 Health inequalities and gender - life with axial spondyloarthritis (axial SpA)
Bibliographic record
Abstract
Abstract Background/Aims Previous studies have indicated that there are inequalities for women in the diagnosis and management of axial SpA. LQBTQ+ people experience significant inequalities in healthcare more generally in terms of healthcare service provision, health outcomes and risk factors, and in comparison to cis-heterosexual populations, greater incidence of poor mental health, risk of suicide and self-harm.The present study sought to understand more deeply people’s clinical and personal experiences through the lens of sex, gender and gender identity, addressing the following areas: Living with axial SpA (health inequality through a gendered lens) Length to diagnosis and experience of seeking diagnosis of axial SpA Discrimination, ignorance and stigma - gender identity, sexuality (LGBTQ+) Other impacts Methods This used a combination of online focus groups and interviews with participants initially recruited using social media and email channels. 25 individuals were interviewed: 10 females, 11 males and 4 individuals who identified as gender diverse. Within the sample we interviewed 9 individuals from minoritised communities. Participants’ ages ranged from 23 - 59. We explored participants’ experience of their diagnosis of axial SpA with a focus on length of time to diagnosis and living with axial SpA and its impact on the individual. For each topic, we asked participants about their experiences with questions that highlighted the influence or impact of gender on those experiences. Results All participants: Felt age had played a role in their delayed diagnosis. Found that having supportive health care professionals who listened to their concerns made a significant difference to their confidence in managing their axial SpA. Women: Had a delayed diagnosis due to misconceptions about axial SpA being ‘a man’s disease,’ especially if they didn’t have the typical low back pain, often being misdiagnosed.Didn’t feel they could discuss issues such as fertility, pregnancy and menopause. Found being considered ‘the nurturer’ for children presented emotional and physical difficulties. Men: Found gender stereotyping had impacted on their diagnosis, with manual labour or lifestyle symptoms often being blamed for symptoms. Were concerned about their abilities to be ‘an active dad.’ Are more likely to struggle on with a ‘stiff upper lip’. Gender diverse people: Were less open about discussing their experiences. Did not feel comfortable revealing their gender status to their health care professionals. Found NHS use of gendered pronouns frustrating and distressing. Conclusion More gender specific research is needed from both a clinical and non-clinical perspective, to enable health care professionals to deliver the best possible care. More research is needed amongst the LGBTQ+ community who were reticent to discuss their experiences in comparison to cis-het participants. The psychological impact of living with axial SpA across genders should be investigated further. Health care professionals should be adequately trained to understand gender diversity. Disclosure J.M. Hamilton: None. A. Drury: None. A. Hardy: None. D. Webb: None.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.003 | 0.003 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.000 | 0.003 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.015 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".