On a scale from 1 (less than 20% likely) to 5 (more than 80% likely), physicians were more likely to diagnose black patients (M = 4.08) than white patients (M = 3.71) with CAD as a cause of their chest pain (P = .02). However, participants were equally likely to give thrombolysis for black (52%) and white (48%) patients (chi-square P = .68). In absolute numbers 29.8% (33/112) of physicians who saw a white patient vignette thought he was very likely to have CAD versus 40.1% (43/108) for black patients. Within this subgroup 58.2% of physicians were very likely to offer white patients thrombolysis versus 42.7% for black patients (P = .12) (results not shown). Using the delta score (z-score relating likelihood of diagnosis and treatment) we were able to adjust for covariates and show a racial disparity in thrombolysis relative to CAD diagnosis. For blacks, delta was 0.11, indicating lower likelihood of thrombolysis relative to the physician’s perception of the likelihood of acute myocardial infarction. For whites, delta was −0.14, indicating higher likelihood of thrombolysis (P = .06).
