Analysis of sex and gender-specific research reveals a common increase in publications and marked differences between disciplines

Abstract

BackgroundThe incorporation of sex and gender-specific analysis in medical research is increasing due to pressure from public agencies, funding bodies, and the clinical and research community. However, generations of knowledge and publication trends in this discipline are currently spread over distinct specialties and are difficult to analyze comparatively.MethodsUsing a text-mining approach, we have analysed sex and gender aspects in research within nine clinical subspecialties - Cardiology, Pulmonology, Nephrology, Endocrinology, Gastroenterology, Haematology, Oncology, Rheumatology, Neurology - using six paradigmatic diseases in each one. Articles have been classified into five pre-determined research categories - Epidemiology, Pathophysiology, Clinical research, Management and Outcomes. Additional information has been collected on the type of study (human/animal) and the number of subjects included. Of the 8,836 articles initially retrieved, 3,466 (39%) included sex and gender-specific research and have been further analysed.ResultsLiterature incorporating sex/gender analysis increased over time and displays a stronger trend if compared to overall publication increase. All disciplines, but cardiology (22%), demonstrated an underrepresentation of research about gender differences in management, which ranges from 3 to 14%. While the use of animal models for identification of sex differences in basic research varies greatly among disciplines, studies involving human subjects are frequently conducted in large cohorts with more than 1,000 patients (24% of all human studies).ConclusionsHeterogeneity characterizes sex and gender-specific research. Although large cohorts are often analysed, sex and gender differences in clinical management are insufficiently investigated leading to potential inequalities in health provision and outcomes.

Sex differences in the association between plasma copeptin and incident type 2 diabetes: the Prevention of Renal and Vascular Endstage Disease (PREVEND) study

“…In conclusion, it is particularly important for the assessment of the value of novel biomarkers to take into account possible sex differences [38,39]. We found a stronger association of plasma copeptin with the risk of type 2 diabetes in women than in men.…”

Sex and gender considerations in Canadian clinical practice guidelines: a systematic review

“…Given early recognition of sex and gender differences in mental health conditions and cardiovascular disease, we expected clinical practice guidelines in these fields to reliably highlight information about females and males separately. 13 Recent attention to sex differences in cancer, [81][82][83] lung disease 6-8 and diabetes [84][85][86] predicted meaningful uptake in these areas as well. Although some clinical practice guidelines targeting these conditions incorporated differentiated data in a way that guides practice, many keyword mentions were superficial and of limited value.…”

“…88,89 Although more publications that consider females and males separately in medicine are emerging, less than 25% address differences in management decisions for patients based on sex or gender. 13 Another explanation for the suboptimal integration of sex and gender considerations into clinical practice guidelines relates to the lag time between research discovery and practice transformation. 90,91 A recent study showed that microglial cells play a role in mediating pain pathways in male mice, whereas T cells are responsible for this same function in female mice.…”

“…These differences relate to sex (molecular, cellular and epigenetic mechanisms of male and female physiology) and gender (adopted or imposed social norms, behaviours, identities and expectations). 11,12 Better understanding of these mechanisms has led to a near-linear rise in sex-and genderspecific research publications since the 1990s in all medical disciplines, 13 although terminology can be confused.…”

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