Examples of sex/gender sensitivity in epidemiological research: results of an evaluation of original articles published in JECH 2006–2014

Abstract

BackgroundDuring the last decades, sex and gender biases have been identified in various areas of biomedical and public health research, leading to compromised validity of research findings. As a response, methodological requirements were developed but these are rarely translated into research practice. The aim of this study is to provide good practice examples of sex/gender sensitive health research.MethodsWe conducted a systematic search of research articles published in JECH between 2006 and 2014. An instrument was constructed to evaluate sex/gender sensitivity in four stages of the research process (background, study design, statistical analysis, discussion).ResultsIn total, 37 articles covering diverse topics were included. Thereof, 22 were evaluated as good practice example in at least one stage; two articles achieved highest ratings across all stages. Good examples of the background referred to available knowledge on sex/gender differences and sex/gender informed theoretical frameworks. Related to the study design, good examples calculated sample sizes to be able to detect sex/gender differences, selected sex/gender sensitive outcome/exposure indicators, or chose different cut-off values for male and female participants. Good examples of statistical analyses used interaction terms with sex/gender or different shapes of the estimated relationship for men and women. Examples of good discussions interpreted their findings related to social and biological explanatory models or questioned the statistical methods used to detect sex/gender differences.ConclusionsThe identified good practice examples may inspire researchers to critically reflect on the relevance of sex/gender issues of their studies and help them to translate methodological recommendations of sex/gender sensitivity into research practice.Electronic supplementary materialThe online version of this article (doi:10.1186/s12961-017-0174-z) contains supplementary material, which is available to authorized users.

Intensive gestational glycemic management and childhood obesity: a systematic review and meta-analysis

“…Models were stratified by sex as CVD literature indicates possible differences between males and females 192 and in keeping with recent calls for increased reporting of sex-stratified analyses. 193,194 Models using only the secondary composite outcomes (CVD endpoints alone, CVD risk factors alone) were also run to test the adequacy of our composite outcome compared to CVD endpoints. We also used the following approaches to evaluate if our results were affected by confounding.…”

“…Models were also sexstratified as CVD literature indicates possible differences between males and females in CVD risk 192,204 and in keeping with recent calls for increased reporting of sex-stratified analyses. 193,194 We also ran the models on a dataset restricted to complete cases for high school completion to evaluate the effect of missing high school values. In the full model for the primary outcome, we also used birthweight (continuous) and gestational age at birth (preterm vs term) instead of birth weight for gestational age, and birth year categories (1985-1989; 1990-1994; 1995-1999 Values are mean ± standard deviation or number (%).…”

Sex differences in incidence of respiratory symptoms and management by general practitioners

“…This variation is caused by biological characteristics such as anatomy or hormonal factors (sex) ( 1 ), together with ‘gender’, meaning the different expected social roles, behaviours and cultural aspects related to being male or female ( 2 , 3 ). The past years, growing scientific interest in the role of gender and sex on health care and specific diseases has developed ( 4 ). Previous studies show several discrepancies in epidemiology and symptoms of conditions in males and females.…”

Sex difference: an important issue to consider in epidemiological and clinical studies dealing with serum paraoxonase-1

“…As both factors play together, they contribute to the widely reported differences in life expectancy and in the incidence/prevalence of several diseases between women and men. (1) Within this research report, we will employ the term "sex" to include both biological and environmental influence on variables considered.…”