Sex and Gender Equity in Research: rationale for the SAGER guidelines and recommended use

Heidari, Shirin; Babor, Thomas F.; Castro, Paola De; Tort, Sera; Curno, Mirjam

doi:10.1186/s41073-016-0007-6

Cited by 1,167 publications

(1,027 citation statements)

References 21 publications

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“…101 The Sex and Gender Equity in Research guidelines provide rationales and guidance for clinical practice guideline reviewers to look for and incorporate evidence on sex differences and gender and to use the terms appropriately. 11,102 Song and colleagues 103 published a validated search strategy for uncovering publications that report sex-specific diagnostic and treatment evidence. Standardized application of these strategies could enhance the uptake of evidence that is sex and gender specific in future clinical practice guidelines.…”

Section: Discussionmentioning

confidence: 99%

“…The use of "sex" and "gender" specifically was assessed for adherence to current definitions. 11,38 Differences in categorization were resolved by consensus. …”

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confidence: 99%

“…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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confidence: 99%

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

et al. 2017

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Background:The importance of sex and gender in the diagnosis and management of health conditions is well established, but the extent to which this evidence is integrated into clinical practice guidelines remains unknown. We aimed to determine the proportion of Canadian clinical practice guidelines that integrate evidence on sex and gender considerations. Methods:We searched the Canadian Medical Association's CPG Infobase, PubMed, all provincial/territorial websites and websites of professional organizations for English-and French-language Canadian clinical practice guidelines published between January 2013 and June 2015 on selected conditions identified as priorities by policy-makers and practitioners. Citations and text were searched electronically using keyword terms related to sex and gender. Three investigators independently analyzed and categorized the content of text-positive clinical practice guidelines based on clinical relevance for practitioners. Results:Of the 118 clinical practice guidelines that met the inclusion criteria, 79 (66.9%) were text-positive for sex and/or gender keywords; 8 (10%) of the 79 used the keywords only in relation to pregnancy. Of the remaining 71 guidelines, 25 (35%) contained sex-related diagnostic or management recommendations. An additional 5 (7%) contained recommendations for sex-specific laboratory reference values, 29 (41%) referred to differences in epidemiologic features or risk factors only, and 12 (17%) contained nonrelevant mentions of search keywords. Twenty-five (35%) of the text-positive guidelines used the terms "sex" and/or "gender" correctly. higher in women than in men, with increased risk of driving impairment. 19 Rochon and colleagues 20 discovered that, in Ontario, men with dementia who were prescribed antipsychotic drugs had significantly higher risks for hospital admission and death than did women with dementia. Similarly, social risk factors are associated with higher rates of suicide in older men, which suggests that more aggressive screening and treatment may be required. [21][22][23] The extent to which evidence about sex and gender is integrated into clinical practice guidelines for diagnosis and management of diseases remains unknown. We conducted a systematic review to investigate the integration of sex and gender evidence into Canadian clinical practice guidelines published between 2013 and 2015 for noncommunicable health conditions. Methods Data sources and inclusion criteriaProtocols for this review are posted on Open Science Framework and follow PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) reporting guidelines (www.prisma-statement.org/). The review search focused on selected health conditions identified as priorities by policymakers and practitioners [24][25][26][27][28][29][30] (Box 1). We considered only 2 cancers, lung and colorectal, because they are among the leading causes of death from cancer for both females and males, 31 and important sex and/or gender differences in prevalence, risk and screening, path...

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Section: Discussionmentioning

confidence: 99%

“…The use of "sex" and "gender" specifically was assessed for adherence to current definitions. 11,38 Differences in categorization were resolved by consensus. …”

mentioning

confidence: 99%

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confidence: 99%

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

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“…34,40 Finally, a relative paucity of data is available about the number of women versus men either eligible for EVAR or not considered for any intervention, which underscores the importance of reporting primary data by sex. 41 Moreover, our review has several strengths. All the studies included in this series had to include both men and women and present the data for each separately, so that men and women from the same population and the same time period are compared in each study.…”

Section: Schermerhorn Et Al (2012) 30mentioning

confidence: 99%

Morphological suitability for endovascular repair, non-intervention rates, and operative mortality in women and men assessed for intact abdominal aortic aneurysm repair: systematic reviews with meta-analysis

Ulug¹,

Sweeting²,

vonAllmen³

et al. 2017

Journal of Vascular Surgery

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1 ArticlesMorphological suitability for endovascular repair, non-intervention rates, and operative mortality in women and men assessed for intact abdominal aortic aneurysm repair: systematic reviews with meta-analysis Pinar Ulug, Michael J Sweeting, Regula S von Allmen, Simon G Thompson, Janet T Powell, on behalf of the SWAN collaborators* Summary Background Prognosis for women with abdominal aortic aneurysm might be worse than the prognosis for men. We aimed to systematically quantify the differences in outcomes between men and women being assessed for repair of intact abdominal aortic aneurysm using data from study periods after the year 2000.Methods In these systematic reviews and meta-analysis, we identified studies (randomised, cohort, or cross-sectional) by searching MEDLINE, Embase, CENTRAL, and grey literature published between Jan 1, 2005, and Sept 2, 2016, for two systematic reviews and Jan 1, 2009, and Sept 2, 2016, for one systematic review. Studies were included if they were of both men and women, with data presented for each sex separately, with abdominal aortic aneurysms being assessed for aneurysm repair by either endovascular repair (EVAR) or open repair. We conducted three reviews based on whether studies reported the proportion morphologically suitable (within manufacturers' instructions for use) for EVAR (EVAR suitability review), non-intervention rates (non-intervention review), and 30-day mortality (operative mortality review) after intact aneurysm repair. Studies had to include at least 20 women (for the EVAR suitability review), 20 women (for the non-intervention review), and 50 women (for the operative mortality review). Studies were excluded if they were review articles, editorials, letters, or case reports. For the operative review, studies were also excluded if they only provided hazard ratios or only reported in-hospital mortality. We assessed the quality of the studies using the NewcastleOttawa scoring system, and contacted authors for the provision of additional data if needed. We combined results across studies by random-effects meta-analysis. This study is registered with PROSPERO, number CRD42016043227.Findings Five studies assessed the morphological eligibility for EVAR (1507 men, 400 women). The overall pooled proportion of women eligible (34%) for EVAR was lower than it was in men (54%; odds ratio [OR] 0·44, 95% CI 0·32-0·62). Four single-centre studies reported non-intervention rates (1365 men, 247 women). The overall pooled non-intervention rates were higher in women (34%) than men (19%; OR 2·27, 95% CI 1·21-4·23). The review of 30-day mortality included nine studies (52 018 men, 11 076 women). The overall pooled estimate for EVAR was higher in women (2·3%) than in men (1·4%; OR 1·67, 95% CI 1·38-2·04). The overall estimate for open repair also was higher in women (5·4%) than in men (2·8%; OR 1·76, 95% CI 1·35-2·30).Interpretation Compared with men, a smaller proportion of women are eligible for EVAR, a higher proportion of women are not offered intervention, and operative...

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“…Whereas the gender and personal characteristics of the researcher or participant should not dictate how the research is conducted, the influence of gender cannot be ignored in the dynamics that take place in perinatal research -where gender underpins so many issues. We would like to reiterate a call by Howard and colleagues (2016) in that researchers should refer to the SAGER guidelines when reporting their findings as these are a comprehensive procedure for reporting of sex and gender information in study design, data analysis, results and interpretations of findings (Heidari, Babor, De Castro, Tort, & Curno, 2016). Ultimately, it is important that neither reproductive healthcare nor research is seen as the domain of a specific gender.…”

Section: If Gender Matters In Maternity Care Does It Matter In Matermentioning

confidence: 98%

If gender matters in maternity care, does it matter in maternity care research?

Newham

Alderdice

2017

Journal of Reproductive and Infant Psychology

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Sex and Gender Equity in Research: rationale for the SAGER guidelines and recommended use

Cited by 1,167 publications

References 21 publications

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

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

Morphological suitability for endovascular repair, non-intervention rates, and operative mortality in women and men assessed for intact abdominal aortic aneurysm repair: systematic reviews with meta-analysis

If gender matters in maternity care, does it matter in maternity care research?

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