Sex Bias in Hand Surgery Research

Kalliainen, Loree K.; Wisecarver, Ian; Cummings, Allison; Stone, Jennifer A.

doi:10.1016/j.jhsa.2018.03.026

Cited by 10 publications

(9 citation statements)

References 16 publications

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“…Three studies were reviews of the published literature 25–27 defined as collation of all empirical evidence that fits prespecified eligibility criteria, 28 nine were cross-sectional analyses 29–38 (observational studies of the published literature over a defined time period 39 ), and the five remaining studies were within-subject experimental design. 40–43 Of the 12 studies examining gender gaps ( Table 3 ), 11 were conducted in the United States 25 , 26 , 29–33 , 35–38 and 1 in Canada. 34 …”

Section: Resultsmentioning

confidence: 99%

“…In diseases perceived to affect greater number of men than women, such as coronary disease and heart failure, females were under-represented. 32 Kalliainen et al noted that the female–male recruitment ratio in hand surgery research was dependent on the pathology, but the ratios recruited were roughly in keeping with sex prevalence of the disease, 35 noting a need to increase members of the less-represented sex to enhance statistical power.…”

Section: Discussionmentioning

confidence: 99%

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Sex Inequalities in Medical Research: A Systematic Scoping Review of the Literature

Merone

Tsey

Russell

et al. 2022

Women's Health Reports

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Background: Historically, medical studies have excluded female participants and research data have been collected from males and generalized to females. The gender gap in medical research, alongside overarching misogyny, results in real-life disadvantages for female patients. This systematic scoping review of the literature aims to determine the extent of research into the medical research sex and gender gap and to assess the extent of misogyny, if any, in modern medical research. Methods: Initial literature searches were conducted using PubMed, Science Direct, PsychINFO and Google Scholar. Articles published between January 01, 2009, and December 31, 2019, were included. An article was deemed to display misogyny if it discussed the female aesthetic in terms of health, but did not measure health or could not be utilized to improve clinical practice. Results: Of the 17 included articles, 12 examined the gender gap in medical research and 5 demonstrated misogyny, assessing female attractiveness for alleged medical reasons. Females remain broadly under-represented in the medical literature, sex and gender are poorly reported and inadequately analyzed in research, and misogynistic perceptions continue to permeate the narrative. Conclusion: The gender gap and misogynistic studies remain present in the contemporary medical literature. Reasons and implications for practice are discussed.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Sex Inequalities in Medical Research: A Systematic Scoping Review of the Literature

Merone

Tsey

Russell

et al. 2022

Women's Health Reports

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“… 10 , 13 , 25 , 31 Studies from other fields have similarly reported that clinical trial features may vary within disease foci. 31 , 32 Medical fields with more balanced sex representation may serve as a model for decreasing sex bias in clinical trials.…”

Section: Discussionmentioning

confidence: 99%

Analysis of Female Enrollment and Participant Sex by Burden of Disease in US Clinical Trials Between 2000 and 2020

et al. 2021

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IMPORTANCE Although female representation has increased in clinical trials, little is known about how clinical trial representation compares with burden of disease or is associated with clinical trial features, including disease category. OBJECTIVE To describe the rate of sex reporting (ie, the presence of clinical trial data according to sex), compare the female burden of disease with the female proportion of clinical trial enrollees, and investigate the associations of disease category and clinical trial features with the female proportion of clinical trial enrollees. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study included descriptive analyses and logistic and generalized linear regression analyses with a logit link. Data were downloaded from the Aggregate Analysis of ClinicalTrials.gov database for all studies registered between March 1, 2000, and March 9, 2020. Enrollment was compared with data from the 2016 Global Burden of Disease database. Of 328 452 clinical trials, 70 095 were excluded because they had noninterventional designs, 167 936 because they had recruitment sites outside the US, 69 084 because they had no reported results, 1003 because they received primary funding from the US military, and 314 because they had unclear sex categories. A total of 20 020 interventional studies enrolling approximately 5.11 million participants met inclusion criteria and were divided into those with and without data on participant sex. EXPOSURES The primary exposure variable was clinical trial disease category. Secondary exposure variables included funding, study design, and study phase. MAIN OUTCOMES AND MEASURES Sex reporting and female proportion of participants in clinical trials. RESULTS Among 20 020 clinical trials from 2000 to 2020, 19 866 studies (99.2%) reported sex, and 154 studies (0.8%) did not. Clinical trials in the fields of oncology (46% of disability-adjusted lifeyears [DALYs]; 43% of participants), neurology (56% of DALYs; 53% of participants), immunology (49% of DALYs; 46% of participants), and nephrology (45% of DALYs; 42% of participants) had the lowest female representation relative to corresponding DALYs. Male participants were underrepresented in 8 disease categories, with the greatest disparity in clinical trials of musculoskeletal disease and trauma (11.3% difference between representation and proportion of DALYs). Clinical trials of preventive interventions were associated with greater female enrollment (adjusted relative difference, 8.48%; 95% CI, 3.77%-13.00%). Clinical trials in cardiology (adjusted relative difference, −18.68%; 95% CI, −22.87% to −14.47%) and pediatrics (adjusted relative difference, −20.47%; 95% CI, −25.77% to −15.16%) had the greatest negative association with female enrollment. (continued) Key Points Question How is disease burden associated with female representation in US-based clinical trials, and how are disease category and other clinical trial features associated with female representation in clinical trials? Findings In this cross-sectional study...

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“…12 A literature search for 1999 to 2018 showed 13 major analyses of sex bias in clinical studies, but these analyses were limited in size (range, 36-865 studies and 2339-398 801 participants) and disease categories and were performed with manual methods or analysis of isolated data sets (eAppendix and eTable 1 in the Supplement). 12,13,14,15,16,17,18,19,20,21,22,23,24…”

Section: Introductionmentioning

confidence: 99%

Quantifying Sex Bias in Clinical Studies at Scale With Automated Data Extraction

et al. 2019

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Key Points Question What is the magnitude of female underrepresentation in clinical studies? Findings In this cross-sectional study, machine reading to extract sex data from 43 135 published articles and 13 165 clinical trial records showed substantial underrepresentation of female participants, with studies as measurement unit, in 7 of 11 disease categories, especially HIV/AIDS, chronic kidney diseases, and cardiovascular diseases. Sex bias in articles for all categories combined was unchanged over time with studies as the measurement unit but improved with participants as measurement unit. Meaning This study suggests that sex bias against female participants in clinical studies persists, but results differ when studies vs participants are the measurement units.

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Sex Bias in Hand Surgery Research

Cited by 10 publications

References 16 publications

Sex Inequalities in Medical Research: A Systematic Scoping Review of the Literature

Sex Inequalities in Medical Research: A Systematic Scoping Review of the Literature

Analysis of Female Enrollment and Participant Sex by Burden of Disease in US Clinical Trials Between 2000 and 2020

Quantifying Sex Bias in Clinical Studies at Scale With Automated Data Extraction

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