Research Analyzed and Reported by Sex and Gender for Muskuloskeletal Conditions
The Sine Qua Non of Clinical Care, Health Profession Education, and Research
By Kim Templeton
There is limited evidence currently available to demonstrate that the majority of clinical studies do not report findings based on the sex and/or gender of research participants. There are potential negative effects on patient care if it is not determined that a given treatment is equally successful in all patients, regardless of sex, or if there are negative outcomes in one sex versus the other.
In addition, lack of research regarding sex- or gender-based influences on the presentation of various conditions or response to treatments limits the knowledge base from which healthcare professional students can be taught and impacts the ability to identify and develop future research studies that explore sex- and/or gender-based differences.
Consider How Outcomes May Differ by Sex
To assess the current status of reporting of sex-based differences in musculoskeletal conditions, I worked with orthopedic residents at the University of Kansas and an Nth Dimension medical student from the University of Indiana (currently an orthopedic resident at St. Louis University) to review articles on 2 common musculoskeletal conditions, osteoarthritis of the knee and rotator cuff injuries, that had been published in high-impact orthopedic journals. This study, Sex-Based Reporting of Common Musculoskeletal Conditions. was published with my co-authors: Kelly Stumpff, Morgan Hadley, and Karsen Corn.
We selected these two conditions, as osteoarthritis of the knee has well-documented sex and gender differences, while little is known about these differences for the rotator cuff. We found that about one-third of articles assessed and reported data based on sex, without significant differences between among general or subspecialty orthopedic journals, between the two conditions, or the year of publication—before or after 2010—was selected given the watershed publication of the Institute of Medicine (NAM) Report on the Research in Women’s Health.
Our study would seem to indicate that increasing awareness of sex-based differences is not impacting how research is being performed or reported. The only significant variable that we identified that impacted reporting was the gender of authors: those articles with female first and/or last author were significantly more likely to report differences based on sex. As we strive to impact the teaching of sex- and gender-based differences across healthcare, it is imperative that we improve the knowledge on which this education is based.
Call for More Studies to Consider Sex Differences
I would encourage interested AMWA members to perform studies similar to ours in their own fields: identify a common condition or 2 that impacts both men and women, select a few journals in your field that are widely read, identify clinical studies for a given period of time, and then look for how data are reported (beyond noting how many men and women are included in the study). Having more studies that assess reporting of sex and gender can help to highlight the need for more consistent disaggregation of data based on sex and/or gender and may encourage more journals to support the use of Sex And Gender Equity in Research (SAGER) guidelines
For assistance in initiating such research, sharing completed research, or to learn more about joining the Sex and Gender Health Collaborative, contact: SGHC@amwa-doc.org