AI Article Synopsis
- The study aimed to analyze how sex and gender are considered in acute care trials and whether there have been changes in reporting practices since the 2016 guidelines on sex and gender equity in research.
- The systematic review included 88 trials published in major medical journals, finding that the representation of female participants was low at 34.2%, and only 28.4% reported race or ethnicity, predominantly featuring white and male participants.
- Results revealed limited use of sex and gender-based analysis (SGBA), with cardiovascular trials performing better than ICU trials, indicating a significant need for improvement in inclusivity and reporting practices in clinical research.*
Article Abstract
Objective: To characterise sex and gender-based analysis (SGBA) and diversity metric reporting, representation of female/women participants in acute care trials and temporal changes in reporting before and after publication of the 2016 Sex and Gender Equity in Research guideline.
Design: Systematic review.
Data Sources: We searched MEDLINE for trials published in five leading medical journals in 2014, 2018 and 2020.
Study Selection: Trials that enrolled acutely ill adults, compared two or more interventions and reported at least one clinical outcome.
Data Abstraction And Synthesis: 4 reviewers screened citations and 22 reviewers abstracted data, in duplicate. We compared reporting differences between intensive care unit (ICU) and cardiology trials.
Results: We included 88 trials (75 (85.2%) ICU and 13 (14.8%) cardiology) (n=111 428; 38 140 (34.2%) females/women). Of 23 (26.1%) trials that reported an SGBA, most used a forest plot (22 (95.7%)), were prespecified (21 (91.3%)) and reported a sex-by-intervention interaction with a significance test (19 (82.6%)). Discordant sex and gender terminology were found between headings and subheadings within baseline characteristics tables (17/32 (53.1%)) and between baseline characteristics tables and SGBA (4/23 (17.4%)). Only 25 acute care trials (28.4%) reported race or ethnicity. Participants were predominantly white (78.8%) and male/men (65.8%). No trial reported gendered-social factors. SGBA reporting and female/women representation did not improve temporally. Compared with ICU trials, cardiology trials reported significantly more SGBA (15/75 (20%) vs 8/13 (61.5%) p=0.005).
Conclusions: Acute care trials in leading medical journals infrequently included SGBA, female/women and non-white trial participants, reported race or ethnicity and never reported gender-related factors. Substantial opportunity exists to improve SGBA and diversity metric reporting and recruitment of female/women participants in acute care trials.
Prospero Registration Number: CRD42022282565.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11103199 | PMC |
| http://dx.doi.org/10.1136/bmjopen-2023-081118 | DOI Listing |
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