Skip to main content
Top
Published in: BMC Medicine 1/2010

Open Access 01-12-2010 | Correspondence

Analysis of sex and gender-specific research reveals a common increase in publications and marked differences between disciplines

Authors: Sabine Oertelt-Prigione, Roza Parol, Stephan Krohn, Robert Preißner, Vera Regitz-Zagrosek

Published in: BMC Medicine | Issue 1/2010

Login to get access

Abstract

Background

The incorporation of sex and gender-specific analysis in medical research is increasing due to pressure from public agencies, funding bodies, and the clinical and research community. However, generations of knowledge and publication trends in this discipline are currently spread over distinct specialties and are difficult to analyze comparatively.

Methods

Using a text-mining approach, we have analysed sex and gender aspects in research within nine clinical subspecialties - Cardiology, Pulmonology, Nephrology, Endocrinology, Gastroenterology, Haematology, Oncology, Rheumatology, Neurology - using six paradigmatic diseases in each one. Articles have been classified into five pre-determined research categories - Epidemiology, Pathophysiology, Clinical research, Management and Outcomes. Additional information has been collected on the type of study (human/animal) and the number of subjects included. Of the 8,836 articles initially retrieved, 3,466 (39%) included sex and gender-specific research and have been further analysed.

Results

Literature incorporating sex/gender analysis increased over time and displays a stronger trend if compared to overall publication increase. All disciplines, but cardiology (22%), demonstrated an underrepresentation of research about gender differences in management, which ranges from 3 to 14%. While the use of animal models for identification of sex differences in basic research varies greatly among disciplines, studies involving human subjects are frequently conducted in large cohorts with more than 1,000 patients (24% of all human studies).

Conclusions

Heterogeneity characterizes sex and gender-specific research. Although large cohorts are often analysed, sex and gender differences in clinical management are insufficiently investigated leading to potential inequalities in health provision and outcomes.
Appendix
Available only for authorised users
Literature
1.
go back to reference Legato MJ: Beyond women's health the new discipline of gender-specific medicine. Med Clin North Am. 2003, 87: 917-937. 10.1016/S0025-7125(03)00063-4. viiCrossRefPubMed Legato MJ: Beyond women's health the new discipline of gender-specific medicine. Med Clin North Am. 2003, 87: 917-937. 10.1016/S0025-7125(03)00063-4. viiCrossRefPubMed
2.
go back to reference Anderson GD: Gender differences in pharmacological response. Int Rev Neurobiol. 2008, 83: 1-10. 10.1016/S0074-7742(08)00001-9.CrossRefPubMed Anderson GD: Gender differences in pharmacological response. Int Rev Neurobiol. 2008, 83: 1-10. 10.1016/S0074-7742(08)00001-9.CrossRefPubMed
3.
go back to reference Goldberg RJ, O'Donnell C, Yarzebski J, Bigelow C, Savageau J, Gore JM: Sex differences in symptom presentation associated with acute myocardial infarction: a population-based perspective. Am Heart J. 1998, 136: 189-195. 10.1053/hj.1998.v136.88874.CrossRefPubMed Goldberg RJ, O'Donnell C, Yarzebski J, Bigelow C, Savageau J, Gore JM: Sex differences in symptom presentation associated with acute myocardial infarction: a population-based perspective. Am Heart J. 1998, 136: 189-195. 10.1053/hj.1998.v136.88874.CrossRefPubMed
4.
go back to reference Maynard C, Litwin PE, Martin JS, Weaver WD: Gender differences in the treatment and outcome of acute myocardial infarction. Results from the Myocardial Infarction Triage and Intervention Registry. Arch Intern Med. 1992, 152: 972-976. 10.1001/archinte.152.5.972.CrossRefPubMed Maynard C, Litwin PE, Martin JS, Weaver WD: Gender differences in the treatment and outcome of acute myocardial infarction. Results from the Myocardial Infarction Triage and Intervention Registry. Arch Intern Med. 1992, 152: 972-976. 10.1001/archinte.152.5.972.CrossRefPubMed
5.
go back to reference Oertelt-Prigione S, Regitz-Zagrosek V: Gender aspects in cardiovascular pharmacology. J Cardiovasc Transl Res. 2009, 2: 258-266. 10.1007/s12265-009-9114-9.CrossRefPubMed Oertelt-Prigione S, Regitz-Zagrosek V: Gender aspects in cardiovascular pharmacology. J Cardiovasc Transl Res. 2009, 2: 258-266. 10.1007/s12265-009-9114-9.CrossRefPubMed
6.
go back to reference Regitz-Zagrosek V: Therapeutic implications of the gender-specific aspects of cardiovascular disease. Nat Rev Drug Discov. 2006, 5: 425-438. 10.1038/nrd2032.CrossRefPubMed Regitz-Zagrosek V: Therapeutic implications of the gender-specific aspects of cardiovascular disease. Nat Rev Drug Discov. 2006, 5: 425-438. 10.1038/nrd2032.CrossRefPubMed
7.
go back to reference Nordmeyer J, Eder S, Mahmoodzadeh S, Martus P, Fielitz J, Bass J, Bethke N, Zurbrugg HR, Pregla R, Hetzer R, Regitz-Zagrosek V: Upregulation of myocardial estrogen receptors in human aortic stenosis. Circulation. 2004, 110: 3270-3275. 10.1161/01.CIR.0000147610.41984.E8.CrossRefPubMed Nordmeyer J, Eder S, Mahmoodzadeh S, Martus P, Fielitz J, Bass J, Bethke N, Zurbrugg HR, Pregla R, Hetzer R, Regitz-Zagrosek V: Upregulation of myocardial estrogen receptors in human aortic stenosis. Circulation. 2004, 110: 3270-3275. 10.1161/01.CIR.0000147610.41984.E8.CrossRefPubMed
8.
9.
go back to reference Correa-De-Araujo R: Serious gaps: how the lack of sex/gender-based research impairs health. J Womens Health (Larchmt). 2006, 15: 1116-1122. 10.1089/jwh.2006.15.1116.CrossRef Correa-De-Araujo R: Serious gaps: how the lack of sex/gender-based research impairs health. J Womens Health (Larchmt). 2006, 15: 1116-1122. 10.1089/jwh.2006.15.1116.CrossRef
10.
go back to reference Kim AM, Tingen CM, Woodruff TK: Sex bias in trials and treatment must end. Nature. 2010, 465: 688-689. 10.1038/465688a.CrossRefPubMed Kim AM, Tingen CM, Woodruff TK: Sex bias in trials and treatment must end. Nature. 2010, 465: 688-689. 10.1038/465688a.CrossRefPubMed
11.
go back to reference NIH: NIH Guidelines on the inclusion of women and minorities as subjects in clinical research. 2001, Health UNIo ed.: NIH NIH: NIH Guidelines on the inclusion of women and minorities as subjects in clinical research. 2001, Health UNIo ed.: NIH
12.
go back to reference Obias-Manno D, Scott PE, Kaczmarczyk J, Miller M, Pinnow E, Lee-Bishop L, Jones-London M, Chapman K, Kallgren D, Uhl K: The Food and Drug Administration Office of Women's Health: impact of science on regulatory policy. J Womens Health (Larchmt). 2007, 16: 807-817. 10.1089/jwh.2006.0135.CrossRef Obias-Manno D, Scott PE, Kaczmarczyk J, Miller M, Pinnow E, Lee-Bishop L, Jones-London M, Chapman K, Kallgren D, Uhl K: The Food and Drug Administration Office of Women's Health: impact of science on regulatory policy. J Womens Health (Larchmt). 2007, 16: 807-817. 10.1089/jwh.2006.0135.CrossRef
13.
go back to reference Geller SE, Adams MG, Carnes M: Adherence to federal guidelines for reporting of sex and race/ethnicity in clinical trials. J Womens Health (Larchmt). 2006, 15: 1123-1131. 10.1089/jwh.2006.15.1123.CrossRef Geller SE, Adams MG, Carnes M: Adherence to federal guidelines for reporting of sex and race/ethnicity in clinical trials. J Womens Health (Larchmt). 2006, 15: 1123-1131. 10.1089/jwh.2006.15.1123.CrossRef
14.
go back to reference McCandless MHE, Gospodnetić O: Lucene in Action. 2008, Manning Publications, Second McCandless MHE, Gospodnetić O: Lucene in Action. 2008, Manning Publications, Second
15.
go back to reference Vaccarino V, Horwitz RI, Meehan TP, Petrillo MK, Radford MJ, Krumholz HM: Sex differences in mortality after myocardial infarction: evidence for a sex-age interaction. Arch Intern Med. 1998, 158: 2054-2062. 10.1001/archinte.158.18.2054.CrossRefPubMed Vaccarino V, Horwitz RI, Meehan TP, Petrillo MK, Radford MJ, Krumholz HM: Sex differences in mortality after myocardial infarction: evidence for a sex-age interaction. Arch Intern Med. 1998, 158: 2054-2062. 10.1001/archinte.158.18.2054.CrossRefPubMed
16.
go back to reference Vaccarino V, Rathore SS, Wenger NK, Frederick PD, Abramson JL, Barron HV, Manhapra A, Mallik S, Krumholz HM: Sex and racial differences in the management of acute myocardial infarction, 1994 through 2002. N Engl J Med. 2005, 353: 671-682. 10.1056/NEJMsa032214.CrossRefPubMedPubMedCentral Vaccarino V, Rathore SS, Wenger NK, Frederick PD, Abramson JL, Barron HV, Manhapra A, Mallik S, Krumholz HM: Sex and racial differences in the management of acute myocardial infarction, 1994 through 2002. N Engl J Med. 2005, 353: 671-682. 10.1056/NEJMsa032214.CrossRefPubMedPubMedCentral
17.
go back to reference Demirovic J, Blackburn H, McGovern PG, Luepker R, Sprafka JM, Gilbertson D: Sex differences in early mortality after acute myocardial infarction (the Minnesota Heart Survey). Am J Cardiol. 1995, 75: 1096-1101. 10.1016/S0002-9149(99)80737-1.CrossRefPubMed Demirovic J, Blackburn H, McGovern PG, Luepker R, Sprafka JM, Gilbertson D: Sex differences in early mortality after acute myocardial infarction (the Minnesota Heart Survey). Am J Cardiol. 1995, 75: 1096-1101. 10.1016/S0002-9149(99)80737-1.CrossRefPubMed
18.
go back to reference Towfighi A, Zheng L, Ovbiagele B: Sex-specific trends in midlife coronary heart disease risk and prevalence. Arch Intern Med. 2009, 169: 1762-1766. 10.1001/archinternmed.2009.318.CrossRefPubMed Towfighi A, Zheng L, Ovbiagele B: Sex-specific trends in midlife coronary heart disease risk and prevalence. Arch Intern Med. 2009, 169: 1762-1766. 10.1001/archinternmed.2009.318.CrossRefPubMed
19.
go back to reference Vaccarino V, Parsons L, Peterson ED, Rogers WJ, Kiefe CI, Canto J: Sex differences in mortality after acute myocardial infarction: changes from 1994 to 2006. Arch Intern Med. 2009, 169: 1767-1774. 10.1001/archinternmed.2009.332.PubMedPubMedCentral Vaccarino V, Parsons L, Peterson ED, Rogers WJ, Kiefe CI, Canto J: Sex differences in mortality after acute myocardial infarction: changes from 1994 to 2006. Arch Intern Med. 2009, 169: 1767-1774. 10.1001/archinternmed.2009.332.PubMedPubMedCentral
20.
go back to reference Legato MJ, Gelzer A, Goland R, Ebner SA, Rajan S, Villagra V, Kosowski M: Gender-specific care of the patient with diabetes: review and recommendations. Gend Med. 2006, 3: 131-158. 10.1016/S1550-8579(06)80202-0.CrossRefPubMed Legato MJ, Gelzer A, Goland R, Ebner SA, Rajan S, Villagra V, Kosowski M: Gender-specific care of the patient with diabetes: review and recommendations. Gend Med. 2006, 3: 131-158. 10.1016/S1550-8579(06)80202-0.CrossRefPubMed
21.
go back to reference Postma DS: Gender differences in asthma development and progression. Gend Med. 2007, 4: S133-146. 10.1016/S1550-8579(07)80054-4.CrossRefPubMed Postma DS: Gender differences in asthma development and progression. Gend Med. 2007, 4: S133-146. 10.1016/S1550-8579(07)80054-4.CrossRefPubMed
22.
go back to reference Charney P, Morgan C: Do treatment recommendations reported in the research literature consider differences between women and men?. J Womens Health (Larchmt). 1996, 5: 579-584. 10.1089/jwh.1996.5.579.CrossRef Charney P, Morgan C: Do treatment recommendations reported in the research literature consider differences between women and men?. J Womens Health (Larchmt). 1996, 5: 579-584. 10.1089/jwh.1996.5.579.CrossRef
23.
go back to reference Merkatz R: Promoting gender analysis in peer-reviewed scientific journals: a call to publishers. J Womens Health (Larchmt). 1996, 5: 525-527. 10.1089/jwh.1996.5.525.CrossRef Merkatz R: Promoting gender analysis in peer-reviewed scientific journals: a call to publishers. J Womens Health (Larchmt). 1996, 5: 525-527. 10.1089/jwh.1996.5.525.CrossRef
24.
go back to reference Makkar RR, Fromm BS, Steinman RT, Meissner MD, Lehmann MH: Female gender as a risk factor for torsades de pointes associated with cardiovascular drugs. JAMA. 1993, 270: 2590-2597. 10.1001/jama.270.21.2590.CrossRefPubMed Makkar RR, Fromm BS, Steinman RT, Meissner MD, Lehmann MH: Female gender as a risk factor for torsades de pointes associated with cardiovascular drugs. JAMA. 1993, 270: 2590-2597. 10.1001/jama.270.21.2590.CrossRefPubMed
25.
go back to reference Wysowski DK, Swartz L: Adverse drug event surveillance and drug withdrawals in the United States, 1969-2002: the importance of reporting suspected reactions. Arch Intern Med. 2005, 165: 1363-1369. 10.1001/archinte.165.12.1363.CrossRefPubMed Wysowski DK, Swartz L: Adverse drug event surveillance and drug withdrawals in the United States, 1969-2002: the importance of reporting suspected reactions. Arch Intern Med. 2005, 165: 1363-1369. 10.1001/archinte.165.12.1363.CrossRefPubMed
26.
go back to reference Baird KL: The new NIH and FDA medical research policies: targeting gender, promoting justice. J Health Polit Policy Law. 1999, 24: 531-565.CrossRefPubMed Baird KL: The new NIH and FDA medical research policies: targeting gender, promoting justice. J Health Polit Policy Law. 1999, 24: 531-565.CrossRefPubMed
27.
go back to reference Putting gender on the agenda. Nature. 2010, 465: 665. Putting gender on the agenda. Nature. 2010, 465: 665.
28.
go back to reference Oertelt-Prigione S, Regitz-Zagrosek V: Women's cardiovascular health: prevention is key. Arch Intern Med. 2009, 169: 1740-1741. 10.1001/archinternmed.2009.353.CrossRefPubMed Oertelt-Prigione S, Regitz-Zagrosek V: Women's cardiovascular health: prevention is key. Arch Intern Med. 2009, 169: 1740-1741. 10.1001/archinternmed.2009.353.CrossRefPubMed
29.
30.
go back to reference Wald C, Wu C: Biomedical research. Of mice and women: the bias in animal models. Science. 327: 1571-1572. 10.1126/science.327.5973.1571. Wald C, Wu C: Biomedical research. Of mice and women: the bias in animal models. Science. 327: 1571-1572. 10.1126/science.327.5973.1571.
31.
go back to reference Alexanderson K: An assessment protocol for gender analysis of medical literature. Women Health. 1999, 29: 81-98. 10.1300/J013v29n02_06.CrossRefPubMed Alexanderson K: An assessment protocol for gender analysis of medical literature. Women Health. 1999, 29: 81-98. 10.1300/J013v29n02_06.CrossRefPubMed
32.
go back to reference Rathore SS, Wang Y, Krumholz HM: Sex-based differences in the effect of digoxin for the treatment of heart failure. N Engl J Med. 2002, 347: 1403-1411. 10.1056/NEJMoa021266.CrossRefPubMed Rathore SS, Wang Y, Krumholz HM: Sex-based differences in the effect of digoxin for the treatment of heart failure. N Engl J Med. 2002, 347: 1403-1411. 10.1056/NEJMoa021266.CrossRefPubMed
Metadata
Title
Analysis of sex and gender-specific research reveals a common increase in publications and marked differences between disciplines
Authors
Sabine Oertelt-Prigione
Roza Parol
Stephan Krohn
Robert Preißner
Vera Regitz-Zagrosek
Publication date
01-12-2010
Publisher
BioMed Central
Published in
BMC Medicine / Issue 1/2010
Electronic ISSN: 1741-7015
DOI
https://doi.org/10.1186/1741-7015-8-70

Other articles of this Issue 1/2010

BMC Medicine 1/2010 Go to the issue