SynthesisBMJ (Clinical research ed.)2016
Sex based subgroup differences in randomized controlled trials: empirical evidence from Cochrane meta-analyses.
Synthesis in BMJ (Clinical research ed.), 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 48 papers, 6 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
48 citing papers in PubMed, 6 syntheses or guidelines pooled it, 87 citations in OpenAlex.
- A sex- and gender-based analysis of alcohol treatment intervention research involving youth: A methodological systematic review.PLoS medicine · 2024Pooled it
- Association of gestational diabetes mellitus with overall and type specific cardiovascular and cerebrovascular diseases: systematic review and meta-analysis.BMJ (Clinical research ed.) · 2022Pooled it
- Do recommended interventions widen or narrow inequalities in musculoskeletal health? An equity-focussed systematic review of differential effectiveness.Journal of public health (Oxford, England) · 2022Pooled it
- Age-treatment subgroup analyses in Cochrane intervention reviews: a meta-epidemiological study.BMC medicine · 2019Pooled it
- Pooled it
- Pooled it
- Pain as a causal motivator of alcohol consumption: Associations with gender and race.Journal of psychopathology and clinical science · 2023Trial
- Comparative effectiveness of initial computed tomography and invasive coronary angiography in women and men with stable chest pain and suspected coronary artery disease: multicentre randomised trial.BMJ (Clinical research ed.) · 2022Trial
- Trial
- Long-term results and recurrence patterns from SCOPE-1: a phase II/III randomised trial of definitive chemoradiotherapy +/- cetuximab in oesophageal cancer.British journal of cancer · 2017Trial
- Sex-linked placental DNA methylation associated with early-onset preeclampsia.Research square · 2026Article
- Claims of sex-dependent effects in the behavioral and brain sciences are infrequently supported by valid statistical comparisons.Proceedings of the National Academy of Sciences of the United States of America · 2026Article
- Enhancing randomized controlled trials through smartwatch-guided participant matching for infectious disease outcomes.Scientific reports · 2026Article
- Human milk oligosaccharide supplementation for metabolic health and obesity: potential mechanisms, current evidence, and research priorities.World journal of pediatrics : WJP · 2026Article
- The "sex-specific effect:" Evaluating analytical approaches to sex-dependence in the behavioral and brain sciences.bioRxiv : the preprint server for biology · 2026Article
- HPV genotype-specific p16/Ki67 expression with machine learning-assisted assessment in cervical neoplasia.Frontiers in oncology · 2026Article
- Understanding Sex Differences in Autoimmune Diseases: Immunologic Mechanisms.International journal of molecular sciences · 2025Review
- Mapping sex and gender in the landscape of spinal cord injury research: a bibliometric analysis and research framework.Spinal cord · 2025Article
- CONSORT 2025 explanation and elaboration: updated guideline for reporting randomised trials.BMJ (Clinical research ed.) · 2025Article
- Machine-learning approaches to predict individualized treatment effect using a randomized controlled trial.European journal of epidemiology · 2025Article
Corrections and comments
- Commented on by
Authors and funding
5 authors at 2 institutions in 2 countries.
Funding
Abstract
objectiveTo evaluate the frequency, validity, and relevance of statistically significant (P<0.05) sex-treatment interactions in randomized controlled trials in Cochrane meta-analyses.
designMeta-epidemiological study. DATA SOURCES: Cochrane Database of Systematic Reviews (CDSR) and PubMed. ELIGIBILITY CRITERIA FOR STUDY SELECTION: Reviews published in the CDSR with sex-treatment subgroup analyses in the forest plots, using data from randomized controlled trials. DATA EXTRACTION: Information on the study design and sex subgroup data were extracted from reviews and forest plots that met inclusion criteria. For each statistically significant sex-treatment interaction, the potential for biological plausibility and clinical significance was considered.
resultsAmong the 41 reviews with relevant data, there were 109 separate treatment-outcome analyses ("topics"). Among the 109 topics, eight (7%) had a statistically significant sex-treatment interaction. The 109 topics included 311 randomized controlled trials (162 with both sexes, 46 with males only, 103 with females only). Of the 162 individual randomized controlled trials that included both sexes, 15 (9%) had a statistically significant sex-treatment interaction. Of four topics where the first published randomized controlled trial had a statistically significant sex-treatment interaction, no meta-analyses that included other randomized controlled trials retained the statistical significance and no meta-analyses showed statistical significance when data from the first published randomized controlled trial were excluded. Of the eight statistically significant sex-treatment interactions from the overall analyses, only three were discussed by the CDSR reviewers for a potential impact on different clinical management for males compared with females. None of these topics had a sex-treatment interaction that influenced treatment recommendations in recent guidelines. UpToDate, an online physician-authored clinical decision support resource, suggested differential management of men and women for one of these sex-treatment interactions.
conclusionStatistically significant sex-treatment interactions are only slightly more frequent than what would be expected by chance and there is little evidence of subsequent corroboration or clinical relevance of sex-treatment interactions.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.