SynthesisBMJ open2024
Sex and gender-based analysis and diversity metric reporting in acute care trials published in high-impact journals: a systematic review.
Synthesis in BMJ open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 4 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
14 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Consideration of sex/gender aspects in cardiovascular clinical trials.Clinical research in cardiology : official journal of the German Cardiac Society · 2025Pooled it
- Sex related differences in efficacy and safety of antithrombotic therapy in patients with coronary artery disease: systematic review and meta-analysis.BMJ (Clinical research ed.) · 2025Pooled it
- Sex and gender considerations in randomized controlled trials in critical care nephrology: a meta-epidemiologic study.BMC medicine · 2025Pooled it
- Eligibility Criteria of Randomized Clinical Trials in Critical Care Medicine.JAMA network open · 2025Pooled it
- Perspectives on sex and gender inclusion in clinical practice guidelines: a qualitative study.BMJ open · 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
- Influence of patients' sex on radiomics-based predictions of lung artery thrombus.International journal of computer assisted radiology and surgery · 2026Article
- Twenty years of sex and gender science in health research: a policy statement from the Organization for the Study of Sex Differences.Biology of sex differences · 2026Review
- Sex Differences in Cancer-Associated Thrombosis.International journal of molecular sciences · 2026Review
- Sex, time, and disability status differences in mortality, multidimensional morbidity, and health care utilization: a secondary analysis of the Canadian RECOVER study.Intensive care medicine · 2026Article
- Patient and author diversity and representation in studies supporting the European Respiratory Society/European Society of Intensive Care Medicine/European Society of Clinical Microbiology and Infectious Diseases/Asociación Latinoamericana de Tórax severe community-acquired pneumonia guidelines.Respiratory research & clinical practice · 2026Article
- Core sociodemographic data variables reported in Canadian intensive care unit studies: a scoping review.Canadian journal of anaesthesia = Journal canadien d'anesthesie · 2025Review
- Sex-related differences in cardiovascular pharmacotherapy: fiction or fact? Why can't we see the evidence?European heart journal. Cardiovascular pharmacotherapy · 2025Review
- Beyond Standard Shocks: A Critical Review of Alternative Defibrillation Strategies in Refractory Ventricular Fibrillation.Journal of clinical medicine · 2025Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
26 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo 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.
designSystematic 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.
resultsWe 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).
conclusionsAcute 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.
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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.