ArticleJACC. Advances2022
A Systematic Review of Sex-Specific Reporting in Heart Failure Clinical Trials: Trial Flow and Results.
Article in JACC. Advances, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 2 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
13 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Participation of Women in Cardiovascular Trials From 2017 to 2023: A Systematic Review.JAMA network open · 2025Pooled it
- Pooled it
- Sex Differences in Efficacy of Multidomain Rehabilitation Among Older Adults With Acute HF: The REHAB-HF Trial.JACC. Heart failure · 2025Trial
- Comprehensive Analysis of the Effects of Sacubitril/Valsartan According to Sex Among Patients With Heart Failure and Reduced Ejection Fraction in PARADIGM-HF.Journal of the American Heart Association · 2025Trial
- Human milk oligosaccharide supplementation for metabolic health and obesity: potential mechanisms, current evidence, and research priorities.World journal of pediatrics : WJP · 2026Article
- Women's cardiovascular health in 2025:Saudi medical journal · 2026Review
- Sex-related differences in cardiovascular pharmacotherapy: fiction or fact? Why can't we see the evidence?European heart journal. Cardiovascular pharmacotherapy · 2025Review
- Sex and gender in perioperative cardiovascular research: protocol for a scoping review.Systematic reviews · 2025Article
- Underrepresentation of women in cardiovascular disease clinical Trials-What's in a Name?International journal of cardiology. Heart & vasculature · 2024Article
- Review
- Article
- Improving representativeness in trials: a call to action from the Global Cardiovascular Clinical Trialists Forum.European heart journal · 2023Review
- Importance of Sex Disaggregated Data in Heart Failure Clinical Trials: Where Are We in 2022?JACC. Advances · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Females are historically underenrolled in heart failure (HF) randomized controlled trials (RCTs) relative to disease prevalence. Sex differences in trial flow, including withdrawals and losses to follow up, may further limit the generalizability of results. Objectives: This study aimed to assess the frequency of sex-specific reporting of trial flow, treatment efficacy, and adverse events in HF RCTs. Methods: We systematically searched MEDLINE, Embase, and CINAHL for HF RCTs published between 2000 and 2020 in journals with an impact factor ≥10. We assessed whether trial flow, treatment effect, and adverse events were disaggregated by sex. We used multivariable regression to assess associations between trial characteristics and sex subgroup analysis. We analyzed temporal trends in sex-specific reporting. Results: We included 224 RCTs with 228,801 total participants (28.2% female). No RCT reported sex-disaggregated screening, consent, or withdrawal rates; and 2 (0.9%) reported sex-disaggregated losses to follow-up. Seventy-five RCTs (33.4%) presented sex subgroup analysis, and 63 (28.3%) reported sex-treatment interaction. No RCT reported sex-specific adverse events. Large trial size (odds ratio: 13.16, 95% CI: 5.67-30.52; Conclusions: HF RCTs rarely reported sex differences in trial flow or adverse events and uncommonly performed sex subgroup analysis. Improved sex-disaggregated reporting could highlight the causes and extent of sex differences in trial participation and facilitate appropriate inferences about treatment effect.
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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.