ArticleBMJ public health2025
Are sex and gender dimensions accounted for in NICE guidelines? A systematic review of 223 clinical guidelines.
Article in BMJ public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.
What it found
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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.
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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.
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Who cites it
6 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Inclusion of sex and gender in clinical practice guidelines: an umbrella review.BMJ open quality · 2026Pooled it
- A Guide for the Inclusion of Sex and Gender Considerations in Clinical Practice Guidelines.Clinical and public health guidelines · 2026Article
- Perspectives on sex and gender inclusion in clinical practice guidelines: a qualitative study.BMJ open · 2026Article
- Equity and Respect in Maternal and Infant Healthcare-A Report From the 2025 Venice Forum.Acta paediatrica (Oslo, Norway : 1992) · 2026Review
- Article
- An AI-enhanced NHS will rely on clinical guidelines, but what if the evidence is inequitable?BMJ public health · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Introduction: The importance of sex and gender in the diagnosis and management of health conditions is well established, but the extent to which sex and gender disaggregated evidence is integrated into UK clinical practice guidelines remains unknown. Recent reviews of clinical guidelines in Canada and Europe identified that limited and inconsistent attention was paid to sex and gender dimensions of health and illness. This study aimed to determine how the UK's National Institute of Clinical Excellence (NICE) clinical guidelines account for sex and gender. Methods: The study reviewed all NICE guidelines categorised as 'clinical guidelines' by NICE (223), excluding those solely linked to single-sex conditions (26). Reviewers evaluated whether they included information on sex and/or gender dimensions of disease risk, presentation, investigations and management. They also examined if sex and/or gender dimensions were considered outside of pregnancy, and how the gender of guideline committee chairs and members corresponded to how well sex and/or gender were accounted for. Results: Of 197 guidelines reviewed, 120 (61%) referenced sex and/or gender dimensions, with 81 (41%) referencing these dimensions outside of pregnancy and childbearing. A minority of guidelines mentioned sex and/or gender dimensions related to disease pathophysiology (2%), clinical presentation (9%), investigations (15%) and epidemiology (19%). 162 guidelines published details of their committee chairs, and 126 (76%) were men. Committees chaired by women tended to produce guidelines, which scored better for consideration of sex and gender. Conclusion: This study highlights key gaps in NICE guidelines which must be addressed through systematic, whole-sector progress to integrate sex and gender disaggregated research into clinical guidelines. As the single focal point responsible for guideline development in England and Wales, NICE has a unique opportunity to establish robust mechanisms to routinely embed this important evidence in guidelines. Multiple initiatives are recommended to identify relevant existing evidence across all clinical specialties.
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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.