Attention to Sex-Related Factors in The Development of Clinical Practice Guidelines

Keuken, Debby G; Haafkens, Joke A.; Moerman, C. J.; Klazinga, Niek; Riet, Gerben ter

doi:10.1089/jwh.2006.0004

Cited by 28 publications

(47 citation statements)

References 18 publications

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“…87 Several reasons may account for the variable inclusion of disaggregated evidence in clinical practice guidelines. A simple explanation is the lack of research on sex and gender differences in medicine.…”

Section: Discussionmentioning

confidence: 99%

“…19 Finally, failure to integrate such considerations into clinical practice guidelines likely results from lack of awareness as well as lack of guidance on how to do so. 87,94,95 Current guideline development instruments do not provide instruction for synthesizing sex and gender evidence. 96 The AGREE (Appraisal of Guidelines, Research and Evaluation) II instrument requires systematic reviewers to specify populations of interest, but does not require identification of evidence particular to males or females or any note of sex or gender differences.…”

Section: Discussionmentioning

confidence: 99%

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Sex and gender considerations in Canadian clinical practice guidelines: a systematic review

et al. 2017

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Background:The importance of sex and gender in the diagnosis and management of health conditions is well established, but the extent to which this evidence is integrated into clinical practice guidelines remains unknown. We aimed to determine the proportion of Canadian clinical practice guidelines that integrate evidence on sex and gender considerations. Methods:We searched the Canadian Medical Association's CPG Infobase, PubMed, all provincial/territorial websites and websites of professional organizations for English-and French-language Canadian clinical practice guidelines published between January 2013 and June 2015 on selected conditions identified as priorities by policy-makers and practitioners. Citations and text were searched electronically using keyword terms related to sex and gender. Three investigators independently analyzed and categorized the content of text-positive clinical practice guidelines based on clinical relevance for practitioners. Results:Of the 118 clinical practice guidelines that met the inclusion criteria, 79 (66.9%) were text-positive for sex and/or gender keywords; 8 (10%) of the 79 used the keywords only in relation to pregnancy. Of the remaining 71 guidelines, 25 (35%) contained sex-related diagnostic or management recommendations. An additional 5 (7%) contained recommendations for sex-specific laboratory reference values, 29 (41%) referred to differences in epidemiologic features or risk factors only, and 12 (17%) contained nonrelevant mentions of search keywords. Twenty-five (35%) of the text-positive guidelines used the terms "sex" and/or "gender" correctly. higher in women than in men, with increased risk of driving impairment. 19 Rochon and colleagues 20 discovered that, in Ontario, men with dementia who were prescribed antipsychotic drugs had significantly higher risks for hospital admission and death than did women with dementia. Similarly, social risk factors are associated with higher rates of suicide in older men, which suggests that more aggressive screening and treatment may be required. [21][22][23] The extent to which evidence about sex and gender is integrated into clinical practice guidelines for diagnosis and management of diseases remains unknown. We conducted a systematic review to investigate the integration of sex and gender evidence into Canadian clinical practice guidelines published between 2013 and 2015 for noncommunicable health conditions. Methods Data sources and inclusion criteriaProtocols for this review are posted on Open Science Framework and follow PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) reporting guidelines (www.prisma-statement.org/). The review search focused on selected health conditions identified as priorities by policymakers and practitioners [24][25][26][27][28][29][30] (Box 1). We considered only 2 cancers, lung and colorectal, because they are among the leading causes of death from cancer for both females and males, 31 and important sex and/or gender differences in prevalence, risk and screening, path...

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Sex and gender considerations in Canadian clinical practice guidelines: a systematic review

et al. 2017

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“…Geleneksel tıbbın hastalık tanımı için çizdiği çerçeve belirti ve semptomlara dayalı biyomedikal bir çerçevedir (8). Klinik yaklaşım kılavuzlarında biyolojik cinsiyet temelli sorunlara dair yaklaşımlar mevcutken sağlığa dair karar verme aşamasında belirleyici olan toplumsal cinsiyete dayalı sorunlar görünmez durumdadır (2,9,10). Bu durumun yansıması olarak tıp eğitimi de biyolojik-toplumsal cinsiyet ayrımına dikkat çekmeyen toplumsal cinsiyet körü, androsentrik (erkek-merkezci) bir kurgudadır ve dolayısıyla sosyal tıbbı atlayan bir müfredata dayanmaktadır (1,2,8,11,12).…”

Section: Introductionunclassified

Bir tıp fakültesi birinci sınıf öğrencilerinde toplumsal cinsiyet algı düzeyi ve ilişkili faktörlerin değerlendirilmesi

Varol¹,

Çiçeklioğlu²,

Taner³

2016

Ege Tıp Dergisi

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Amaç: Bu çalışmanın amacı bir tıp fakültesi birinci sınıf öğrencilerinin toplumsal cinsiyet algı düzeyi ve ilişkili faktörleri değerlendirmektir. Gereç ve Yöntem:Kesitsel araştırma şeklinde yürütülen çalışma Ege Üniversitesi Tıp Fakültesi 2013-2014 eğitim yılında birinci sınıfta okuyan 435 öğrenciden 352'sine (%81) ulaşılarak gerçekleştirilmiştir. Veri toplama aracı olarak 24 sorudan ve iki alt skaladan oluşan Cinsiyet Eşitliği Ölçeğinin (CEÖ) Türkçe versiyonu ve sosyo-demografik özellikleri sorgulayan bilgi formu kullanılmıştır. Bulgular:Öğrencilerin CEÖ puan ortalaması 62.6±5.6'dür. Öğrencilerin CEÖ "Geleneksel Cinsiyet Normları" alt skala puan ortalaması 43.1±5.1 "Eşitlikçi Cinsiyet Normları" alt skala puan ortalaması 19.6±2.1'dir. Kadın öğrencilerin CEÖ ortalaması 65.3±3.9, erkek öğrencilerin puan ortalaması 60.6±5.8 idi. Cinsiyetler arasında cinsiyet eşitliği açısından fark istatistiksel olarak anlamlı bulunmuştur (p<0.001). CEÖ açısından annesi işsiz-ev emekçisi olan öğrencilerin puan ortalaması (61.9±5.8) annesi herhangi bir işte çalışanlardan (63.5±5.3) anlamlı düzeyde daha düşüktür. Anne ve baba eğitim düzeyi ilkokul ve altında olanların puan ortalaması ( sırasıyla 61.3±5.9 ve 59.9±6.2), ilkokul üzerinde eğitime sahip olanlardan (sırasıyla 63.2±5.4 ve 63.2±5.4) anlamlı düzeyde daha düşüktür (p<0.05 ve p<0.05).Sonuç: Bu çalışmanın bulgularına göre cinsiyet eşitliği tutumunu sosyo-demografik değişkenler etkilemektedir. Tıp fakülteleri müfredatlarına öğrencilerin sosyoekonomik özelliklerinden kaynaklanan cinsiyet eşitliği algı düzeyi farklılıklarını azaltacak eğitimler eklenmelidir.Anahtar Sözcükler: Toplumsal cinsiyet, cinsiyet eşitliği, tutum, tıp öğrencisi. Abstract Aim: The aim of this study was to evaluate levels of gender perception and factors relating to this among first-year students in a medical faculty. Materials and Methods: The population of this cross-sectional study consisted of 356 (81%) of the 435 first-year students attending Ege University Faculty of Medicine in the 2013-2014 academic year. Data were collected using the Turkish version of the "Gender Equality Scale", which includes 24 items and 2 sub-scales, along with an information form to gather socio-demographic data.Results: Mean total score of students on the Gender Equality Scale was 62.6±5.6. Mean score on the "Traditional Gender Norms" sub-scale was 43.1±5.1 and mean score on the "Equalitarian Gender Norms" sub-scale was 19.6±2.1. Mean total score was 65.3±3.9 for female students and 60.6±5.8 for male students. This difference between the genders regarding gender equality was found to be statistically significant (p<0.001). The mean score of students whose mothers were unemployed or homemakers (61.9 ± 5.8) was significantly lower than that of students with a working mother (63.5±5.3). Mean scores of students whose mother's and father's educational level was primary school and below (61.3±5.9 and 59.9±6.2 respectively) were significantly lower than scores of students whose mother's and father's educational level was higher tha...

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“…In a previous study, we showed that the two major Dutch guideline-developing organisations, the Dutch College of General Practitioners (NHG) and the Dutch Institute for Healthcare Improvement (CBO), paid no systematic attention to sex-related factors in either the development or content of their guidelines 11. Other research showed little attention to ethnic background of patients in guidelines 12.…”

mentioning

confidence: 99%

“…Our previous study identified two barriers to considering gender issues in guideline development: lack of awareness that it might improve the quality of guidelines and lack of know-how for doing so 11. We designed an intervention to remove these barriers using education and expert feedback.…”

mentioning

confidence: 99%

Evaluating the effectiveness of an educational and feedback intervention aimed at improving consideration of sex differences in guideline development

Keuken

Haafkens

Mohrs

et al. 2010

BMJ Quality & Safety

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Objectives To investigate the effect of an educational and feedback intervention to enhance consideration of sex differences in clinical guideline development. Design Preintervention and postintervention questionnaires in intervention and control groups. Content analysis of intervention guidelines and former versions. Setting Guideline consultants, working-group members and guideline documents of two Dutch guidelinedeveloping organisations. Main outcome measures Attitudes of guideline developers concerning the importance of considering sex differences and the number of the sex-specific statements in the contents of guideline documents. Results The attitude of the intervention group did not change significantly relative to the control group. Consideration of sex-related factors within the guidelines increased relative to available previous versions. Conclusion Education and expert feedback may increase consideration of sex differences in guidelines. Further efforts are needed to implement and test these interventions.Clinical guidelines describe the best available evidence concerning the diagnosis and treatment of patients, and they play an important role in improving the quality of care.1 2 Since 1993, the National Institutes of Health and other researchfunding agencies have required the equitable inclusion of men and women in clinical research. This has generated more evidence on sex differences in health outcomes.6e8 Women and men may need different preventive, diagnostic or therapeutic strategies. 6 For example, the alcohol use disorders identification test (AUDIT) screening instrument for alcohol problems is less sensitive and more specific for women than it is for men, indicating different cut-off points. In a previous study, we showed that the two major Dutch guideline-developing organisations, the Dutch College of General Practitioners (NHG) and the Dutch Institute for Healthcare Improvement (CBO), paid no systematic attention to sexrelated factors in either the development or content of their guidelines.11 Other research showed little attention to ethnic background of patients in guidelines.12 Both organisations therefore agreed to participate in a follow-up project (the Diversity Consultation Project) to improve consideration of diversity issues in guideline development.Our previous study identified two barriers to considering gender issues in guideline development: lack of awareness that it might improve the quality of guidelines and lack of know-how for doing so. 11 We designed an intervention to remove these barriers using education and expert feedback. Evidence from other settings suggests that such intervention strategies can effect change among professionals. 13e17This article describes the intervention and evaluates the extent to which it influenced the awareness and know-how of guideline developers regarding the importance of considering sex differences when developing and writing guidelines. METHODS SettingThe CBO and the NHG have been developing clinical guidelines since the 1980s.18 1...

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Attention to Sex-Related Factors in The Development of Clinical Practice Guidelines

Cited by 28 publications

References 18 publications

Sex and gender considerations in Canadian clinical practice guidelines: a systematic review

Sex and gender considerations in Canadian clinical practice guidelines: a systematic review

Bir tıp fakültesi birinci sınıf öğrencilerinde toplumsal cinsiyet algı düzeyi ve ilişkili faktörlerin değerlendirilmesi

Evaluating the effectiveness of an educational and feedback intervention aimed at improving consideration of sex differences in guideline development

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