Sex bias in basic science and translational otolaryngology research

Stephenson, Elizabeth D.; Farzal, Zainab; Kilpatrick, Lauren A.; Senior, Brent A.; Zanation, Adam M.

doi:10.1002/lary.27498

Cited by 18 publications

(7 citation statements)

References 20 publications

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“…As a result, the CFD findings can not be generalized to others due to inter-individual anatomic differences (13) . However, this highlights the previously demonstrated importance of providing subject sex and race data so that the applicability (external validity) of the findings can be assessed by the reader (28)(29)(30) . The findings presented here do agree with those of prior studies in different individuals (16)(17)(18)(19)(20) .…”

Section: O R R E C T E D P R O O Fmentioning

confidence: 88%

A computational fluid dynamics analysis of the effects of size and shape of anterior nasal septal perforations

Farzal

Signore

Zanation

et al. 2019

Rhin

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Background: Nasal septal perforations (NSPs) often cause bleeding, crusting, obstruction, and/or whistling. The objective was to analyze the impact of anterior NSP size and shape on nasal physiology using computational fluid dynamics (CFD). Methods:A 3-dimensional model of the nasal cavity was constructed from a radiologically normal CT scan using imaging software. Anterior NSPs (ovoid (ONSP): 0.5, 1, 2, and 3 cm long anterior-to-posteriorly and round (RNSP, 0.5 and 1 cm)) were virtually created in the model and divided into ventral, dorsal, anterior, and posterior regions. Steady-state inspiratory airflow, heat, and water vapor transport were simulated using Fluent™ CFD software. Air crossover through the perforation, wall shear, heat flux, water vapor flux, resistance, and humidification were analyzed.Results: Air crossover and wall shear increased with perforation size. Regionally, wall shear and heat and water vapor flux were highest posteriorly and lowest anteriorly, generally increasing with size in those regions. RNSPs had greater heat and water vapor flux compared to corresponding size ONSPs. Resistance decreased by 10% or more from normal only in the 3 cm ONSP. Maximum water content was achieved more posteriorly in larger NSP nasal cavities. Conclusions:High wall shear and heat and water vapor flux in posterior perforation regions may explain the crusting most commonly noted on posterior NSP edges. This preliminary study suggests that larger NSPs have a greater effect on nasal resistance and water content. Decrease in resistance with larger NSP size may be implicated in reported symptomatic improvement following enlargement of NSPs for treatment.

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Section: O R R E C T E D P R O O Fmentioning

confidence: 88%

A computational fluid dynamics analysis of the effects of size and shape of anterior nasal septal perforations

Farzal

Signore

Zanation

et al. 2019

Rhin

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“…Recent studies analyzing high‐impact general surgery and orthopedic surgery literature demonstrated that approximately one‐third of recently published studies performed analysis of outcomes by sex . A similar review of the otolaryngology literature by our institution found similar lack of sex‐ or gender‐based reporting of outcomes in three major otolaryngology journals . Males and females experience many conditions differently, including disease prevalence, symptom manifestations, and response to therapeutics.…”

Section: Discussionmentioning

confidence: 52%

Sex‐based outcomes in type I thyroplasty for nonparalytic glottic incompetence

et al. 2019

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Objective: Clinical outcomes for type I Gore-Tex thyroplasty (GMT) for nonparalytic glottic incompetence (GI) have been reported in the literature. Given differences in male and female laryngeal anatomy, sex-based outcomes should also be evaluated. We endeavored to evaluate sex-specific post-GMT voice outcomes.Methods: We performed a retrospective review of patients undergoing GMT for nonparalytic GI. Multidimensional voice outcome measures including voice-related quality of life (VRQOL), Glottal Function Index (GFI), and grade/roughness/breathiness/ asthenia/strain (GRBAS) were analyzed at postoperative time frames: 0 to 3 months, 3 to 9 months, and 9 to 18 months.Results: Eighty-five subjects (43 females, 42 males) with mean age 53.5 undergoing GMT for nonparalytic GI from 2005 to 2017 met inclusion criteria. Etiologies included vocal fold hypomobility (N = 36, 42%), paresis (N = 18, 21%), vocal fold atrophy (N = 17, 20%), and scarring (N = 14, 17%). Females had significantly greater improvement on VRQOL at 0 to 3 months and 9 to 18 months timeframes compared to males, with mean change in VRQOL: 41.3 versus 22.4 (P = 0.0002) and 42.5 versus 20.8 (P = 0.002), respectively. Similarly, women had significantly greater improvement in GFI at 0 to 3 months follow-up (mean difference − 10.8 vs. −4.9, respectively, P = 0.0002). There was no statistically significant sex difference in GRBAS at any followup interval.Conclusion: Following GMT, females had greater improvement in patient-reported voice outcomes in the early postoperative period. No significant difference between sexes was noted in perceptual measures (GRBAS). Sex-specific outcomes should be evaluated for clinical interventions to improve specificity of preoperative counseling.

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“…Sex-based results reporting was only identified in 1% of the studies included [11]. Similar data exist in otolaryngology and orthopaedic research [12,13]. This study aimed to establish the prevalence of sex-specific reporting and the consideration of sex as a statistically controlled variable in preclinical and clinical research studies on renal cancer.…”

Section: Introductionmentioning

confidence: 79%

Kidney Cancer Research: Sex-Inclusive but Sex-Unspecific

Fuentes-Bonachera¹,

Meunier²,

Waters³

et al. 2020

COR

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Background: Preclinical and clinical research is largely inclusive of both the female and the male population, but the lack of specific separation of data according to patient sex prevents the detection of the impact of sex on cancer biology and response to medications and treatment. This study aimed to examine the consideration of sex as a biological variable in preclinical and clinical studies in kidney cancer. Methods: Preclinical and clinical studies pertaining to kidney cancer published in three leading urology journals over a two-year period were reviewed for the reporting of cells, animal or patient sex, and the inclusion of sex as a biological variable in both study design and data analysis. Results: 171 clinical studies and 5 preclinical studies were included. While the sex of the participants was disclosed in all but 10 of the 171 clinical studies reviewed, the patient populations were largely maledominated (male to female ratio > 1.5). Only 5 studies contained more female than male patients. Sexspecific reporting was performed in 3% of studies, and only 37% included sex as part of the statistical analysis. 26% of these identified a statistically significant difference in measured outcomes between male and female participants. Conclusion: Kidney cancer research is sex-inclusive, but the female patient population remains underrepresented. The consideration of sex in data analysis is low and could prevent the identification of key sex-specific optimization opportunities for the improved management of the disease.

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Sex bias in basic science and translational otolaryngology research

Cited by 18 publications

References 20 publications

A computational fluid dynamics analysis of the effects of size and shape of anterior nasal septal perforations

A computational fluid dynamics analysis of the effects of size and shape of anterior nasal septal perforations

Sex‐based outcomes in type I thyroplasty for nonparalytic glottic incompetence

Kidney Cancer Research: Sex-Inclusive but Sex-Unspecific

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