Sex and gender considerations in UK clinical guidelines: a systematic review of 197 NICE guidelines.

IF 5.2
Marina Politis, Rachel Fowden-Hulme, Alice Witt, Kate Womersley
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Abstract

Background: Despite growing recognition of sex and gender differences in disease presentation and treatment responses, clinical guidelines often fail to address these variables, risking patient safety.

Aim: This study aimed to determine how many NICE clinical guidelines incorporate sex and/or gender considerations, and to analyse gender composition of guideline committees.

Method: The study reviewed 197 non-sex-specific NICE guidelines, evaluating whether they mentioned sex or gender beyond pregnancy and childbirth. Secondary outcomes included whether sex and/or gender were considered in disease risk, presentation, and management and perceived gender of guideline committee chairs and members.

Results: Of 223 guidelines, 197 assessed a non-sex-specific condition. 120 referenced sex or gender related terminology, of which only 81 deployed this terminology outside of pregnancy and childbearing. Only 4 (2%) of guidelines stated sex/gender differences related to disease pathophysiology, 18 guidelines (9%) related to disease presentation, 29 (15%) related to investigations, and 38 (19%) related to epidemiology.Of 162 published committee chairs, 126 (76%) were men. Committees chaired by women produced clinical guidelines which better account for sex and gender.

Conclusion: Recommendations related to sex and gender are underreported in NICE guidelines. Women are underrepresented as committee chairs, failing to reflect participation in the healthcare workforce. Meaningful change will require systematic, whole sector progress to integrate sex and/or gender disaggregated research into clinical guidelines. In the UK, the MESSAGE project has co-design a sex and gender policy framework for funding and regulatory organisations, supporting policy implementation across the UK research sector.

英国临床指南中的性别和性别考虑:对197份NICE指南的系统回顾。
背景:尽管人们越来越认识到疾病表现和治疗反应中的性别差异,但临床指南往往未能解决这些变量,从而危及患者安全。目的:本研究旨在确定有多少NICE临床指南纳入了性别和/或性别考虑,并分析指南委员会的性别构成。方法:该研究回顾了197份非性别特异性NICE指南,评估它们是否提到了怀孕和分娩以外的性别。次要结局包括在疾病风险、表现和管理中是否考虑了性别和/或性别,以及指南委员会主席和成员的感知性别。结果:223项指南中,197项评估了非性别特异性疾病。120份报告提到了性别或与性别有关的术语,其中只有81份报告在怀孕和生育之外使用了这一术语。只有4份(2%)指南指出了与疾病病理生理学相关的性别/性别差异,18份(9%)指南与疾病表现相关,29份(15%)指南与调查相关,38份(19%)指南与流行病学相关。在162位公开的委员会主席中,有126位(76%)是男性。由妇女担任主席的委员会制定了更好地说明性别和社会性别的临床指南。结论:NICE指南中有关性和性别的建议被低估了。妇女担任委员会主席的人数不足,未能反映医疗保健工作人员的参与情况。有意义的变革将需要系统的、整个部门的进展,将性别和/或按性别分类的研究纳入临床指南。在英国,MESSAGE项目为资助和管理组织共同设计了一个性别和社会性别政策框架,支持整个英国研究部门的政策实施。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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