Designing clinical practice guidelines for equitable, inclusive, and contextualised care

Sabine Oertelt-Prigione and colleagues argue that European clinical practice guidelines need standardised, inclusive, sex and gender sensitive development to not only guide healthcare but also drive innovation and research agendas As the global governance of healthcare is being reshaped, a timely opportunity and an urgent need exist to institutionalise standardised, equity focused approaches that embed innovation in the design and delivery of care.1 Clinical practice guidelines (CPGs) are essential to this transformation—they are not only endpoints that translate research into care but can also function as upstream influencers that shape research agendas, funding priorities, and innovation pathways.2 Through inclusive sex, gender, and context sensitive processes, CPGs can act as catalysts for advancing women’s and gender sensitive healthcare by identifying and highlighting persistent gaps in data and care, potentially driving innovation in research and service provision. CPGs can thus have a systemic impact beyond their essential role in clinical care. To successfully enact this upstream role, the CPG development process needs to build on strong, inclusive evidence guaranteed by structural and methodological premises and possibly embrace some technological innovations. Women and gender diverse individuals are under-represented and underserved in clinical research and care. Although sex and gender sensitive medicine is expanding and knowledge gaps are being filled as a result of structural interventions such as funding mandates, policy reforms, and publishing prerequisites,3 implementation into clinical practice is lagging behind. Previous reviews from Canada, the US, and Australia have shown the limited attention to sex/gender in national guidelines.456 Sex and gender were either not systematically mentioned in recommendations or used interchangeably—for example, by using “gender” when considering biological sex. Incorrect use of terminology can reduce the target specificity of healthcare interventions, ultimately disadvantaging already underserved populations.7 Furthermore, a lack of adequate inclusion of female participants …