Department of General Practice, Division of Clinical Methods and Public Health, Academic Medical Center - University of Amsterdam, Amsterdam, The Netherlands.
J Eval Clin Pract. 2012 Apr;18(2):369-77. doi: 10.1111/j.1365-2753.2010.01591.x. Epub 2010 Nov 22.
RATIONALE, AIMS AND OBJECTIVES: Increasing evidence indicates that sex-specific issues may have impact on prevention, diagnosis, or treatment. These issues are not systematically considered during the development of Dutch clinical practice guidelines. The aim of this study is to identify how members of guideline development groups discuss sex-specific evidence, and whether and how the outcomes of these discussions are reflected in the guideline.
Six guideline development committees (GDCs) were studied. Each committee was supported by a staff member from the guideline organization who was trained and received feedback to facilitate uptake of evidence on sex differences in the process of guideline development. Non-participant observation and transcription of audio recordings from 22 GDC meetings were performed. Content analysis of meeting transcripts and guidelines were studied to analyse characteristics of discussion episodes on sex-specific research data-based issues (subject matter, initiator and group approach towards the topic and themes) and whether or not conclusions on evidence were reflected in the final guideline text.
Of the 87 identified discussion episodes, 68 dealt with sex-specific research evidence potentially relevant to guidelines. Respectively 51%, 28% and 21% of the latter episodes were initiated by committee members, staff members and chairpersons. Group approaches towards the subject matter were generally positive. Data from 60% of those episodes were reflected in the final guideline text. Sex-specific data on reproductive issues were more often discussed and reflected in guideline texts than data on other health issues. Discussion episodes on sex-specific evidence initiated by chairpersons were most often reflected in the guidelines.
This pilot study indicates that GDCs regularly focused on sex-specific issues. The participation of a trained staff member contributed to this.
背景、目的和目标：越来越多的证据表明，性别特异性问题可能会对预防、诊断或治疗产生影响。在制定荷兰临床实践指南时，并没有系统地考虑这些问题。本研究旨在确定指南制定小组的成员如何讨论基于性别的证据，以及这些讨论的结果是否以及如何反映在指南中。
研究了六个指南制定委员会（GDC）。每个委员会都得到了来自指南组织的一名工作人员的支持，该工作人员接受了培训并获得了反馈，以促进在指南制定过程中考虑性别差异方面的证据。对 22 次 GDC 会议的非参与式观察和音频记录的转录进行了研究。对会议记录和指南的内容分析用于分析基于性别特异性研究数据的问题讨论片段的特征（主题、发起者和小组对该主题的方法以及对证据的结论是否反映在最终指南文本中）。
在确定的 87 个讨论片段中，有 68 个涉及与指南相关的潜在基于性别的研究证据。分别有 51%、28%和 21%的后续片段由委员会成员、工作人员和主席发起。小组对主题的方法总体上是积极的。这些片段中 60%的数据反映在最终的指南文本中。与其他健康问题相比，生殖问题的基于性别的数据更多地在指南中进行了讨论和反映。由主席发起的关于基于性别的证据的讨论片段最常在指南中得到反映。
这项试点研究表明，GDC 经常关注基于性别的问题。一名经过培训的工作人员的参与促成了这一点。
