Runnels Vivien, Tudiver Sari, Doull Marion, Boscoe Madeline
Globalization and Health Equity Research Unit, Institute of Population Health, University of Ottawa, 1 Stewart Street, Ottawa, ON K1N 6N5, Canada.
Syst Rev. 2014 Apr 10;3:33. doi: 10.1186/2046-4053-3-33.
Systematic review methodology includes the rigorous collection, selection, and evaluation of data in order to synthesize the best available evidence for health practice, health technology assessments, and health policy. Despite evidence that sex and gender matter to health outcomes, data and analysis related to sex and gender are frequently absent in systematic reviews, raising concerns about the quality and applicability of reviews. Few studies have focused on challenges to implementing sex/gender analysis within systematic reviews.
A multidisciplinary group of systematic reviewers, methodologists, biomedical and social science researchers, health practitioners, and other health sector professionals completed an open-ended survey prior to a two-day workshop focused on sex/gender, equity, and bias in systematic reviews. Respondents were asked to identify challenging or 'thorny' issues associated with integrating sex and gender in systematic reviews and indicate how they address these in their work. Data were analysed using interpretive description. A summary of the findings was presented and discussed with workshop participants.
Respondents identified conceptual challenges, such as defining sex and gender, methodological challenges in measuring and analysing sex and gender, challenges related to availability of data and data quality, and practical and policy challenges. No respondents discussed how they addressed these challenges, but all proposed ways to address sex/gender analysis in the future.
Respondents identified a wide range of interrelated challenges to implementing sex/gender considerations within systematic reviews. To our knowledge, this paper is the first to identify these challenges from the perspectives of those conducting and using systematic reviews. A framework and methods to integrate sex/gender analysis in systematic reviews are in the early stages of development. A number of priority items and collaborative initiatives to guide systematic reviewers in sex/gender analysis are provided, based on the survey results and subsequent workshop discussions. An emerging 'community of practice' is committed to enhancing the quality and applicability of systematic reviews by integrating considerations of sex/gender into the review process, with the goals of improving health outcomes and ensuring health equity for all persons.
系统评价方法包括严格收集、筛选和评估数据，以便为卫生实践、卫生技术评估和卫生政策综合出最佳可得证据。尽管有证据表明性别对健康结果至关重要，但系统评价中经常缺少与性别相关的数据和分析，这引发了对评价质量和适用性的担忧。很少有研究关注在系统评价中实施性别分析所面临的挑战。
一组由系统评价者、方法学家、生物医学和社会科学研究人员、卫生从业者及其他卫生部门专业人员组成的多学科团队，在为期两天的关于系统评价中的性别、公平性和偏倚的研讨会之前完成了一项开放式调查。受访者被要求识别与在系统评价中纳入性别相关的具有挑战性或“棘手”的问题，并说明他们在工作中如何处理这些问题。使用解释性描述对数据进行分析。向研讨会参与者展示并讨论了研究结果的总结。
受访者识别出概念性挑战，如定义性别，测量和分析性别方面的方法学挑战，与数据可用性和数据质量相关的挑战，以及实践和政策挑战。没有受访者讨论他们如何应对这些挑战，但所有人都提出了未来应对性别分析的方法。
受访者识别出在系统评价中实施性别考量存在的一系列相互关联的挑战。据我们所知，本文首次从进行和使用系统评价的人员的角度识别出这些挑战。将性别分析纳入系统评价的框架和方法尚处于早期发展阶段。基于调查结果和随后的研讨会讨论，提供了一些优先事项和合作倡议，以指导系统评价者进行性别分析。一个新兴的“实践社区”致力于通过将性别考量纳入评价过程来提高系统评价的质量和适用性，目标是改善健康结果并确保所有人的健康公平。
