School of Informatics, Computing, and Engineering, Indiana University Bloomington, USA.
École de Bibliothéconomie et des Sciences de l'Information, Université de Montréal, Canada.
Lancet. 2019 Feb 9;393(10171):550-559. doi: 10.1016/S0140-6736(18)32995-7.
Clinical and preclinical studies have shown that there are sex-based differences at the genetic, cellular, biochemical, and physiological levels. Despite this, numerous studies have shown poor levels of inclusion of female populations into medical research. These disparities in sex inclusion in research are further complicated by the absence of sufficient reporting and analysis by sex of study populations. Disparities in the inclusion of the sexes in medical research substantially reduce the utility of the results of such research for the entire population. The absence of sex-related reporting are problematical for the translation of research from the preclinical to clinical and applied health settings. Large-scale studies are needed to identify the extent of sex-related reporting and where disparities are more prevalent. In addition, while several studies have shown the dearth of female researchers in science, few have evaluated whether a scarcity of women in science might be related to disparities in sex inclusion and reporting. We aimed to do a cross-disciplinary analysis of the degree of sex-related reporting across the health sciences-from biomedical, to clinical, and public health research-and the role of author gender in sex-related reporting.
This bibliometric analysis analysed sex-related reporting in medical research examining more than 11·5 million papers indexed in Web of Science and PubMed between 1980 and 2016 and using sex-related Medical Subject Headings as a proxy for sex reporting. For papers that were published between 2008 and 2016 and could be matched with PubMed, we assigned a gender to first and last authors on the basis of their names, according to our gender assignment algorithm. We removed papers for which we could not determine the gender of either the first or last author. We grouped papers into three disciplinary categories (biomedical research, clinical medicine, and public health). We used descriptive statistics and regression analyses (controlling for the number of authors and representation of women in specific diseases, countries, continents, year, and specialty areas) to study associations between the gender of the authors and sex-related reporting.
Between Jan 1, 1980, and Dec 31, 2016, sex-related reporting increased from 59% to 67% in clinical medicine and from 36% to 69% in public health research. But for biomedical research, sex remains largely under-reported (31% in 2016). Papers with female first and last authors had an increased probability of reporting sex, with an odds ratio of 1·26 (95% CI 1·24 to 1·27), and sex-related reporting was associated with publications in journals with low journal impact factors. For publications in 2016, sex-related reporting of both male and female is associated with a reduction of -0·51 (95% CI -0·54 to -0·47) in journal impact factors.
Gender disparities in the scientific workforce and scarcity of policies on sex-related reporting at the journal and institutional level could inhibit effective research translation from bench to clinical studies. Diversification in the scientific workforce and in the research populations-from cell lines, to rodents, to humans-is essential to produce the most rigorous and effective medical research.
Canada Research Chairs.
临床前和临床研究表明，在遗传、细胞、生化和生理水平上存在性别差异。尽管如此，许多研究表明，将女性纳入医学研究的比例很低。在研究人群的性别纳入方面存在的这些差异，因缺乏充分的报告和按性别进行分析而进一步复杂化。医学研究中性别纳入的差异极大地降低了此类研究结果对整个人群的实用性。缺乏与性别相关的报告对于将研究从临床前转化为临床和应用健康环境是有问题的。需要进行大规模研究，以确定与性别相关的报告的程度，以及在哪些方面差异更为普遍。此外，尽管有几项研究表明女性在科学界的人数较少，但很少有研究评估女性在科学界的匮乏是否与性别纳入和报告方面的差异有关。我们旨在对健康科学领域的性别相关报告进行跨学科分析——从生物医学到临床和公共卫生研究——并探讨作者性别在性别相关报告中的作用。
本文献计量学分析使用与性别相关的医学主题词（MeSH）作为性别报告的替代指标，对 1980 年至 2016 年间在 Web of Science 和 PubMed 中索引的超过 1150 万篇论文进行了性别相关报告分析。对于 2008 年至 2016 年期间发表且可与 PubMed 匹配的论文，我们根据我们的性别分配算法，根据作者的姓名确定第一作者和最后作者的性别。我们排除了无法确定第一作者或最后作者性别的论文。我们将论文分为三个学科类别（生物医学研究、临床医学和公共卫生）。我们使用描述性统计和回归分析（控制作者人数以及特定疾病、国家、大陆、年份和专业领域中女性的代表性）来研究作者性别与性别相关报告之间的关联。
在 1980 年 1 月 1 日至 2016 年 12 月 31 日期间，临床医学中的性别报告从 59%增加到 67%，公共卫生研究中的性别报告从 36%增加到 69%。但对于生物医学研究，性别仍然在很大程度上未得到报告（2016 年为 31%）。有第一作者和最后作者为女性的论文更有可能进行性别报告，其优势比为 1.26（95%CI 1.24 至 1.27），性别相关报告与期刊影响因子较低的期刊有关。对于 2016 年发表的论文，男性和女性的性别相关报告与期刊影响因子降低 -0.51（95%CI -0.54 至 -0.47）相关。
科学界的性别差异以及期刊和机构层面缺乏与性别相关的报告政策，可能会阻碍有效的研究从基础研究转化为临床研究。从细胞系、啮齿动物到人类，科学界和研究人群的多样化对于产生最严格和最有效的医学研究至关重要。
加拿大研究主席。
