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Review
. 2014 Sep;156(3):508-16.
doi: 10.1016/j.surg.2014.07.001.

Sex bias exists in basic science and translational surgical research

Dustin Y Yoon  1 , Neel A Mansukhani  1 , Vanessa C Stubbs  1 , Irene B Helenowski  2 , Teresa K Woodruff  3 , Melina R Kibbe  4
Affiliations
Review

Sex bias exists in basic science and translational surgical research

Dustin Y Yoon et al. Surgery. 2014 Sep.

Abstract

Background: Although the Revitalization Act was passed in 1993 to increase enrollment of women in clinical trials, there has been little focus on sex disparity in basic and translational research. We hypothesize that sex bias exists in surgical biomedical research.

Methods: Manuscripts from Annals of Surgery, American Journal of Surgery, JAMA Surgery, Journal of Surgical Research, and Surgery from 2011 to 2012 were reviewed. Data abstracted included study type, sex of the animal or cell studied, location, and presence of sex-based reporting of data.

Results: Of 2,347 articles reviewed, 618 included animals and/or cells. For animal research, 22% of the publications did not specify the sex of the animals. Of the reports that did specify the sex, 80% of publications included only males, 17% only females, and 3% both sexes. A greater disparity existed in the number of animals studied: 16,152 (84%) male and 3,173 (16%) female (P < .0001). For cell research, 76% of the publications did not specify the sex. Of the papers that did specify the sex, 71% of publications included only males, 21% only females, and 7% both sexes. Only 7 (1%) studies reported sex-based results. For publications on female-prevalent diseases, 44% did not report the sex studied. Of those reports that specified the sex, only 12% studied female animals. More international than national (ie, United States) publications studied only males (85% vs 71%, P = .004), whereas more national publications did not specify the sex (47% vs 20%, P < .0001). A subanalysis of a single journal showed that across three decades, the number of male-only studies and usage of male animals has become more disparate over time.

Conclusion: Sex bias, be it overt, inadvertent, situational, financial, or ignorant, exists in surgical biomedical research. Because biomedical research serves as the foundation for subsequent clinical research and medical decision-making, it is imperative that this disparity be addressed because conclusions derived from such studies may be specific to only one sex.

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Comment in

  • Invisible.
    Freischlag JA. Freischlag JA. Surgery. 2014 Sep;156(3):519-20. doi: 10.1016/j.surg.2014.07.002. Surgery. 2014. PMID: 25175503 No abstract available.
  • Commentary on "Sex bias exists in basic science and translational surgical research".
    Crandall M; Association of Women Surgeons Council. Crandall M, et al. Surgery. 2015 Mar;157(3):603. doi: 10.1016/j.surg.2014.10.003. Epub 2015 Jan 26. Surgery. 2015. PMID: 25633733 No abstract available.
  • Sex-based biomedical research policy needs an implementation plan.
    Woodruff TK, Green S, Paller A, Schlosser BJ, Spring B, Castle M, Stock MC, Carnethon MR, Clark CT, Gerard E, Turek FW, Wisner KL, Wakschlag LS, Kibbe MR, Mendelson MA, Simon MA, Hansen NM, Kenton K, Garcia PM, Zee P, Ramsey-Goldman R, Sutton SH, Van Horn L. Woodruff TK, et al. Womens Health (Lond). 2015 Jul;11(4):449-52. doi: 10.2217/WHE.15.28. Epub 2015 Aug 3. Womens Health (Lond). 2015. PMID: 26237204 No abstract available.

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