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Making women visible in research

September 5, 2017

By Lindsay Jolivet

Most older people with dementia are women. However, we do not know how dementia medications affect women, specifically, because studies virtually never report data on men and women separately.

Missing data means that doctors do not always know if they should prescribe lower doses to women, for example, or choose one drug over another for women or men.

“For dementia, missing data means the primary population is receiving treatment based on evidence that does not always account for their needs,” says Dr. Paula Rochon, vice-president of research at Women’s College Hospital. Dr. Rochon’s research has found that a third of residents in long-term care have to split their pills to take the dose the doctor prescribed.

A new study reinforces this point. Students Nishila Mehta, Craig Rodrigues and Manpreet Lamba, supervised by Dr. Rochon, reviewed 33 clinical studies of cholinesterase inhibitors, a class of dementia medications, for data presented about women and men. One study reported outcomes for both women and men. None reported how many women versus men had adverse events in response to the drugs being tested.

After years of advocacy, clinical trials and other studies now routinely recruit women to participate in studies. But they seldom publish findings in a way that allows the exploration of the differences between women and men. These differences can include biological sex, but also gender. As a result of this gap, many women are overlooked and underserved in our healthcare system.

An initiative at Women’s College Hospital called Women’s Xchange is working to close health gaps by ensuring the impact of sex and gender is made visible in research. Women’s Xchange, a knowledge translation and exchange centre based at Women’s College Hospital, supports community research in women’s health and operates a consultation service to help researchers incorporate sex and gender into their research from the proposal stage through execution, analysis, and dissemination.

Research has shown that scientists do not routinely incorporate and report on sex and gender in their studies. The Canadian Institutes of Health Research introduced a requirement that researchers integrate sex and gender into their research designs when appropriate, yet found in a follow-up study that many still fail to do so.

Women’s Xchange recently published metrics for researchers and funders to assess how well sex and gender are incorporated into research proposals. The metrics, published in the journal PLOS ONE, include questions, examples and assessment criteria for identifying and reporting on an array of sex and gender considerations in every stage of the research process. The team is working with the Ministry of Health and Long-Term Care on a follow-up project to test and validate the metrics.

“For too long, too many researchers have neglected consideration of how sex and gender may influence research findings. Even when there are no differences between men and women, reporting that lack of difference is important,” says Robin Mason, PhD, the scientific lead for Women’s Xchange. “Developing the tools and supports to integrate sex and gender into research is one of the aims of Women’s Xchange.”

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