PDF(Pubmed)
Abstract：
Background/Objectives: Evidence-based medicine (EBM) shapes most clinical guidelines. Although the advent of EBM marked a significant advancement, failure to include sex differences in the study design and analysis of most trials leads to an under-representation of gender-specific medicine (GM) in EBM-directed guidelines. In this review, we evaluated how the topic of GM was developed in the guidelines produced by the European Society of Cardiology (ESC) from 2018 to 2023. Methods: Two independent reviewers evaluated 24 ESC guidelines. Significant mentions of GM were counted and divided between epidemiology, diagnosis, and therapeutics. The qualitative and semi-quantitative analysis of information relating to GM was performed. Data on the number of citations of papers with a title concerning GM and the prevalence and role of women in guidelines\' authorship were also analyzed. Results: Less than 50% of guidelines had a section dedicated to GM. Only nine guidelines were led by a woman, and 144/567 authors were female. In the most recent guidelines and in those with at least 30% of female authors, there was an increased mention of GM. On average, guidelines had four significant mentions of GM regarding epidemiology, two regarding diagnosis, and one regarding therapy. Articles with titles concerning GM made up, on average, 1.5% of the total number of citations. Conclusions: Although sex differences play a significant role in most clinical scenarios, ESC guidelines still do not sufficiently account for this. The problem does not seem to solely lie in the guidelines, but in the lack of attention to GM in research needed for their preparation.
摘要：
背景/目标：循证医学（EBM）塑造了大多数临床指南。尽管EBM的出现标志着重大进步，在大多数试验的研究设计和分析中未能纳入性别差异导致在EBM指导的指南中性别特异性药物(GM)的代表性不足.在这次审查中,我们评估了2018年至2023年欧洲心脏病学会(ESC)制定的指南中GM主题的发展情况.方法：两名独立评审员评估了24条ESC指南。对转基因的重要提及进行了计数，并在流行病学之间进行了划分，诊断,和治疗学。对与GM相关的信息进行了定性和半定量分析。还分析了有关标题为GM的论文的引用数量以及女性在指南中的流行率和作用的数据。结果：不到50％的指南中有专门针对GM的部分。只有九条指导方针是由一名女性领导的，144/567作者为女性。在最新的指南中，以及那些至少有30%女性作者的指南中，对通用汽车的提及有所增加。平均而言,指南在流行病学方面有四次重要提到转基因，两个关于诊断，还有一个关于治疗的。标题与通用汽车有关的文章，平均而言,引用总数的1.5%。结论：尽管性别差异在大多数临床情况下都起着重要作用，ESC指南仍然没有充分考虑到这一点。问题似乎不仅仅在于指导方针，但在研究中缺乏对转基因的关注，需要为他们做准备。
