Monday, October 31, 2016

Sex-Gender Differences in Medical Research

We are only very slowly recognizing the many biological and medical differences between males and females (and masculine/feminine)—besides the obvious ones related to reproduction. There are divergent patterns in the anatomy and physiology of perhaps every body system. However, in medical research male and female subjects are often grouped together in a way that obscures those divergent patterns.

Two "viewpoint" articles in the Journal of the American Medical Association (JAMA) today focus a light on this issue and point the way to improved—more clinically useful—medical research. Links to both articles are listed below.

As one of the articles points out, women have been included in medical trials for only the past few decades. So there is still a lot of work to be done to shore up the database of male-female differences. But also a lot of work to be done in sorting out male-female patterns of health and disease. Then even more work in making this new knowledge part of the everyday practice medicine.

Both articles are brief and relatively nontechnical, but when read together, they provide an important message for those of us teaching pre-clinical health professionals in A&P. That message is that we should consider introducing—then reinforcing—the notion of body-wide sex and gender differences.

Both articles give examples of such differences, but many more are to be found elsewhere, as well. Not that we should teach every possible example in the undergraduate A&P course. However, the general concept of functional variation between males and females may be an important one to emphasize as a sub-theme in our story of the human body.

What can we use from this in teaching undergraduate A&P? 

  • Consider making sex differences a sub-theme in your A&P course.
    • Occasionally point out examples of structural, functional, and clinical patterns of variation that differ between males and females.
      • Compare and contrast sex differences with other types of pattern variations.
      • Discuss "patterns of variability" in contrast to a strictly "binary" view.
    • Consider bringing up sex-difference research that is not yet fully supported.
      • Discuss whether more attention to sex differences across topics in scientific research might help advance this area of knowledge.
      • Discuss the opposing view that there are no clinically significant biological differences between males and females other than those related to reproduction.
    • Look for such examples in your textbook and other teaching/learning resources and point them out to your students.
    • Consider having a classroom or online discussion of this topic. 
    • Ask students to post links to articles that discuss male-female patterns of variation
      • Post to course discussion or course social media channel
      • Bring to class or email to instructor to share with class
      • Post on bulletin board

  • Bring up this issue when discussing how science is done.
    • Consider asking students what effects on public health a more thorough consideration of sex differences may produce.
    • Ask students to look at a study and ask whether sex differences were thoroughly accounted for in the methodology. Could this affect how the study is interpreted and applied in the clinic?

Want to know more? 

Consideration of Sex Differences in Medicine to Improve Health Care and Patient Outcomes

  • Marianne J. Legato, MD; Paula A. Johnson, MD, MPH; JoAnn E. Manson, MD, DrPH.
  • JAMA. Published online October 31, 2016. doi:10.1001/jama.2016.13995
  • One of the two articles cited in the post above.

Reporting Sex, Gender, or Both in Clinical Research? 

  • Janine Austin Clayton, MD; Cara Tannenbaum, MD, MS
  • JAMA. Published online October 31, 2016. doi:10.1001/jama.2016.16405
  • One of the two articles cited in the post above.

Let’s Talk About Sex…and Gender!

  • Amanda M. Rossi, PhD; Louise Pilote, MD, MPH, PhD
  • Circulation: Cardiovascular Quality and Outcomes. 2016; 9: S100-S101 doi: 10.1161/CIRCOUTCOMES.116.002660
  • Brief article that addresses the issue of terminology, specifically distinguishing between terms that address sex (male, female) and gender (masculine, feminine). Includes a solid list of references.
Q-angle image: OpenStax College

1 comment:

jhon alex said...

Awesome post about on sex-gender differences in Mmedical research , I think it is very exclusive post,this is very interesting I love reading and I am always searching for informative information like this.
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