It seems that gender bias has made its way to the surgical table. A new study has highlighted the presence of gender bias in clinical and surgical research.

Just recently, a study published by JAMA Surgery analysed more than 1,300 peer-reviewed research papers and found that only a few studies included an equal number of men and women, and less than a third performed gender-based data analysis. The study also found that the proportion of men and women used in clinical tests varied widely across different studies and disciplines.

Gender bias

Most notably, the study also shed light on how women are under-represented in the field of medical science research. It was revealed that internationally, 49% of surgical research participants were male, while only 26% were female. Roughly 26% of participants were of unknown genders.

Furthermore, the researchers also discovered that less than half of the studies included at least one woman for every two men, or vice versa. When the researchers looked at individual surgical specialties, they found that colorectal surgery studies were most likely to include even numbers of both sexes, while heart surgery was least likely.

Back home in Asia, the problem of unequal gender inclusion also appears to be apparent. For instance, in a 2005 Singaporean surgical study investigating the prognostic significance of peritoneal lavage cytology in gastric cancer, the number of male participants far outweighed the number of women participants – 91: 51.

The importance of equal inclusion

But why exactly is equal inclusion important? According to Dr Melina Kibbe, chairperson of the Department of Surgery at the University of North Carolina and lead author of the study, including too many people of the same gender may result in findings that are exclusively applicable to men or women only. This is undesirable, as medical interventions may result in different responses from men and women.

Dr Kibbe and her team cite the 1992 Ambien case as an example of the ill effects of unequal gender inclusion in surgical research. Ambien, also known as zolpidem tartrate, is a sleeping aid commonly prescribed by doctors. However, reports began to surface that women who took the drug were more prone to getting into morning traffic accidents. This prompted a thorough investigation on the drug and its effects, which revealed that women inherently metabolised the drug more slowly than men.

"The next morning they're basically still drugged up on it and getting behind the wheel of the car," commented Dr Kibbe.

Ambien is not alone. In the study, Dr Kibbe and her team also state that women were more likely to develop adverse reactions to drugs as compared to men. In fact, of all the drugs that the FDA has pulled from the market, about 80% were due to the undesirable adverse effects that they left on female patients.

“Thus, whereas it is important to collect data of male and female participants, performing independent data analysis and reporting can produce findings leading to valuable contributions to the health and well-being of males or females independently,” concluded the team. MIMS

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