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Sex/gender and additional equity characteristics of providers and patients in perioperative anesthesia trials: a cross-sectional analysis of the literature

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Published inKorean journal of anesthesiology, vol. 74, no. 1, p. 6-14
Publication date2021-10-01
Abstract

Sex and gender, among other equity-related characteristics, influence the process of care and patients’ outcomes. Currently, the extent to which these characteristics are considered in the anesthesia literature remains unknown. This study assesses their incorporation in randomized controlled trials (RCTs) on anesthesia-related interventions, for both patients and healthcare providers. This is a cross-sectional analysis using an existing dataset derived from the anesthesia literature. The dataset originated from a scoping review searching MEDLINE, Embase, CINAHL, CENTRAL, and the Cochrane Database of Systematic reviews. RCTs investigating the effect of anesthesia-related interventions on mortality for adults undergoing surgery were included. Equity outcome measures were recorded for both patients and providers and assessed for inclusion in the study design, reporting of results, and analysis of intervention effects. Three-hundred sixty-one RCTs (n = 144,674) were included. Most RCTs (91%) reported patient sex/gender, with 58% of patients identified as male. There were 139 studies (39%), where 70% or more of the sample was male, compared to just 14 studies (4%), where 70% or more of the sample was female. Only 10 studies (3%) analyzed results by patient sex/gender, with one reporting a significant effect. There was substantial variation in how age was reported, although nearly all studies (98%) reported some measure of age. For healthcare providers, equity-related information was never available. Better consideration of sex/gender and additional health equity parameters for both patients and providers in RCTs is needed to improve evidence quality, and ultimately, patient care and outcome.

Keywords
  • Anesthesiology
  • Cross-sectional studies
  • Gender identity
  • Review
  • Sex
  • Social class
  • Adult
  • Anesthesia
  • Cross-Sectional Studies
  • Female
  • Humans
  • Male
  • Randomized Controlled Trials as Topic
  • Systematic Reviews as Topic
Affiliation entities Not a UNIGE publication
Citation (ISO format)
ETHERINGTON, Cole, WU, Michael, BOET, Sylvain. Sex/gender and additional equity characteristics of providers and patients in perioperative anesthesia trials: a cross-sectional analysis of the literature. In: Korean journal of anesthesiology, 2021, vol. 74, n° 1, p. 6–14. doi: 10.4097/kja.19484
Main files (1)
Article (Published version)
Secondary files (4)
Supplemental data - Supplementary Table 1. PROGRESS-Plus representation of patients in RCTs testing anesthesia-related interventions (n = 361)
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Supplemental data - Supplementary Table 2. Studies that report race/ethnicity.
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Supplemental data - Supplementary Table 3. Studies that disaggregate by sex/gender.
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Updates (1)
Corrigendum
Identifiers
Journal ISSN2005-6419
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