Reporting of sex effects by systematic reviews on interventions for depression, diabetes, and chronic pain

W. Duan-Porter, K.M. Goldstein, J.R. McDuffie, J.M. Hughes, M.E.B. Clowse, R.S. Klap, V. Masilamani, N.M.A. LaPointe, A. Nagi, J.M. Gierisch, J.W. Williams

Research output: Contribution to journalArticlepeer-review

10 Scopus citations


Systematic reviews (SRs) have the potential to contribute uniquely to the evaluation of sex and gender differences (termed "sex effects"). This article describes the reporting of sex effects by SRs on interventions for depression, type 2 diabetes mellitus, and chronic pain conditions (chronic low back pain, knee osteoarthritis, and fibromyalgia). It includes SRs published since 1 October 2009 that evaluate medications, behavioral interventions, exercise, quality improvement, and some condition-specific treatments. The reporting of sex effects by primary randomized, controlled trials is also examined. Of 313 eligible SRs (86 for depression, 159 for type 2 diabetes mellitus, and 68 for chronic pain), few (n = 29) reported sex effects. Most SRs reporting sex effects used metaregression, whereas 9 SRs used subgroup analysis or individual-patient data meta-analysis. The proportion of SRs reporting the sex distribution of primary studies varied from a low of 31% (n = 8) for low back pain to a high of 68% (n = 23) for fibromyalgia. Primary randomized, controlled trials also infrequently reported sex effects, and most lacked an adequate sample size to examine them. Therefore, all SRs should report the proportion of women enrolled in primary studies and evaluate sex effects using appropriate methods whenever power is adequate. © 2016 American College of Physicians.
Original languageEnglish
Pages (from-to)184-193
Number of pages10
JournalAnnals of Internal Medicine
Issue number3
StatePublished - 2016

Bibliographical note

Cited By :4

Export Date: 26 December 2018


Correspondence Address: Duan-Porter, W.; Durham Veterans Affairs Medical Center, Duke University, School of Medicine, 411 West Chapel Hill Street, United States; email:


  • Article
  • chronic pain
  • clinical trial (topic)
  • data synthesis
  • depression
  • diabetes mellitus
  • evidence based practice
  • funding
  • human
  • intervention study
  • meta analysis (topic)
  • nonhuman
  • priority journal
  • program evaluation
  • quality control
  • randomized controlled trial (topic)
  • sex
  • sex ratio
  • systematic review
  • Diabetes Mellitus, Type 2
  • female
  • literature
  • low back pain
  • male
  • sex difference
  • Chronic Pain
  • Depression
  • Female
  • Humans
  • Low Back Pain
  • Male
  • Randomized Controlled Trials as Topic
  • Review Literature as Topic
  • Sex Factors

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