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Abstract

Background Clinical and pre-clinical studies have shown that there are sex-based differences at the genetic, cellular, biochemical, and physiological levels. Despite this, numerous studies have demonstrated a lack of inclusion of female populations into medical research. These disparities in sex inclusion are further problematized by the lack of sex reporting: that is, describing the population under study. Disparities in inclusion of both sexes in medical research significantly reduces the utility of the results of medical research for the entire population. The lack of sex reporting can be problematic for the translation of research from the pre-clinical to clinical and applied health settings. Large-scale studies are needed to identify the degree of sex-related reporting and where disparities are more prevalent. Furthermore, there are several studies showing the dearth of female researchers in science, yet few have evaluated whether a lack of women in science may be related to disparities in sex inclusion and reporting. Methods This paper analyses sex-related reporting in medical research, based on a set of more than 11.5 million papers indexed in Web of Science and PubMed between 1980 and 2016 and using sex-related Medical Subject Headings as a proxy for sex reporting. Descriptive statistics and regression analyses are used to analyze these data. Results Despite an increase in sex-related reporting between 1980 and 2016 in clinical medicine (59% to 67%) and public health research (36% to 69%), sex remains largely underreported in biomedical research (31% in 2016). Furthermore, papers with female first and last authors have a higher probability of reporting sex, with an odds ratio of 1.26 (95% CI: 1.24-1.27) and sex-related reporting is associated with publications in journals with low impact factors. For instance, for the publications in 2016, sex-related reporting of both male and female is associated with the reduction of -0.51 (95% CI: -0.54, -0.47) in impact factors. Interpretation This paper suggests that the current gender disparities in the scientific workforce and lack of policies on sex-reporting at the journal and institutional level may inhibit effective research translation from bench to clinical studies.

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