Sex and Gender Appraisal Tool for Systematic Reviews (SGAT-SR): impact on the consideration of sex and gender in Cochrane Reviews of interventions to prevent healthcare associated infections

Session: 

Oral session: Global health and equity

Date: 

Monday 17 September 2018 - 11:40 to 11:50

Location: 

Ochil 2

All authors in correct order:

Lopez-Alcalde J1, Stallings E2, Cabir Nunes S3, Daheron M4, Fernández-Chávez A5, Fernandez-Felix BM6, Bonfill Cosp X7, SEXCOMPLEX W8, Zamora J9
1 Cochrane Associate Center of Madrid (Universidad Francisco de Vitoria-Madrid, Hospital Universitario Ramón y Cajal-IRYCIS); Department of Paediatrics, Obstetrics & Gynaecology and Preventative Medicine, UAB, Spain
2 Clinical Biostatistics Unit. Hospital Universitario Ramón y Cajal (IRYCIS), Spain
3 Independent consultant, Spain
4 Independent consultant, United Kingdom
5 Preventive medicine Unit. Hospital Universitario Ramón y Cajal, Spain
6 CIBER Epidemiology and Public Health (CIBERESP), Spain
7 Department of Paediatrics, Obstetrics & Gynaecology and Preventative Medicine. Universitat Autònoma de Barcelona, Spain
8 SEXCOMPLEX Working Group, Hospital Ramón y Cajal, Spain
9 Clinical Biostatistics Unit. Hospital Universitario Ramón y Cajal (IRYCIS)/CIBER Epidemiology and Public Health (CIBERESP), Spain
Presenting author and contact person

Presenting author:

Jesús López-Alcalde

Contact person:

Jesús López-Alcalde
Abstract text
Background:
Healthcare-associated infections (HAIs) are common, but infection control research often neglects sex/gender differences. The ´Sex and Gender Appraisal Tool for Systematic Reviews´ (SGAT-SR) (2010) assesses how sex and gender are considered in a systematic review (SR). This tool was the basis of the ‘Sex and Gender in Systematic Reviews: Planning Tool’ (2011), which helps Cochrane reviewers integrate sex/gender when planning a review.

Objectives:
To evaluate the impact of the SGAT-SR on the consideration of sex and gender in Cochrane Reviews of interventions to prevent HAIs.

Methods:
Study design: pre-post uncontrolled retrospective study. We retrieved all Cochrane Reviews of interventions to prevent HAIs published before 2017. Two authors independently assessed the consideration of sex and gender in each review with the SGAT-SR. We extracted data with EPPI-Reviewer 4 and classified reviews as ‘pre-‘ or ‘post-planning tool’ (review protocol published before/after 1 January 2013). We used STATA 15.1 to compare percentages (Pearson’s Chi-squared or Fischer´s exact tests).

Results:
The study included 102 reviews (85 reviews ‘pre-tool period’ versus eight ‘post-tool period’). Nine reviews were not analysed, as the protocol publication date was unavailable. The total proportion of correct items was 3.38% (pre-tool) versus 3.97% (post-tool) (P = 0.919). None of the reviews considered sex/gender differences in their inclusion/exclusion criteria or extracted data by sex:
- 3.5% of pre-tool reviews and 0% of post-tool reviews completed subgroup analyses by sex (P = 0.761);
- 1.18% pre-tool reviews and 0% post-tool addressed sex/gender implications for clinical practice (P= 0.914);
- no review, either in the pre- or post-tool periods, addressed sex/gender implications for policy and regulation.

Conclusions:
Consideration of sex and gender in Cochrane Reviews of interventions to prevent HAIs is practically absent, both before and after the implementation of the SGAT-SR. This highlights the need for effective strategies to guide Cochrane reviewers in the consideration of sex and gender.

Patient or healthcare consumer involvement:
The SGAT was developed to increase the applicability of research findings for healthcare consumers of both sexes and genders, thus making it important to evaluate its impact.

Relevance to patients and consumers: 

The ´Sex and Gender Appraisal Tool for Systematic Reviews´ (SGAT-SR) was developed to increase the applicability of research findings for healthcare consumers of both sexes and genders, thus making it important to evaluate its impact.