Inclusion of sex and gender variables in musculoskeletal research and publications

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Abstract Sex and gender impact all areas of health, including musculoskeletal health. Examples of sex- and gender- based differences in musculoskeletal health include risks for developing and treatment outcomes of osteoporosis, osteoarthritis, and ACL injuries. However, these differences are not routinely considered, assessed, or reported in published articles, as demonstrated in several recent reviews of the literature for various musculoskeletal conditions. The lack of consideration and published data regarding sex- and gender- based differences impacts the development of future research, improvement in healthcare professional education, and ultimately the quality of care for men, women, and transgender patients. We plan to assemble a group of researchers active in the area of sex and gender and the editorial staffs of the major scientific journals in musculoskeletal medicine and surgery to review the current status of research regarding the impacts of sex and gender. We will discuss the need to assure that these variables are appropriately considered in published research and will also assess options and platforms through which to communicate the importance of sex and gender as variables in musculoskeletal health and disease to investigators and journal reviewers. The goals of this one-day meeting at the intersection of the goals of goals of the NIH Office of Research on Women’s Health to advance research “to improve the fundamental understanding of how sex and gender, among other critical factors, influence health and disease, and to extend this knowledge to translational and clinical studies” and those of NIAMS to “support research into the causes, treatment, and prevention of arthritis and musculoskeletal… diseases”. At the end of the meeting, the deliverables will be to (i) develop plans to consistently assess for the appropriate inclusion of sex and/or gender in published research, including evaluating the role for adopting SAGER or similar guidelines, and to communicate this across journal platforms and to reviewers, ii) identify communication strategies from journals to investigators about the roles of sex and gender and the expectations for consideration and inclusion of these in submitted manuscripts across musculoskeletal conditions, and iii) explore opportunities to work with researchers early in the study process to assure that sex and gender are considered in research project development and plans for data analysis. The meeting symposia will be published in a Journal of Bone and Joint Surgery supplement and shared with NIAMS.