User:3562nn01/sandbox

Hospital sign from Kolkata.

I'm am a bio-engineering major who is new to Wikipedia. I'm interested in researching the gender bias in medical diagnosis.

Articles I am considering:

• Gender bias in medical diagnosis
• Health care in the United States
• Sexism in medicine

Topic: Gender Bias in Medical Diagnosis

Hypothesis: Years of sex biased clinical research has led to less effective treatments fro women.

Overarching Question: How has sex biased drug testing influenced the treatments available for women?

Rough Draft: Sex Bias in Clinical Trials

Men and women are biologically different. They differ in the mechanical workings of their hearts and in their lung capacities, resulting in women being 20-70% more likely to develop lung cancer. The differences between men and women are also seen at the cellular level. For example, the ways immune cells convey pain signals are different in men and women . As a result of these biological differences, men and women react to certain drugs and medical treatments differently. One example is opioids. When using opioids for pain relief, women and men have different reactions. Surveys of the literature also conclude that there is a need for more clinical trials that study the gender specific response to opioids.

Although there is evidence pointing to the biological difference between men and women, historically women have been excluded from clinical trials and men have been used as the standard. This male standard has its roots in ancient Greece, where the female body was viewed as a mutilated version of the male body . However, the male bias was furthered in the United States after the FDA issued guidelines excluding women of childbearing potential from trials . Individual studies also excluded women for other reasons including that women were more expensive to use as test subjects because of fluctuating hormone levels. The assumption that women would have the same reaction to the treatments as men was also used to justify excluding women from clinical trials.

To help improve the representation of women in clinical trials a series of guidelines for clinical studies have been made. In 1993 the FDA reversed its 1977 guideline banning women of childbearing potential from participating clinical trials. Then in 1993 the United States congress mandated the inclusion of women in NIH-sponsored clinical trials.

Although guidelines have been introduced, sex bias remains an issue. A 2001 meta-analysis found that of 120 trials published in the New England Journal of Medicine, on average just 24.6 percent of participants enrolled were women. In addition, the same 2001 meta-analysis found that 14 percent of the trials included sex specific data analysis.Years later, in a 2019 meta-analysis it was reported that 36.41 percent of participants in 40 trials for anti-psychotic drugs were women.