Abstract
Shared decision making (SDM) in healthcare is an approach in which health professionals support patients in making decisions based on best evidence and their values and preferences. Considering sex and gender in SDM research is necessary to produce precisely-targeted interventions, improve evidence quality and redress health inequities. A first step is correct use of terms. We therefore assessed sex and gender terminology in SDM intervention studies. We performed a secondary analysis of a Cochrane review of SDM interventions. We extracted study characteristics and their use of sex, gender or related terms (mention; number of categories). We assessed correct use of sex and gender terms using three criteria: "non-binary use", "use of appropriate categories" and "non-interchangeable use of sex and gender". We computed the proportion of studies that met all, any or no criteria, and explored associations between criteria met and study characteristics. Of 87 included studies, 58 (66.7%) mentioned sex and/or gender. The most mentioned related terms were "female" (60.9%) and "male" (59.8%). Of the 58 studies, authors used sex and gender as binary variables respectively in 36 (62%) and in 34 (58.6%) studies. No study met the criterion "non-binary use". Authors used appropriate categories to describe sex and gender respectively in 28 (48.3%) and in 8 (13.8%) studies. Of the 83 (95.4%) studies in which sex and/or gender, and/or related terms were mentioned, authors used sex and gender non-interchangeably in 16 (19.3%). No study met all three criteria. Criteria met did not vary according to study characteristics (p>.05). In SDM implementation studies, sex and gender terms and concepts are in a state of confusion. Our results suggest the urgency of adopting a standardized use of sex and gender terms and concepts before these considerations can be properly integrated into implementation research.
Highlights
Shared decision making (SDM) is an interpersonal, interdependent process in which health professionals and patients relate to and influence each other as they collaborate in making decisions about the patient’s health [1,2,3]
In SDM implementation studies, sex and gender terms and concepts are in a state of confusion
Often supported by decision aids, SDM is based on best available evidence as well as the patient’s values and preferences [4]
Summary
Shared decision making (SDM) is an interpersonal, interdependent process in which health professionals and patients relate to and influence each other as they collaborate in making decisions about the patient’s health [1,2,3]. Often supported by decision aids, SDM is based on best available evidence as well as the patient’s values and preferences [4]. SDM improves patient experiences and the quality of care provided by health professionals [14]. Despite this potential, SDM is not implemented as much as it could be in clinical practice [15, 16]. Shared decision making (SDM) in healthcare is an approach in which health professionals support patients in making decisions based on best evidence and their values and preferences. Considering sex and gender in SDM research is necessary to produce precisely-targeted interventions, improve evidence quality and redress health inequities. We assessed sex and gender terminology in SDM intervention studies
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