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Biskup E, Marra AM, Ambrosino I, Barbagelata E, Basili S, de Graaf J, Gonzalvez-Gasch A, Kaaja R, Karlafti E, Lotan D, Kautzky-Willer A, Perticone M, Politi C, Schenck-Gustafsson K, Vilas-Boas A, Roeters van Lennep J, Gans EA, Regitz-Zagrosek V, Pilote L, Proietti M, Raparelli V. Awareness of sex and gender dimensions among physicians: the European federation of internal medicine assessment of gender differences in Europe (EFIM-IMAGINE) survey. Intern Emerg Med 2022; 17:1395-1404. [PMID: 35604515 PMCID: PMC9352607 DOI: 10.1007/s11739-022-02951-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 02/15/2022] [Indexed: 11/28/2022]
Abstract
Sociocultural gender is a complex construct encompassing different aspects of individuals' life, whereas sex refers to biological factors. These terms are often misused, although they impact differently on individuals' health. Recognizing the role of sex and gender on health status is fundamental in the pursuit of a personalized medicine. Aim of the current study was to investigate the awareness in approaching clinical and research questions on the impact of sex and gender on health among European internists. Clinicians affiliated with the European Federation of Internal Medicine from 33 countries participated to the study on a voluntary basis between January 1st, 2018 and July 31st, 2019. Internists' awareness and knowledge on sex and gender issues in clinical medicine were measured by an online anonymized 7-item survey. A total of 1323 European internists responded to the survey of which 57% were women, mostly young or middle-aged (78%), and practicing in public general medicine services (74.5%). The majority (79%) recognized that sex and gender are not interchangeable terms, though a wide discrepancy exists on what clinicians think sex and gender concepts incorporate. Biological sex and sociocultural gender were recognized as determinants of health mainly in cardiovascular and autoimmune/rheumatic diseases. Up to 80% of respondents acknowledged the low participation of female individuals in trials and more than 60% the lack of sex-specific clinical guidelines. Internists also express the willingness of getting more knowledge on the impact of sex and gender in cerebrovascular/cognitive and inflammatory bowel diseases. Biological sex and sociocultural gender are factors influencing health and disease. Although awareness and knowledge remain suboptimal across European internists, most acknowledge the underrepresentation of female subjects in trials, the lack of sex-specific guidelines and the need of being more informed on sex and gender-based differences in diseases.
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Affiliation(s)
- Ewelina Biskup
- Division of Internal Medicine, University Hospital of Basel, Basel, Switzerland
- Department of Advanced Biomedical Sciences, Federico II University of Naples, Naples, Italy
| | - Alberto M Marra
- Department of Translational Medical Sciences, "Federico II" University of Naples, Naples, Italy
- Center for Pulmonary Hypertension, Thoraxklinic, University Hospital Heidelberg, Member of the German Center for Lung Research (DZL), Heidelberg, Germany
| | | | - Elena Barbagelata
- Department of Internal Medicine, Lavagna Hospital ASL 4 Chiavarese, Genoa, Italy
| | - Stefania Basili
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Jacqueline de Graaf
- Radboud University Medical Centre, Radboud Health Academy - division of PGME, Nijmegen, Netherlands
| | | | - Risto Kaaja
- Internal Medicine, University of Turku, Turku, Finland
| | - Eleni Karlafti
- 1st Propedeutic Clinic of Internal Medicine, AHEPA University Hospital of Thessaloniki, Thessaloniki, Greece
| | - Dor Lotan
- Division of Cardiology, Columbia University Irving Medical Center, New York, USA
| | - Alexandra Kautzky-Willer
- Gender Medicine Unit, Division of Endocrinology and Metabolism, Department of Internal MedicineIII, Medical University Vienna, Vienna, Austria
- Gender Institute, Gars am Kamp, Austria
| | - Maria Perticone
- Department of Medical and Surgical Sciences, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Cecilia Politi
- Internal Medicine, "F. Veneziale" Hospital, Isernia, Italy
| | - Karin Schenck-Gustafsson
- Centre for Gender Medicine, Department of Medicine, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | - Andreia Vilas-Boas
- Internal Medicine, Hospital da Luz Arrábida, Vila Nova de Gaia, Portugal
| | | | - Emma A Gans
- Department of Internal Medicine, Leiden University Medical Center, Leiden, Netherlands
| | - Vera Regitz-Zagrosek
- Charité, University Medicine Berlin, DZHK, Berlin, Germany
- University of Zurich, Zurich, Switzerland
| | - Louise Pilote
- Division of Clinical Epidemiology and General Internal Medicine, McGill University Health Centre Research Institute, Montreal, Canada
| | - Marco Proietti
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
- Geriatric Unit, IRCCS Istituti Clinici Scientifici Maugeri, Milan, Italy
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart and Chest Hospital, Liverpool, UK
| | - Valeria Raparelli
- Department of Translational Medicine, University of Ferrara, Via dei Borsari 46, 44121, Ferrara, Italy.
- University Center for Studies On Gender Medicine, University of Ferrara, Ferrara, Italy.
- Faculty of Nursing, University of Alberta, Edmonton, Canada.
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