Multifactorial Aspects of Sex Bias in Surgical Research Interview with:
Neel Mansukhani, MD
Department of Surgery
Northwestern University and

Melina R. Kibbe, MD, FACS, FAHA
Colin G. Thomas Jr. Distinguished Professor and Chair
Department of Surgery
Professor, Department of Biomedical Engineering
The University of North Carolina at Chapel Hill
Chapel Hill, NC 27599-7050
Editor in Chief, JAMA Surgery What is the background for this study? What are the main findings? 

Response: This study is a follow-up to our previous work that examined sex bias in surgical research. Previously, we examined sex bias in basic and translational science surgical research, as well as in clinical surgical research. We discovered previously that sex bias exists in basic and translational surgical research in the unequal inclusion of male and female research subjects.
In clinical research, we found sex bias in the degree of sex matching of included subjects, and in the frequency of sex-based reporting, analysis, and discussion of the data.

In this current work, we sought to understand the effect of author gender on sex bias in surgical research. In this work, we found that most authors are male, most authors work with other authors of the same gender, and sex bias is prevalent regardless of author gender. Most importantly, we found that sex inclusive research receives more citations after publication compared to sex-biased research. What should readers take away from your report?

Response: Sex bias in surgical research exists and is multifactorial. In order for surgical therapies to be developed for both sexes, there must be an increased awareness of this issue so that sex inclusive research can be achieved. When sex inclusive research is performed, it is recognized by more citations than sex-biased research. What recommendations do you have for future research as a result of this work?

Response: Researchers should perform research and produce data that is as sex unbiased as possible. When enrolling and including research subjects, attempts should be made to match the number of male and female research subjects included. Sex should be included as an independent variable in study design, and data should be analyzed and reported by sex. This will make the results and conclusions of all research more generalizable to the entire population.

The authors have no disclosures.


Xiao N, Mansukhani NA, Mendes de Oliveira DF, Kibbe MR. Association of Author Gender With Sex Bias in Surgical Research. JAMA Surg. Published online March 28, 2018. doi:10.1001/jamasurg.2018.0040

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Last Updated on April 2, 2018 by Marie Benz MD FAAD