title: Are aspects of study design associated with the reported prevalence of female sexual difficulties?
abstract: OBJECTIVE
  To investigate associations between the prevalence of sexual difficulties reported in published studies and design features of those studies to determine if differences in design contribute to variation in prevalence estimates.
  
  
  METHODS
  Systematic review, multivariate analysis.
  
  
  METHODS
  Studies published internationally in English.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  None.
  
  
  METHODS
  Prevalence estimates of difficulty with desire, arousal, orgasm, and sexual pain reported in published studies.
  
  
  RESULTS
  Our systematic literature search identified 1,380 publications. Fifty-five studies met our inclusion criteria (reporting prevalence, sample size and response rate, sample size greater than 100, not clinic based). Reported prevalence of sexual difficulty varied across studies (up to tenfold). Eleven aspects of research conduct in these studies were included in our multivariate analysis as explanatory variables. Five aspects of study design and conduct (data collection procedures, inclusion criteria, duration of sexual difficulty recorded, sample size, and response rate) were associated with the reported prevalence of at least one type of sexual difficulty independently of likely predictors of true variation in prevalence: study location, study year, and age range of participants.
  
  
  CONCLUSIONS
  This review provides evidence that study design may influence reported prevalence estimates of female sexual difficulties and contribute to the wide variation in published estimates.
authors.affiliation: School of Population Health, Department of Public Health, University of Melbourne, Victoria, Australia. r.hayes@pgrad.unimelb.edu.au
authors.forename: Richard D
authors.initials: RD
authors.lastname: Hayes
authors.forename: Catherine M
authors.initials: CM
authors.lastname: Bennett
authors.forename: Lorraine
authors.initials: L
authors.lastname: Dennerstein
authors.forename: John R
authors.initials: JR
authors.lastname: Taffe
authors.forename: Christopher K
authors.initials: CK
authors.lastname: Fairley
mesh_terms: D015982:Bias; D015340:Epidemiologic Research Design; D005260:Female; D006801:Humans; D038622:Internationality; D008297:Male; D015995:Prevalence; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D012735:Sexual Dysfunction, Physiological / Q000453:epidemiology*; D020018:Sexual Dysfunctions, Psychological / Q000453:epidemiology*; D016387:Women's Health