title: A systematic approach for uptake of evidence on sex-specific issues in guidelines--a pilot study.
abstract: OBJECTIVE
  Increasing evidence indicates that sex-specific issues may have impact on prevention, diagnosis, or treatment. These issues are not systematically considered during the development of Dutch clinical practice guidelines. The aim of this study is to identify how members of guideline development groups discuss sex-specific evidence, and whether and how the outcomes of these discussions are reflected in the guideline.
  
  
  METHODS
  Six guideline development committees (GDCs) were studied. Each committee was supported by a staff member from the guideline organization who was trained and received feedback to facilitate uptake of evidence on sex differences in the process of guideline development. Non-participant observation and transcription of audio recordings from 22 GDC meetings were performed. Content analysis of meeting transcripts and guidelines were studied to analyse characteristics of discussion episodes on sex-specific research data-based issues (subject matter, initiator and group approach towards the topic and themes) and whether or not conclusions on evidence were reflected in the final guideline text.
  
  
  RESULTS
  Of the 87 identified discussion episodes, 68 dealt with sex-specific research evidence potentially relevant to guidelines. Respectively 51%, 28% and 21% of the latter episodes were initiated by committee members, staff members and chairpersons. Group approaches towards the subject matter were generally positive. Data from 60% of those episodes were reflected in the final guideline text. Sex-specific data on reproductive issues were more often discussed and reflected in guideline texts than data on other health issues. Discussion episodes on sex-specific evidence initiated by chairpersons were most often reflected in the guidelines.
  
  
  CONCLUSIONS
  This pilot study indicates that GDCs regularly focused on sex-specific issues. The participation of a trained staff member contributed to this.
authors.affiliation: Department of General Practice, Division of Clinical Methods and Public Health, Academic Medical Center - University of Amsterdam, Amsterdam, The Netherlands. d.g.keuken@amc.uva.nl
authors.forename: Debby
authors.initials: D
authors.lastname: Keuken
authors.forename: Patrick
authors.initials: P
authors.lastname: Bindels
authors.forename: Niek
authors.initials: N
authors.lastname: Klazinga
authors.forename: Joke
authors.initials: J
authors.lastname: Haafkens
mesh_terms: D000437:Alcoholism / Q000175:diagnosis / Q000628:therapy; D001172:Arthritis, Rheumatoid / Q000175:diagnosis / Q000628:therapy; D003110:Colonic Neoplasms / Q000175:diagnosis / Q000628:therapy; D004485:Eczema / Q000175:diagnosis / Q000628:therapy; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D008297:Male; D009426:Netherlands; D010865:Pilot Projects; D017410:Practice Guidelines as Topic / Q000592:standards*; D010818:Practice Patterns, Physicians' / Q000592:standards*; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis / Q000628:therapy; D012107:Research Design / Q000592:standards; D012737:Sex Factors; D013959:Thyroid Diseases / Q000175:diagnosis / Q000628:therapy