Sex and gender reporting in neurosurgical journals: A cross-sectional study on enactment of the SAGER guidelines

Abstract

Background: In 2016, the SAGER (sex and gender equity in research) guidelines were developed to standardize research reporting and to facilitate the generalizability of research findings for women and men, thereby impacting clinical practice.

Objectives: To assess the extent to which the SAGER guidelines have been implemented in neurosurgical publications.

Methods: Original research articles from leading neurosurgical journals indexed in Google Scholar under the category ‘Neurosurgery’ were examined and assessed for the extent to which the articles conformed to the SAGER guidelines. Data were extracted on subjects (sample size and relative proportions of sex or gender) and on adherence to the SAGER guidelines (one item for general principles and five items from recommendations for each section of the article) and summarized.

Results: We included 98 articles from 10 leading neurosurgical journals. The average number of subjects for a journal was 4728, of which 2056 (43.5%) were women. Only nine (9.2%) of the 98 articles used the terms ‘sex’ and ‘gender’ appropriately. The outcomes were disaggregated by sex in 16 (16.3%) articles; sex differences were acknowledged in the introduction in six (6.1%) articles; considered in the ‘Methods’ section in five (5.1%) articles; the differing numbers of women and men were justified in the methods in two (2%) articles; and the generalizability of the results to women or men was discussed in five (5.1%) articles. The journals showed no differences in the extent to which they adhered to the guidelines.

Conclusions: Reporting sex and gender equity in neurosurgical journals is negligible for the most screened SAGER items as is the endorsement of the guidelines. The results likely reflect the lack of awareness of both the importance of disaggregating data by sex or gender and the existence of pertinent guidelines.