Editor’s Spotlight/Take 5: Sex-specific Analysis of Data in High-impact Orthopaedic Journals: How Are We Doing?

M edical conditions affect men and women differently, a fact one can easily miss when reading scientific journals. Most federally funded randomized trials do not report outcomes separately for men and women [2], and the research supporting many treatments administered more commonly to women—such as the prescription of COX-II antiinflammatories [7]—has been performed disproportionately on men [1]. A recent report from Brigham and Women’s Hospital found severe gender disparities in the diagnosis and treatment of conditions that cause disproportionate harm to women, including lung cancer, Alzheimer’s disease, and depression [3]—all of which have important orthopaedic implications (bone metastases, falls causing injury, and poorer outcomes scores after surgery, respectively). For these reasons, Clinical Orthopaedics and Related Research has taken a number of steps to level the field where we can. For example, we instituted reporting standards for sex and gender [6], and we have highlighted those studies in our Journal that we believe can help identify and minimize gender-driven disparities in care [4, 5]. In August of this year, we published an important symposium on sex differences in musculoskeletal disease and science. We are especially proud of our affiliation with the Ruth Jackson Orthopaedic Society, an organization that supports women orthopaedic professionals through education, mentoring, research and outreach, and that promotes issues related to sex and gender differences in musculoskeletal health. However, there is only so much a journal can do; ultimately, it is up to scientists to design clinical trials that appropriately enroll women and report results separately by sex and gender. So how are scientists doing with respect to these key obligations? According to a multiinstitutional collaborative lead by Dr. Jo A. Hannafin from the Hospital for Special Surgery, published in a cannot-miss article in this month’s CORR, the answer is that musculoskeletal investigators were doing somewhat better in 2010 than they were doing in 2000. But even in 2010 (the latest year Dr. Hannafin’s team surveyed), seven in 10 articles from five leading orthopaedic surgery journals did not provide sexor gender-specific analyses. And rather Note from the Editor-In-Chief: In ‘‘Editor’s Spotlight,’’ one of our editors provides brief commentary on a paper we believe is especially important and worthy of general interest. Following the explanation of our choice, we present ‘‘Take Five,’’ in which the editor goes behind the discovery with a oneon-one interview with an author of the article featured in ‘‘Editor’s Spotlight.’’ The author certifies that he, or any members of his immediate family, has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article. All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research editors and board members are on file with the publication and can be viewed on request. The opinions expressed are those of the writers, and do not reflect the opinion or policy of CORR or The Association of Bone and Joint Surgeons. This comment refers to the article available at: DOI: 10.1007/s11999-015-4457-9. S. S. Leopold MD (&) Clinical Orthopaedics and Related Research, 1600 Spruce Street, Philadelphia, PA 19013, USA e-mail: sleopold@clinorthop.org Editor’s Spotlight/Take 5 Published online: 22 August 2015 The Association of Bone and Joint Surgeons1 2015