Clinical algorithms that are used to guide medical decision-making often include sex as a variable. However, binary considerations of sex and/or gender might introduce bias due to potentially inaccurate assumptions about sex and gender-specific physiology, hormones and exposures. An equity-focused approach to sex and gender is essential when using clinical algorithms to ensure health equity across populations.
This is a preview of subscription content, access via your institution
Access options
Access Nature and 54 other Nature Portfolio journals
Get Nature+, our best-value online-access subscription
$29.99 / 30 days
cancel any time
Subscribe to this journal
Receive 12 print issues and online access
$209.00 per year
only $17.42 per issue
Buy this article
- Purchase on SpringerLink
- Instant access to full article PDF
Prices may be subject to local taxes which are calculated during checkout
References
Lett, E., Logie, C. H. & Mohottige, D. Intersectionality as a lens for achieving kidney health justice. Nat. Rev. Nephrol. 19, 353–354 (2023).
Cary, M. P. Jr et al. Mitigating racial and ethnic bias and advancing health equity in clinical algorithms: a scoping review. Health Aff. (Millwood) 42, 1359–1368 (2023).
Miranda, K. T. et al. A holistic framework for the evaluation of kidney function in a gender-diverse landscape. Am. J. Kidney Dis. https://doi.org/10.1053/j.ajkd.2024.01.522 (2024).
Jankowska, M., Soler, M. J., Stevens, K. I. & Torra, R. Why do we keep ignoring sex in kidney disease? Clin. Kidney J. 16, 2327–2335 (2023).
Chesnaye, N. C., Carrero, J. J., Hecking, M. & Jager, K. J. Differences in the epidemiology, management and outcomes of kidney disease in men and women. Nat. Rev. Nephrol. 20, 7–20 (2024).
Bairey Merz, C. N. et al. Sex and the kidneys: current understanding and research opportunities. Nat. Rev. Nephrol. 15, 776–783 (2019).
Witchel, S. F. Disorders of sex development. Best Pract. Res. Clin. Obstet. Gynaecol. 48, 90–102 (2018).
Kaufman, M. R., Eschliman, E. L. & Karver, T. S. Differentiating sex and gender in health research to achieve gender equity. Bull. World Health Organ. 101, 666–671 (2023).
Alahamadi, Z. et al. Race, sex, and kidney disease trial participation. Kidney Med. 5, 100594 (2023).
Gülgöz, S., DeMeules, M., Gelman, S. A. & Olson, K. R. Gender essentialism in transgender and cisgender children. PLoS ONE 14, e0224321 (2019).
Chin, M. H. et al. A roadmap and best practices for organizations to reduce racial and ethnic disparities in health care. J. Gen. Intern. Med. 27, 992–1000 (2012).
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Competing interests
The authors declare no competing interests.
Supplementary information
Rights and permissions
About this article
Cite this article
Mohottige, D., Farouk, S., Poteat, T. et al. Considerations of sex as a binary variable in clinical algorithms. Nat Rev Nephrol 20, 347–348 (2024). https://doi.org/10.1038/s41581-024-00840-2
Published:
Issue Date:
DOI: https://doi.org/10.1038/s41581-024-00840-2