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A framework to analyse gender bias in epidemiological research
  1. María Teresa Ruiz-Cantero1,2,8,
  2. Carmen Vives-Cases1,2,8,
  3. Lucía Artazcoz1,3,8,
  4. Ana Delgado4,
  5. Maria del Mar García Calvente1,4,
  6. Consuelo Miqueo5,
  7. Isabel Montero1,6,
  8. Rocío Ortiz2,
  9. Elena Ronda2,
  10. Isabel Ruiz1,
  11. Carme Valls1,7
  1. 1
    Red de Investigación en salud y Género, Ministerio de Sanidad y Consumo, Spain
  2. 2
    Medicina Preventiva y Salud Pública, Universidad de Alicante, Spain
  3. 3
    Agencia de Salud Pública de Barcelona, Spain
  4. 4
    Escuela Andaluza de Salud Pública, Granada, Spain
  5. 5
    Departamento de Ciencias Documentación e Historia de la Ciencia, Universidad de Zaragoza, Spain
  6. 6
    Departamento de Medicina, Universidad de Valencia, Spain
  7. 7
    Centro de Análisis y Planificación Sanitaria, Barcelona, Spain
  8. 8
    CIBERESP, Spain
  1. Maria Teresa Ruiz-Cantero, Área de Medicina Preventiva y Salud Pública, Departamento de Salud Pública, Universidad de Alicante, Apdo 99, 03080-Alicante, Spain; cantero{at}


The design and analysis of research may cause systematic gender dependent errors to be produced in results because of gender insensitivity or androcentrism. Gender bias in research could be defined as a systematically erroneous gender dependent approach related to social construct, which incorrectly regards women and men as similar/different.

Most gender bias can be found in the context of discovery (development of hypotheses), but it has also been found in the context of justification (methodological process), which must be improved. In fact, one of the main effects of gender bias in research is partial or incorrect knowledge in the results, which are systematically different from the real values.

This paper discusses some forms of conceptual and methodological bias that may affect women’s health. It proposes a framework to analyse gender bias in the design and analysis of research carried out on women’s and men’s health problems, and on specific women’s health issues.

Using examples, the framework aims to show the different theoretical perspectives in a social or clinical research context where forms of selection, measurement and confounding bias are produced as a result of gender insensitivity. Finally, this paper underlines the importance of re-examining results so that they may be reinterpreted to produce new gender based knowledge.

  • androcentrism
  • gender bias
  • sex differences

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  • Funding: This work has been financed by the Spanish Research Network on Health and Gender (RISG).

  • Abbreviations:
    American Conference of Governmental Industrial Hygienists
    adjusted odds ratios
    clinical epidemiology
    confidence intervals
    Diagnostic and statistical manual of mental disorders
    eating disorders not otherwise specified
    information retrieval system
    intimate partner violence
    measurement bias
    medical subject headings
    odds ratios
    post-traumatic stress disorder
    randomised controlled trials
    relative risk
    selection bias
    social epidemiology
    threshold limit values

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