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Considerations of sex as a binary variable in clinical algorithms

Nature Reviews Nephrology (2024)Cite this article

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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.

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Author notes

  1. These authors contributed equally: Tonia Poteat, Asa Radix, Selma Feldman Witchel.

Authors and Affiliations

  1. Barbara T. Murphy Division of Nephrology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA

    Dinushika Mohottige & Samira Farouk

  2. Institute for Health Equity Research, Icahn School of Medicine at Mount Sinai, New York, NY, USA

    Dinushika Mohottige

  3. Recanati Miller Transplant Institute, Mount Sinai Hospital, New York, NY, USA

    Samira Farouk

  4. Division of Health Care in Adult Populations, Duke University School of Nursing, Durham, NC, USA

    Tonia Poteat

  5. Callen-Lorde Community Health Center, New York, NY, USA

    Asa Radix

  6. Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA

    Asa Radix

  7. Division of Pediatric Endocrinology, Department of Pediatrics, UPMC Children’s Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, PA, USA

    Selma Feldman Witchel

Authors
  1. Dinushika Mohottige
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  2. Samira Farouk
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  3. Tonia Poteat
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  4. Asa Radix
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  5. Selma Feldman Witchel
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Corresponding author

Correspondence to Dinushika Mohottige.

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The authors declare no competing interests.

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Mohottige, D., Farouk, S., Poteat, T. et al. Considerations of sex as a binary variable in clinical algorithms. Nat Rev Nephrol (2024). https://doi.org/10.1038/s41581-024-00840-2

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  • DOI: https://doi.org/10.1038/s41581-024-00840-2

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