Poster 384: Inequalities in the Evaluation of Male vs. Female Athletes in Sports Medicine Research: A Systematic Review

OBJECTIVES: Female sport participation has steadily increased over the past several decades; however, inequalities still exist regarding participation rates, social norms, and available resources. It is possible that inequalities between male and female athletes extend beyond the performance of sport and into medical research. Therefore, the purposes of this systematic review were to 1) compare the number of published studies evaluating male vs. female athletes in various sports, and 2) identify which co-ed sports currently under-represent female athletes in the sports medicine literature. METHODS: All non-review research studies published from 2017-2021 in six top sports medicine journals were considered for inclusion. Only sports medicine studies that isolated athletes, reported study outcomes specific to male and/or female patients, provided study outcomes for specific sport(s), and evaluated three or fewer different sports, were included. The total number of studies reporting on male and/or female athletes were compared for all sports, and odds ratios (OR) were calculated. Comparisons of study design, level of sport participation, outcomes assessed, and study quality were also made based on subject sex. RESULTS: Overall, 669 studies were included the systematic review. Most of the included studies isolated male athletes (70.7%), while 8.8% isolated female athletes and 20.5% included both male and female athletes. Female athletes were more frequently studied in softball and volleyball, while male athletes were more commonly researched in baseball, soccer, American football, basketball, rugby, hockey, and Australian football. Notably, male athletes were largely favored in baseball/softball (91% vs. 5%, OR=18.2), rugby (72% vs. 5%, OR=14.4), soccer (65% vs. 15%, OR=4.3), and basketball (58% vs. 18%, OR=3.2). CONCLUSIONS: Sports medicine research has favored the evaluation of male athletes in most sports, including the majority of co-ed sports. Potential reasons for this inequality of research evaluation include availability of public and database data, financial and promotional incentive, a high percentage of sports medicine clinicians and researchers being male, and sex biases in sport. While the causes of these differences are multi-faceted, researchers should consider both sexes for study inclusion whenever possible and journals should support a more balanced representation of research publications regarding male and female athletes.