Critically appraise relevant research, and to collect and analyse data from the studies that are included in the review. Statistical methods may or may not be used to analyse and summarise the results of the included studies “. Systematic reviews are increasingly accepted as important evidence-based decision-making aids. However, decision-makers cite the lack of equity considerations as barriers to using systematic reviews. The lack of analysis and lack of reporting of evidence about sex/gender in systematic reviews raise scientific and ethical concerns. Barriers to implementing sex/gender analysis in systematic reviews are manifold. Evidence suggests that there is a general lack of understanding of the concepts of sex and gender, how they are interrelated, whether and how they affect health interventions. Other barriers include: limited access to sexdisaggregated data, issues with data quality and reporting, challenges related to measuring and analysing gender and, a lack of guidance on methods.
More recently, however, because many funding agencies now have policies mandating that both men and women be included in clinical trials and that results for men and women be reported and interpreted separately, more researchers have begun to conduct sex/gender analysis. Systematic reviewers, most notably those working within the Cochrane Collaboration, are also increasingly examining the related question “To whom does this evidence apply?” in their assessment of the quality of available evidence. However, this is an emerging area of inquiry and there continues to be a lack of exemplar reviews that address sex/gender considerations. When reviewers have addressed sex/gender their conclusions have often been contingent on methodological or data limitations. For example, a systematic review of tobacco and smoking cessation interventions found some differences in intervention effects for girls and boys. The authors reported that school-based restrictions may be more effective for girls whereas increases in the price of tobacco products may have more influence on boys; however, these findings were often from single or methodologically weak studies. Further, in a systematic review on quality of life after total hip or total knee arthroplasty, men appeared to benefit more from the intervention but the authors stated that their conclusion was tempered by the few studies that addressed this issue.
A recent meta-analysis of 89 studies using clinical trials, interrupted time series and other methods assessed the effectiveness of antibiotic stewardship programs. It showed that policy interventions changed antibiotic treatment and this was associated with significant improvement in outcomes. Unfortunately, there were hardly any studies from LMIC in this metanalysis. This is an important aspect to consider since infections and irrational antibiotic use are widely prevalent in these countries. Another purpose of antibiotic stewardship is to contain antibiotic use. Containment is important as increased antibiotic use leading to environmental pressure contributes more to bacterial resistance.