Thursday, April 15, 2010

Gender Disparity in Drug Trials


For my previous post on One Size Fits None, I did some digging (with the help of the
Medical Anthroplogy community and a librarian at OHSU). I found a number of really interesting sources discussing the gender disparity in drug trials, and thought I'd list them here.

Since I do not have deep research in this area, I will decline in-depth comment. The upshot is, that although the NIH guidelines require "inclusion of women and minorities" - it is clear we have a long way to go.


Organizations


Books

Women and health research : ethical and legal issues of including women in clinical studies / Anna C. Mastroianni, Ruth Faden, and Daniel Federman, editors ; Committee on the Ethical and Legal Issues Relating to the Inclusion of Women in Clinical Studies, Division of Health Sciences Policy, Institute of Medicine.
Imprint Washington, D.C. : National Academy Press, c1994.

Women's Health - Missing from U.S. Medicine by Sue Rosser. (this can be read online)


Journal Articles
Brettelll, C. and Sargeant, C. (1996) 'Gender and Health an International Perspective'.

Corrigan, O.P. (2002). ‘First in man’: The politics and ethics of women in clinical drug trials. Feminist Review, 72, 40–72. Info here and here. (Pay to access)

"concern about danger to the unborn foetus has meant that, until very recently, ‘women of childbearing potential’ were routinely excluded from most of the early phases of clinical drug testing...exclusion of women during the early phases of clinical drug trials has now been lifted and drugs are currently being more widely tested on women. This paper examines the differing political and ethical positions..."

Online Sources
"Do Women Need Such Big Flu Shots" by Sabra Klein and Phyllis Greenberger - NY Times Opinion Page

"In planning for the swine flu, however, public health authorities ignored the evidence that vaccines affect women more strongly than men"

There are laws (Public Law PL 103-43) mandating the inclusion of women and ethnic minorities in NIH research.

Hayden, E. (2010) 'Sex bias blights drug studies' . Nature. 464, 332-333.

"The typical patient with chronic pain is a 55-year-old woman — the typical chronic-pain study subject is an 8-week-old male mouse.

Tuesday, April 13, 2010

Exit Interview - Dating

Photo by Mike DelGaudio - Flickr

For the most part, I try very hard to keep my personal and professional life separate. However, I had a recent experience that made me want to merge the two. A man I had been dating decided to end things. Happens all the time. (ok, not all the time to me per say, but it happens every day in the world...) But it left me wondering... I like information, I like data. It's fine to end things, but I really wanted more information. Why? What happened? How do you feel?

What if the dating industry took a page from the user experience book? What if, upon ending a marriage, relationship, or friendship, we were given a contextual interview to help us understand how to be a better spouse, partner or friend?

It might look like this:

Intro (tongue planted firmly in cheek):

Before we part ways, I wonder if I can have a few minutes of your time to ask a few questions. You will in no way be reimbursed for your time, but we've gotten this far, so what's a few more minutes?

Nothing you say to me will be confidential, so keep that in mind.

How long did we date?

What first attracted you to me?

Please share with me a really wonderful memory you have of us spending time together.

Please share with me a really unhappy memory you have of us spending time together.
What is one really annoying thing about me?

What is one really wonderful thing about me?

What worked in this relationship?

What didn't work in this relationship?

What is the one thing that made you decide to end this relationship?

Thinking back to the beginning of this relationship, what changed between then and now?

And, wait for it...the magic wand question...if you could change one thing about me, what would it be?

Thanks for participating. Now be on your way and have a nice life.
You might choose to add a diary study or participatory design phase, but I wouldn't push your luck :-).

One Size Fits None

Photo by Zen on Flickr

In the last few days, I've had a few conversations that lead me to expand my dislike of "one size fits none" even further. I used to say "one size fits none" to refer to clothing in stores that says "one size fits all". Really? I don't think so. Unless it's a scarf, apparel needs to be sized for a 5 foot tall female or a 6 foot tall male and the many sizes in between.

This week, the conversation turned to health care. Did you know that prescription drugs are, by and large, tested on males (likely caucasian)? The NIH does require "inclusion" of women and minorities, but there doesn't seem to be an agreed upon minimum percent of participants...but I digress....(in fact, there's been such an influx of information on this topic, that I'll set up a separate blog post shortly)

Again, normal dosing is supposed to work just as well for 300 lb. males, 150 pound males and females and 100 lb. 4 foot 11 females. I'm not a trained scientist, but I'm pretty sure the math on that creates incredibly varied results. Interestingly, there is a new trend in personalized medicine also talked about in Business Week.

And then there are protocols and provider care. When an individual walks into a doctor's office with a pain in her knee - the doctor should listen. (a recent New York Times article talks about just that). Listen not just to what the pain is and where and when, but also listen to what she's done in the past that felt better, what felt worse. Who has treated it and why. Many doctors, upon hearing, knee pain, will immediately go to the Rolodex in their heads from med school, pull up the "knee pain protocol" and prescribe exercises, pills or surgery - depending on the relevant issues.

However, anecdotal information shows that very often, providers don't listen, really listen to what the patient says. A certain medication has already shown to be ineffective. Using ice made it worse. It always hurts after a particular exercise.

We are people, individuals with a complex set of feelings, pains, biology and psychology. Using the "one size fits all" protocol doesn't work for many patients. Using the apparel metaphor, a size 5 female foot will never fit correctly into a size 12 shoe, don't assume the person attached to that size 5 foot has the same issues as the size 12, either.

Thursday, April 1, 2010

Women in Design - Go North

Last night, Office PDX hosted a Women in Design talk at North - a creative brand agency. It is interesting to hear that there is still discrimination and a feeling that it is somehow different to be a woman than a man in the workplace. Of utmost interest to this 5 foot tall design researcher is the fact that each woman who spoke who was in a major position of power, was also 6 feet or taller!

Nevertheless, we had a lively talk and Q & A session. Below are a few pictures of the gorgeous interior of this space which is creatively inspirational in and of itself.

Zillions of post-it notes adorned the walls in the copy room for this beautiful, feathery effect.

North's cool digs and their floating conference room. I'd stay at work all day to be in this relaxing space!