A Survey Evaluating Extent of Undergraduate Medical Education Regarding Sex-Based Differences in Pathophysiology

Introduction A historical gap in research on sex differences in health outcomes has led to a lack of education on sex-based differences in pathophysiology. The primary objective of this research study was to survey pathophysiology professors of medical schools in the United States (US) to understand the current extent to which the impact of sex on disease is included in the pre-clinical curricula of undergraduate medical institutions in the US. Methods A survey tool was created via literature review to assess the extent of education on sex-based differences in pathophysiology. This survey was distributed using the Qualtrics electronic platform to the head professor of pathophysiology at each of the 141 Liaison Committee on Medical Education (LCME) accredited medical schools in the United States. Results The survey response rate was 14.9%. The most taught topics were epidemiology of most common cancers affecting each sex and risk factors for development of osteoporosis between different sexes. Sex-based differences in zolpidem dosing, smoking cessation, and the physiologic mechanism of narcotic addiction had the least curricular coverage. 28.57% of faculty and 38.10% of faculty agree and somewhat agree, respectively, their institution provides faculty development for teaching about topics relating to sex differences in pathophysiology. Medical students are primarily evaluated on their knowledge of sex pathophysiology in the form of written examination, followed by evaluation by standardized patients, and lastly faculty observed patient interactions. Discussion Curricular topics relating to sex-based differences in pathophysiology are taught to varying degrees in medical school preclinical curricula. Improved efforts can be made to increase instruction on specific topics and to support faculty development in teaching about sex-based differences in disease evaluation and management, enhancing the education of the next generation of physicians and facilitating better care for patients

Cost Effectiveness Analyses of Preimplantation Genetic Testing.

Capsule: A systematic review of cost-effectiveness analyses regarding pre-implantation genetic testing reveals a growing, heterogeneous body of literature not uniformly adhering to recommended reporting guidelines

Elevated anti-Müllerian hormone levels are not associated with preterm delivery after in vitro fertilization or ovulation induction.

OBJECTIVE: To investigate the association between anti-Müllerian hormone and preterm birth risk in a larger cohort of patients who underwent either in vitro fertilization or ovulation induction with intrauterine insemination at a US academic fertility center. DESIGN: Retrospective cohort study SUBJECTS: Live singleton births from patients who underwent in vitro fertilization or ovulation induction between 2016 and 2020 at a single academic fertility center were included in this study. Patients were excluded if they had a missing pre-pregnancy AMH level, a pregnancy using donor oocytes or a gestational carrier, multiple gestations, a delivery prior to 20 weeks gestation, or a cerclage in place. EXPOSURE: AMH level MAIN OUTCOME MEASURES: The primary outcome was proportion of preterm delivery. Secondary outcomes included rate of pregnancy-induced hypertension, gestational diabetes, and small for gestational age. RESULTS: In the entire cohort (n=875), 8.4% of deliveries were preterm. Mean AMH values were similar between those with term and preterm births (3.9 vs 4.2 ng/mL, p=0.29). Similar proportions of patients with term and preterm deliveries had AMH levels greater than the 75 CONCLUSION: Elevated AMH levels were not associated with an increased risk of preterm birth in patients who conceived after in vitro fertilization and ovulation induction, including PCOS patients. Although studies suggest that AMH level may help stratify risk of preterm birth in this population, our findings indicate that further studies are needed prior to clinical application