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Editorial
April 12, 2019

Women’s Health: A New JAMA Clinical Insights Series

Author Affiliations
  • 1Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine at University of California, Los Angeles
  • 2Associate Editor, JAMA
  • 3Deputy Editor, JAMA
JAMA. 2019;321(17):1676. doi:10.1001/jama.2019.3957

In this issue of JAMA, a new article series entitled JAMA Clinical Insights: Women’s Health is introduced. This series stems from the observation that in every organ system, there are diseases that are unique to women, more common in women than in men, or characterized by differences in disease course in women compared with men. For example, asthma, iron deficiency, osteoporosis, rheumatoid arthritis, depression, coronary microvascular disease, rosacea, Hashimoto thyroiditis, multiple sclerosis, irritable bowel syndrome, urinary tract infection, and age-related macular degeneration are more common in women than in men. Death due to emphysema is more common in women than in men. Women have higher rates of adverse drug reactions than do men. Pregnancy affects the course of numerous diseases.

In the last decade, there has been greater recognition of the uniqueness of women’s health and the substantial effect of differences on clinical practice, both for women’s health and men’s health. The US National Institutes of Health (NIH) has recognized that historically, research has neglected sex-based considerations and analyses even at the preclinical phase, obscuring sex differences that could guide subsequent clinical studies.1 The mission of the NIH Office of Research on Women’s Health (ORWH) includes strengthening research relating to diseases, disorders, and conditions that affect women, ensuring that research supported by NIH adequately addresses issues regarding women’s health, and ensuring that women are appropriately represented in biomedical and biobehavioral research studies supported by NIH.2 The US Food and Drug Administration’s Office of Women’s Health advocates for the participation of women in clinical trials and has initiatives aimed at improving understanding of the biological basis for sex differences.3 Without an understanding of the reasons for sex differences, it is not possible to develop successful sex-specific approaches to diagnosis and treatment or to fulfill the potential of personalized medicine.

Based on that framework, the articles in the JAMA Clinical Insights: Women’s Health series will encompass virtually every discipline of medicine, acknowledging the increasing appreciation of the importance of multidisciplinary approaches to health and disease. This series will highlight issues of high clinical relevance to clinicians. The articles will be brief, concise, and emphasize graphical presentation of material to maximize their utility to practicing clinicians. Many of the articles will be accompanied by JAMA Clinical Reviews podcasts to facilitate dissemination to those who prefer to acquire information by listening to a conversation.

The series will include the effect of women’s health on all fields of medicine. Articles will therefore target a wide range of signs and symptoms, life transitions (eg, menarche, menopause, pregnancy), and diseases relevant to women’s health over the lifespan. The first article in the series is entitled “Treatment of Nonmetastatic Breast Cancer” and appears in this issue of JAMA.4 In this article, Ruddy and Ganz discuss current practices in breast cancer treatment based on cancer subtype and deescalation of certain treatments to minimize long-term toxicities. We hope that you enjoy JAMA Clinical Insights: Women’s Health.

Potential authors who wish to submit manuscripts for this series should contact the JAMA editorial office to determine whether the topic is appropriate for JAMA Clinical Insights: Women’s Health by sending an email to ccrandall@mednet.ucla.edu or edward.livingston@jamanetwork.org.

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Article Information

Corresponding Author: Carolyn J. Crandall, MD, MS, Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine at University of California, 1100 Glendon Ave, Ste 850, Room 858, Los Angeles, CA 90024 (ccrandall@mednet.ucla.edu).

Published Online: April 12, 2019. doi:10.1001/jama.2019.3957

References
1.
Clayton  JA, Collins  FS.  Policy: NIH to balance sex in cell and animal studies.  Nature. 2014;509(7500):282-283. doi:10.1038/509282aPubMedGoogle ScholarCrossref
2.
National Institutes of Health Office of Research on Women's Health; US Department of Health and Human Services.  Mission and history.https://orwh.od.nih.gov/about/mission-and-history. Accessed April 9, 2019.
3.
US Department of Health and Human Services; US Food and Drug Administration.  Understanding sex differences at FDA. https://www.fda.gov/scienceresearch/specialtopics/womenshealthresearch/ucm131182.htm. Accessed April 9, 2019.
4.
Ruddy  KJ, Ganz  PA.  Treatment of nonmetastatic breast cancer.  JAMA. doi:10.1001/jama.2019.3927Google Scholar
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