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[Gender Bias in Low-Value Clinical Practices in Primary Care: A Scoping Review]
Blanca Obón-Azuara1, Christian Gil Borrelli2, Ana Cristina Sumelzo Liso3
1Grupo de Investigación GRISSA, IIS Aragón, Instituto Aragonés de Ciencias de la Salud, Zaragoza, España; Servicio de Medicina Intensiva, Hospital Clínico Universitario Lozano Blesa, Servicio Aragonés de Salud (SALUD), Zaragoza, España.
Abstract:
Low-value clinical practices (LVPs) in primary care are not sex- or gender-neutral, yet the evidence on this bias remains scattered. Following a scoping review per PRISMA-ScR and JBI, with a PCC-structured question, we searched PubMed/MEDLINE, Embase, CINAHL and Web of Science (1999-2026), complemented by Spanish foundational primary-care safety studies (APEAS, EVADUR). After independent screening (agreement 81.1%) and a 2016-2026 window, 250 documents were included. Evidence concentrated in inappropriate psychotropic prescribing (n=181) and excessive diagnostic testing (n=124), with scarce representation in sex-differential screening, epidemiological reporting and referrals. No Spanish foundational study analysed sex/gender as a primary determinant. Gender operates as a determinant of which LVPs occur, for whom, and with what consequences; integrating sex-disaggregated analyses and SAGER are necessary conditions for equitable, safe primary care.
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