Background & Aims
The perception of pain and how it is reported are impacted by numerous physiological, psychological, and social factors, including gender. Women report chronic pain more frequently than men do, including musculoskeletal and orofacial pain conditions. Gender-related differences have also been observed in pain thresholds and tolerance levels in experimental settings. These effects have been shown to involve not only the patient but also the examiner, with potential practical and theoretical implications. Yet an overview of such gender effects when assessing pain is lacking. Therefore, the aim of this systematic review is to evaluate the relationship between the gender of the patient and the examiner in pain reports.
Methods
This review was carried out in accordance with the PRISMA guidelines and registered in PROSPERO (CRD42023473445). The search strategy included two main concepts, “pain” and “gender of examiner”, and identified articles in PubMed, Web of Science, CINAHL, and PsycINFO. The results were obtained until the end of November 2023. Two authors (HF, AL) independently screened the abstracts found in the initial search and then carried out full text assessment of articles potentially eligible for inclusion and data extraction. Relevant data were obtained from included papers using the participants, exposure, comparison, and outcomes (PECO) framework. The risk of bias was assessed independently by the two reviewers with the Newcastle-Ottawa Scale (NOS).
Results
The literature search yielded 3,431 published studies. After removal of 1,057 duplicates, 2,374 abstracts were screened, and 166 articles were reviewed in full text. Of these, 42 studies were included for data extraction. Our preliminary, qualitative data synthesis indicates that men report a higher level of pain when the examiner is a woman, whereas a smaller effect was identified in terms pain thresholds. Furthermore, it was shown that pain tolerance was significantly affected when individuals were evaluated by an examiner of the opposing gender or a male examiner.
Conclusions
The gender of the examiner should be considered an important factor when assessing pain outcomes. Given the potential impact of gender of examiner on pain outcomes in research and in clinical settings, a meta-analysis of available data can contribute to the understanding such effects.
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Presenting Author
Hessamoddin Faghihian
Poster Authors
Hessamoddin Faghihian
D.D.S., MSc.
Umeå University
Lead Author
Birgitta Häggman-Henrikson
Malmö University
Lead Author
Maria Lalouni
Karolinska Institutet
Lead Author
Peter Svensson
DDS
Department of Dentistry and Oral Health, Aarhus University
Lead Author
Linus Andersson PhD
Umeå University
Lead Author
Anna Lövgren
Umeå University
Lead Author
Topics
- Assessment and Diagnosis