Content of review 1, reviewed on July 26, 2020
This is an interesting paper investigating gender differences in symptoms and and medical procedures in 4,780 covid covid patients between January 1st and May 1st in Madrid, Spain. Data relating to tests and symptoms was extracted from patient records, mainly from the free text using automated text processing - I'm assuming data must have been retrieved from other fields e.g. sex, age, but this isn't mentioned in the methods. It is also not clear whether coded data was used.
The results (clinical manifestations, comorbidities, test results etc.) were tabulated by gender, together with the p-value for difference between gender for each.
These tables were interesting and very comprehensive.
However, the claim of the title, and the main conclusion that the results show gender bias by health professionals is not substantiated. The authors imply that there is a bias because less tests were carried out in women with less hospital admissions. However, this could just as likely be explained by the different disease profiles shown by men and women.
In order to test this claim a proper multivariable analysis is needed adjusting for any potential confounders. This has not been done.
Minor comments The title should be changed to "investigation of gender differences" The title should substitute "big data" for something more meaningful. I suggest a cross sectional study. There is no STROBE checklist.
Source
© 2020 the Reviewer (CC BY 4.0).
References
Ancochea, J., Izquierdo, J. L., Soriano, J. B. 2020. Evidence of gender bias in the diagnosis and management of COVID-19 patients: A Big Data analysis of Electronic Health Records. MedRxiv.
