{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T22:50:00Z","timestamp":1791327000404,"version":"4.3.1"},"reference-count":40,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2026,12,1]],"date-time":"2026-12-01T00:00:00Z","timestamp":1796083200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,12,1]],"date-time":"2026-12-01T00:00:00Z","timestamp":1796083200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T00:00:00Z","timestamp":1790121600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000780","name":"European Commission","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000780","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100020098","name":"Innovative Health Initiative","doi-asserted-by":"publisher","award":["101132901"],"award-info":[{"award-number":["101132901"]}],"id":[{"id":"10.13039\/100020098","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["International Journal of Medical Informatics"],"published-print":{"date-parts":[[2026,12]]},"DOI":"10.1016\/j.ijmedinf.2026.106731","type":"journal-article","created":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T23:32:33Z","timestamp":1789774353000},"page":"106731","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":0,"special_numbering":"C","title":["Sex-specific clinical history improves disease prediction while revealing context-dependent effects on fairness in multimorbid populations"],"prefix":"10.1016","volume":"222","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6192-1757","authenticated-orcid":false,"given":"Ang\u00e9lica","family":"Atehort\u00faa","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-8747-2036","authenticated-orcid":false,"given":"Uma-Maria","family":"Lal-Trehan Estrada","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paula","family":"Petrone","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.ijmedinf.2026.106731_bib0005","article-title":"Sex inequalities in medical research: a systematic scoping review of the literature","volume":"18","author":"Merone","year":"2022","journal-title":"Women\u2019s Health"},{"issue":"2","key":"10.1016\/j.ijmedinf.2026.106731_bib0010","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1177\/15409996251388337","article-title":"Beyond one-size-fits-all: addressing the sex gap in biomedical research","volume":"35","author":"Sheng","year":"2026","journal-title":"J. Women\u2019s Health"},{"issue":"1","key":"10.1016\/j.ijmedinf.2026.106731_bib0015","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1186\/s13293-025-00765-w","article-title":"Sex-specific machine learning classification models improve outcome prediction for abdominal aortic aneurysms","volume":"16","author":"Kerr","year":"2025","journal-title":"Biol. Sex Differ."},{"issue":"12","key":"10.1016\/j.ijmedinf.2026.106731_bib0020","doi-asserted-by":"crossref","first-page":"e711","DOI":"10.1016\/S2666-7568(23)00189-7","article-title":"ExplaiNAble BioLogical age (ENABL age): an artificial intelligence framework for interpretable biological age","volume":"4","author":"Qiu","year":"2023","journal-title":"Lancet Healthy Longev."},{"issue":"1","key":"10.1016\/j.ijmedinf.2026.106731_bib0025","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1038\/s43856-022-00180-x","article-title":"Interpretable machine learning prediction of all-cause mortality","volume":"2","author":"Qiu","year":"2022","journal-title":"Commun. Med."},{"key":"10.1016\/j.ijmedinf.2026.106731_bib0030","article-title":"Machine learning for predicting all-cause mortality of metabolic dysfunction-associated fatty liver disease: a longitudinal study based on NHANES","author":"Wang","year":"2025","journal-title":"BMC Gastroenterol."},{"key":"10.1016\/j.ijmedinf.2026.106731_bib0035","doi-asserted-by":"crossref","DOI":"10.3389\/fcvm.2021.611055","article-title":"Sex-specific patterns of mortality predictors among patients undergoing cardiac resynchronization therapy: a machine learning approach","volume":"8","author":"Tokodi","year":"2021","journal-title":"Front. Cardiovasc. Med."},{"issue":"1","key":"10.1016\/j.ijmedinf.2026.106731_bib0040","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1001\/jamapsychiatry.2019.2905","article-title":"Prediction of sex-specific suicide risk using machine learning and single-payer health care registry data from Denmark","volume":"77","author":"Gradus","year":"2020","journal-title":"JAMA Psychiatry"},{"issue":"1","key":"10.1016\/j.ijmedinf.2026.106731_bib0045","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1186\/s12879-022-07951-w","article-title":"Lethality risk markers by sex and age-group for COVID-19 in Mexico: a cross-sectional study based on machine learning approach","volume":"23","author":"Rojas-Garc\u00eda","year":"2023","journal-title":"BMC Infect. Dis."},{"key":"10.1016\/j.ijmedinf.2026.106731_bib0050","doi-asserted-by":"crossref","DOI":"10.1016\/j.imu.2021.100791","article-title":"Risk markers by sex for in-hospital mortality in patients with acute coronary syndrome: a machine learning approach","volume":"27","author":"V\u00e1zquez","year":"2021","journal-title":"Inform. Med. Unlocked"},{"issue":"4","key":"10.1016\/j.ijmedinf.2026.106731_bib0055","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0250567","article-title":"Sex differences in multimorbidity and polypharmacy trends: a repeated cross-sectional study of older adults in Ontario, Canada","volume":"16","author":"Maxwell","year":"2021","journal-title":"PLoS One"},{"issue":"4","key":"10.1016\/j.ijmedinf.2026.106731_bib0060","doi-asserted-by":"crossref","first-page":"3639","DOI":"10.3390\/ijerph20043639","article-title":"Sex differences in multimorbidity, inappropriate medication, and frailty in older adults","volume":"20","author":"Bar\u00e9","year":"2023","journal-title":"Int. J. Environ. Res. Public Health"},{"issue":"1","key":"10.1016\/j.ijmedinf.2026.106731_bib0065","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1038\/s41746-020-0288-5","article-title":"Sex and gender differences and biases in artificial intelligence for biomedicine and healthcare","volume":"3","author":"Cirillo","year":"2020","journal-title":"NPJ Digit. Med."},{"issue":"12","key":"10.1016\/j.ijmedinf.2026.106731_bib0070","doi-asserted-by":"crossref","first-page":"866","DOI":"10.7326\/M18-1990","article-title":"Ensuring fairness in machine learning to advance health equity","volume":"169","author":"Rajkomar","year":"2018","journal-title":"Ann. Intern. Med."},{"issue":"6","key":"10.1016\/j.ijmedinf.2026.106731_bib0075","doi-asserted-by":"crossref","DOI":"10.1016\/S0197-2456(00)00098-2","article-title":"Design of the prostate, lung, colorectal and ovarian (PLCO) cancer screening trial","volume":"21","author":"Prorok","year":"2000","journal-title":"Control. clin. trials"},{"issue":"4","key":"10.1016\/j.ijmedinf.2026.106731_bib0080","doi-asserted-by":"crossref","first-page":"e37","DOI":"10.2196\/medinform.6328","article-title":"Web-based real-time case finding for the population health management of patients with diabetes mellitus: a prospective validation of the natural language processing\u2013based algorithm with statewide electronic medical records","volume":"4","author":"Zheng","year":"2016","journal-title":"JMIR Med. Inform."},{"key":"10.1016\/j.ijmedinf.2026.106731_bib0085","doi-asserted-by":"crossref","DOI":"10.1016\/j.puhip.2026.100769","article-title":"Improving case-finding of long-term health problems in disadvantaged communities: a policy-focused evidence brief","author":"Ghanchi","year":"2026","journal-title":"Public Health Pract."},{"issue":"2","key":"10.1016\/j.ijmedinf.2026.106731_bib0090","doi-asserted-by":"crossref","DOI":"10.1177\/03000605251412076","article-title":"Use of machine learning for chronic disease case identification in primary care settings: a scoping review of methods, validation, and clinical relevance","volume":"54","author":"Pham","year":"2026","journal-title":"J. Int. Med. Res."},{"issue":"1","key":"10.1016\/j.ijmedinf.2026.106731_bib0095","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1038\/s42256-019-0138-9","article-title":"From local explanations to global understanding with explainable AI for trees","volume":"2","author":"Lundberg","year":"2020","journal-title":"Nat. Mach. Intell."},{"key":"10.1016\/j.ijmedinf.2026.106731_bib0100","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1613\/jair.1.12228","article-title":"A survey on the explainability of supervised machine learning","volume":"70","author":"Burkart","year":"2021","journal-title":"J. Artif. Intell. Res."},{"issue":"4","key":"10.1016\/j.ijmedinf.2026.106731_bib0105","doi-asserted-by":"crossref","DOI":"10.1002\/widm.1312","article-title":"Causability and explainability of artificial intelligence in medicine","volume":"9","author":"Holzinger","year":"2019","journal-title":"Wiley Interdiscip. Rev. Data Min. Knowl. Discov."},{"issue":"1","key":"10.1016\/j.ijmedinf.2026.106731_bib0110","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1002\/1097-0142(1950)3:1<32::AID-CNCR2820030106>3.0.CO;2-3","article-title":"Index for rating diagnostic tests","volume":"3","author":"Youden","year":"1950","journal-title":"Cancer"},{"key":"10.1016\/j.ijmedinf.2026.106731_bib0115","series-title":"Information Retrieval","author":"van Rijsbergen","year":"1979"},{"key":"10.1016\/j.ijmedinf.2026.106731_bib0120","series-title":"Advances in Neural Information Processing Systems","article-title":"Equality of opportunity in supervised learning","author":"Hardt","year":"2016"},{"issue":"1","key":"10.1016\/j.ijmedinf.2026.106731_bib0125","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1175\/1520-0493(1950)078<0001:VOFEIT>2.0.CO;2","article-title":"Verification of forecasts expressed in terms of probability","volume":"78","author":"Brier","year":"1950","journal-title":"Mon. Weather Rev."},{"issue":"21","key":"10.1016\/j.ijmedinf.2026.106731_bib0130","doi-asserted-by":"crossref","first-page":"4051","DOI":"10.1002\/sim.8281","article-title":"The integrated calibration index (ICI) and related metrics for the assessment of calibration of logistic regression models","volume":"38","author":"Austin","year":"2019","journal-title":"Stat. Med."},{"issue":"7","key":"10.1016\/j.ijmedinf.2026.106731_bib0135","doi-asserted-by":"crossref","first-page":"101001","DOI":"10.1016\/j.landig.2026.101001","article-title":"Critical appraisal of fairness metrics for artificial intelligence-based clinical prediction models: a scoping review","volume":"8","author":"Matos","year":"2026","journal-title":"Lancet Digit. Health"},{"issue":"6464","key":"10.1016\/j.ijmedinf.2026.106731_bib0140","doi-asserted-by":"crossref","first-page":"447","DOI":"10.1126\/science.aax2342","article-title":"Dissecting racial bias in an algorithm used to manage the health of populations","volume":"366","author":"Obermeyer","year":"2019","journal-title":"Science"},{"key":"10.1016\/j.ijmedinf.2026.106731_bib0145","series-title":"Fairness and Machine Learning: Limitations and Opportunities","author":"Barocas","year":"2023"},{"key":"10.1016\/j.ijmedinf.2026.106731_bib0150","author":"Liu"},{"issue":"8","key":"10.1016\/j.ijmedinf.2026.106731_bib0155","doi-asserted-by":"crossref","first-page":"813","DOI":"10.1164\/rccm.201512-2379ED","article-title":"Sex differences in chronic obstructive pulmonary disease mechanisms","volume":"193","author":"Barnes","year":"2016","journal-title":"Am. J. Respir. Crit. Care Med."},{"issue":"5","key":"10.1016\/j.ijmedinf.2026.106731_bib0160","first-page":"404","article-title":"Sex steroid receptors, hypertension, and vascular ageing","volume":"36","author":"Connelly","year":"2022","journal-title":"J. Hum. Hypertens."},{"key":"10.1016\/j.ijmedinf.2026.106731_bib0165","doi-asserted-by":"crossref","DOI":"10.3389\/fmicb.2021.711137","article-title":"The gut microbiome and sex hormone-related diseases","volume":"12","author":"He","year":"2021","journal-title":"Front. Microbiol."},{"issue":"11","key":"10.1016\/j.ijmedinf.2026.106731_bib0170","doi-asserted-by":"crossref","first-page":"1362","DOI":"10.1093\/eurheartj\/ehr048","article-title":"Red alert for women\u2019s heart: the urgent need for more research and knowledge on cardiovascular disease in women","volume":"31","author":"Maas","year":"2010","journal-title":"Eur. Heart J."},{"issue":"8","key":"10.1016\/j.ijmedinf.2026.106731_bib0175","first-page":"1083","article-title":"Sex differences in the presentation, diagnosis, and management of acute coronary syndromes","volume":"139","author":"Arora","year":"2019","journal-title":"Circulation"},{"key":"10.1016\/j.ijmedinf.2026.106731_bib0180","series-title":"FDA Drug Safety Communication: Risk of Next-Morning Impairment After Use of Insomnia Drugs","year":"2013"},{"issue":"23","key":"10.1016\/j.ijmedinf.2026.106731_bib0185","doi-asserted-by":"crossref","first-page":"12592","DOI":"10.1073\/pnas.1919012117","article-title":"Gender imbalance in medical imaging datasets produces biased classifiers for computer-aided diagnosis","volume":"117","author":"Larrazabal","year":"2020","journal-title":"PNAS"},{"issue":"11","key":"10.1016\/j.ijmedinf.2026.106731_bib0190","doi-asserted-by":"crossref","first-page":"1322","DOI":"10.3390\/vaccines9111322","article-title":"A systematic review of the sex and gender reporting in COVID-19 clinical trials","volume":"9","author":"Heidari","year":"2021","journal-title":"Vaccines"},{"key":"10.1016\/j.ijmedinf.2026.106731_bib0195","series-title":"Critical sex and gender considerations for equitable research","author":"Heidari","year":"2021"},{"issue":"8","key":"10.1016\/j.ijmedinf.2026.106731_bib0200","doi-asserted-by":"crossref","DOI":"10.1136\/bmjgh-2021-006854","article-title":"Time for action: towards an intersectional gender approach to COVID-19 vaccine development and deployment that leaves no one behind","volume":"6","author":"Heidari","year":"2021","journal-title":"BMJ Glob. Health"}],"container-title":["International Journal of Medical Informatics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1386505626004715?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1386505626004715?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T21:50:33Z","timestamp":1791323433000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S1386505626004715"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,12]]},"references-count":40,"alternative-id":["S1386505626004715"],"URL":"https:\/\/doi.org\/10.1016\/j.ijmedinf.2026.106731","relation":{},"ISSN":["1386-5056"],"issn-type":[{"value":"1386-5056","type":"print"}],"subject":[],"published":{"date-parts":[[2026,12]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Sex-specific clinical history improves disease prediction while revealing context-dependent effects on fairness in multimorbid populations","name":"articletitle","label":"Article Title"},{"value":"International Journal of Medical Informatics","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.ijmedinf.2026.106731","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2026 The Authors. Published by Elsevier B.V.","name":"copyright","label":"Copyright"}],"article-number":"106731"}}