Representation of Women Authors in International Heart Failure Guidelines and Contemporary Clinical Trials

Background: Gender disparities in authorship of heart failure (HF) guideline citations and clinical trials have not been examined. Methods: We identified authors of publications referenced in Class I Recommendations in United States (n=173) and European (n=100) HF guidelines and of publications of all HF trials with >400 participants (n=118) published between 2001 and 2016. Authors’ genders were determined, and changes in authorship patterns over time were evaluated with linear regression and nonparametric testing. Results: The median proportion of women authors per publication was 20% (interquartile range [IQR], 8%–33%) in United States guidelines, 14% (IQR, 2%–20%) in European guidelines, and 11% (IQR, 4%–20%) in HF trials. The proportion of women authors increased modestly over time in United States and European guidelines’ references (β=0.005 and 0.003, respectively, from 1986 to 2016; P <0.001) but not in HF trials (12.5% [IQR, 0%–20%] in 2001–2004 to 8.9% [IQR, 0%–20%] in 2013–2016; P >0.50). Overall proportions of women as first or last authors in HF trials (16%) did not change significantly over time ( P =0.60). North American HF trials had the highest likelihood of having a woman as first or senior author (24%). HF trials with a woman first or senior author were associated with a higher proportion of enrolled female participants (39% versus 26%, P =0.01). Conclusions: In HF practice guidelines and trials, few women are authors of pivotal publications. Higher number of women authors is associated with higher enrollment of women in HF trials. Barriers to authorship and representation of women in HF guidelines and HF trial leadership need to be addressed.

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Trend in women representation among authors of high rank rheumatology journals articles, 2002-2019

Rheumatology ◽

10.1093/rheumatology/keab134 ◽

2021 ◽

Author(s):

Yoel Levinsky ◽

Yoav Vardi ◽

Michal Gafner ◽

Neta Cohen ◽

Michael Mimouni ◽

...

Keyword(s):

Final Analysis ◽

Senior Author ◽

Significant Rise ◽

High Rank ◽

Women Authors ◽

Representation Of Women ◽

Scientific Papers ◽

Over Time

Abstract Objective The representation of women among authors of peer reviewed scientific papers is gradually increasing. The aims of this study were to examine the trend of the proportion of women among authors in the field of rheumatology during the last two decades. Methods Articles published in journals ranked in the top quartile of the field of rheumatology in the years 2002-2019 were analyzed. The authorship positions of all authors, country of the article's source and manuscript type were retrieved by specifically designed software. Results Overall, 153,856 author names were included in the final analysis. Of them, 55,608 (36.1%) were women. There was a significant rise in the percentage of women authors over time (r = 0.979, P < 0.001) from 30.9% in 2002 to 41.2% in 2018, with a slight decline to 39.8% in 2019. There were significantly fewer women in the senior author positions compared to the first author positions (24.3% in senior position Vs. 40.9% as first author, p < 0.001). Conclusion The proportion of women among authors of rheumatology articles has increased over the years, both in general and as a first or senior author, however, their proportion is still less than 50% and there is still a gap between the proportion of women among first authors and the proportion of women among senior authors.

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Gender representation in authorship in later-phase systemic clinical trials in biliary tract cancer (BTC).

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.3_suppl.348 ◽

2021 ◽

Vol 39 (3_suppl) ◽

pp. 348-348

Author(s):

Mairead Geraldine McNamara ◽

John A. Bridgewater ◽

Lipika Goyal ◽

David Goldstein ◽

Rachna T. Shroff ◽

...

Keyword(s):

Clinical Trials ◽

Senior Author ◽

Industry Funding ◽

Factors Associated ◽

End Point ◽

Female Author ◽

Changes Over Time ◽

Google Search ◽

Later Phase ◽

Over Time

348 Background: The proportion of females in medicine is increasing (approx. 50% in medical school/workforce), but disparities in female authorship in oncology research publications exist; female corresponding authorship reportedly ranges from 7.2-39.1% in oncology clinical trials (Ludmir et al 2019). This study aimed to describe and assess factors associated with female first and senior authorship in later phase systemic clinical trials in BTC and to identify any changes over time. Methods: Embase/Medline were used to identify final primary trial publications in BTC (2000-2020) (excluding phase I (PI) (expected to move to later phase), mixed tumour site trials, reviews, editorials and trial-in-progress publications). Gender was determined by inspection of names, google search and author communication. Chi-square tests and log regression were used to assess factors associated with female first and senior authorship, including changes over time (STATA16). Results: Of 501 publications, 163 met inclusion criteria; 80% single-arm PII and 15% and 5% randomised PII and PIII respectively; 73% enrolled ≤50 patients. Tumour primary sites were all BTC: 86%, cholangiocarcinoma: 8%, gallbladder cancer: 6%; 80% involved chemotherapy, 13% targeted therapy and 5% localised/systemic combinations; 65% were in first-line (1L) advanced setting, 17% post 1L, 13% advanced non-specified and 5% neo-adjuvant/adjuvant. Forty-eight percent received industry funding and 65% met primary end-point. Sixty-four percent were published post ABC-02 (Valle et al 2010). Publication impact factor (IF) was ≤5 in 50% and >20 in 12%. Median number of authors in all publications was 11. Geographic location of all first and senior authors were Asia (42%/42%), Europe (29%/29%), USA (24%/22%) and other (4%/6%), respectively. Median individual trial female author representation was 25%; there were no female authors in 12% of trials. Overall, female first and senior author representation was 21% and 11%, respectively. Median position of first female author was second. In publications with IF ≤20 and >20, there were 22% and 16% female first and 13% and 0% female senior authors, respectively. The phase of trial, journal IF, industry funding, or whether met primary end-point did not impact female first or senior author representation (all P>.05). There were more female senior authors associated with “other” geographic locations (40% in 10 trials) (P=.016) vs Asia (7%), Europe (8%) and USA (14%). There were no significant changes in female first or senior author representation over time (‘00-05: 21%/18%, ‘06-10: 27%/5%, ‘11-15: 15%/15%, ‘16-20: 22%/9%, P=.738, and P=.508 respectively). Conclusions: Female first and senior author representation in later phase systemic clinical trial publications in BTC is low and has not changed significantly over time. The underlying reasons for this imbalance need to be better understood and addressed.

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Persistent Underrepresentation of Women’s Science in High Profile Journals

10.1101/275362 ◽

2018 ◽

Cited By ~ 11

Author(s):

Yiqin Alicia Shen ◽

Jason M. Webster ◽

Yuichi Shoda ◽

Ione Fine

Keyword(s):

Academic Success ◽

Impact Factor ◽

Journal Impact Factor ◽

Original Research ◽

Women Authors ◽

Representation Of Women ◽

High Profile ◽

Underrepresentation Of Women ◽

Journal Impact ◽

Over Time

AbstractYiqin Alicia Shen, Jason M. Webster, Yuichi Shoda, and Ione Fine Department of Psychology, University of Washington Past research has demonstrated an under-representation of female editors and reviewers in top scientific journals, but less is known about the representation of women authors within original research articles. We collected research article publication records from 15 high-profile multidisciplinary and neuroscience journals for 2005-2017 and analyzed the representation of women over time, as well as its relationship with journal impact factor. We find that women authors have been persistently underrepresented in high-profile journals. This under-representation has persisted over more than a decade, with glacial improvement over time. Even within our limited group of high profile journals, the percent of female first and last authors is negatively associated with journal impact factor. Since publishing in high-profile journals is a gateway to academic success, this underrepresentation of women may contribute to the lack of women at the top of the academic ladder.

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Comparison of the contributions of female and male authors to medical research in 2000 and 2015: a cross-sectional study

BMJ Open ◽

10.1136/bmjopen-2018-024436 ◽

2019 ◽

Vol 9 (2) ◽

pp. e024436 ◽

Cited By ~ 3

Author(s):

Angele Gayet-Ageron ◽

Antoine Poncet ◽

Thomas Perneger

Keyword(s):

Cross Sectional Study ◽

Sectional Study ◽

Women Authors ◽

Cross Sectional ◽

Representation Of Women ◽

Outcomes Measures ◽

Critical Revision ◽

Author Position ◽

Medical Articles ◽

Over Time

ObjectivesThe proportion of women engaged in clinical research has increased over time. However, it is unclear if women and men contribute to the same extent during the conduct of research and, if so, if they are equally rewarded by a strategic first or last author position. We aim to describe the prevalence of women authors of original articles published 15 years apart and to compare the research contributions and author positions according to gender.DesignRepeated cross-sectional study.SettingPublished original articles.Participants1910 authors of 223 original articles published in the Annals of Internal Medicine in 2000 and 2015.Primary and secondary outcomes measuresSelf-reported contributions to 10 aspects of the article (primary) and author position on the byline.ResultsThe proportion of women authors increased from 32% (n=243) to 41% (n=469) between 2000 and 2015 (p<0.0001). In 2000, women authors were less frequently involved than men in the conception and design (134 (55%) vs 323 (61%); p=0.0256), critical revision (171 (70%) vs 426 (81%); p=0.0009), final approval (196 (81%) vs 453 (86%); p=0.0381) and obtaining of funding (39 (16%) vs 114 (22%); p=0.0245). Women were more frequently involved than men in administration and logistics (85 (35%) vs 137 (26%); p=0.0188) and data collection (121 (50%) vs 242 (46%); p=0.0532), but they were similarly involved in the analysis and interpretation of data, drafting of the manuscript, provision of materials/patients and statistical expertise. Women were less often last authors than men (22 (9%) vs 82 (16%); p=0.0102). These gender differences persisted in 2015.ConclusionsThe representation of women among authors of medical articles increased notably between 2000 and 2015, but still remained below 50%. Women’s roles differed from those of men with no change over time.

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Disparities in patient enrollment on glioblastoma clinical trials

CNS Oncology ◽

10.2217/cns-2020-0008 ◽

2020 ◽

Vol 9 (2) ◽

pp. CNS59

Author(s):

Yang Liu ◽

Andrea Wasilewski ◽

Nimish A Mohile

Keyword(s):

United States ◽

Clinical Trials ◽

Brain Tumor ◽

Population Data ◽

The United States ◽

Tumor Registry ◽

Representation Of Women ◽

Central Brain ◽

The Usa ◽

Patient Enrollment

Aim: To determine if enrollment on glioblastoma (GBM) interventional clinical trials (ICTs) in the USA is representative of the population. Materials & methods: We queried ClinicalTrials.gov for all ICTs in GBM from 1994 to 2019. Demographics were obtained from ClinicalTrials.gov or the trial publication and compared with population data from Central Brain Tumor Registry of the United States. Results: In total, 10617 GBM patients were enrolled in 118 adult ICTs: median age was 54.0 (10.05 years younger than Central Brain Tumor Registry of the United States). Age was most discrepant in recurrent tumors, nonrandomized trials and consortium studies. Median age improved from 52.0 to 59.5 over 25 years. Women represented 37.5% of subjects. Conclusion: GBM ICTs under-represent older patients but representation of women reflects the population. ICTs need to be designed to better represent the population.

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Abstract 13205: Underrepresentation of Women as Clinical Trialists in Heart Failure: A Systematic Review of Randomized Controlled Trials Published in High-impact Medical Journals

Circulation ◽

10.1161/circ.142.suppl_3.13205 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Sera Whitelaw ◽

Kristen Sullivan ◽

Harriette G Van Spall

Keyword(s):

Heart Failure ◽

Clinical Trial ◽

Clinical Trials ◽

Randomized Controlled Trials ◽

Research Training ◽

Senior Author ◽

Controlled Trials ◽

Medical Journals ◽

Gender Distribution ◽

Randomized Controlled

Introduction: Clinical trials change practice in cardiology but leading them typically requires advanced research training, mentorship, sponsorship, and networking. Women are underrepresented in cardiology and report challenges in obtaining mentorship and networking opportunities. Objective: To evaluate the gender distribution of first and senior authors in practice-changing clinical trials in heart failure (HF), and explore clinical trial characteristics associated with women as first authors. Methods: We searched MEDLINE, EMBASE and CINAHL databases for randomized controlled trials (RCTs) published January 2000 - May 2019. We included RCTs that recruited adults with HF with reduced ejection fraction that were published in medical journals with an impact factor of > 10. Two reviewers screened and extracted data independently. We determined the gender distribution of the authors, assessed temporal trends in authorship, and used logistic regression to identify characteristics associated with women in first authorship positions. Results: The search identified 10,596 unique studies, of which 317 met eligibility criteria. We found that 15.8%, 11.7%, and 10.7% of first, senior, and corresponding authors, respectively, were women. Multivariable analysis revealed that the first author was more likely to be a woman if the senior author of a clinical trial was a woman (odds ratio [OR] 2.17, 95% confidence interval [CI] 1.04-4.66, p=0.039), and if the trial was conducted at a single rather than multiple centers (OR 1.40, 95% CI 1.09-6.48, p=0.035). Source of funding (public or industry), type of intervention (health service, drug, device, or surgery), and region of trial coordination (Europe, North America, Central and South America, Asia, and Australia) were not associated with gender of first authors. The proportion of trials that included women as authors has decreased from 2000 to present. Conclusion: Women are under-represented as clinical trialists in HF. Adjusting for other trial characteristics, the first author of a clinical trial was more likely to be a woman if the senior author was a woman. Mentoring women as clinical trialists in the present era may be a strategic way to increase the gender diversity of clinical trialists in years to come.

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Women Are Underrepresented and Receive Differential Outcomes at ASM Journals: a Six-Year Retrospective Analysis

mBio ◽

10.1128/mbio.01680-20 ◽

2020 ◽

Vol 11 (6) ◽

Author(s):

Ada K. Hagan ◽

Begüm D. Topçuoğlu ◽

Mia E. Gregory ◽

Hazel A. Barton ◽

Patrick D. Schloss

Keyword(s):

United States ◽

The United States ◽

Academic Publishing ◽

Negative Outcomes ◽

Women Authors ◽

Representation Of Women ◽

Differential Outcomes ◽

Senior Women ◽

American Society ◽

Type Of Institution

ABSTRACT Despite 50% of biology Ph.D. graduates being women, the number of women that advance in academia decreases at each level (e.g., from graduate to postdoctorate to tenure track). Recently, scientific societies and publishers have begun examining internal submissions data to evaluate representation and evaluation of women in their peer review processes; however, representation and attitudes differ by scientific field, and to date, no studies have investigated academic publishing in the field of microbiology. Using manuscripts submitted between January 2012 and August 2018 to the 15 journals published by the American Society for Microbiology (ASM), we describe the representation of women at ASM journals and the outcomes of their manuscripts. Senior women authors at ASM journals were underrepresented compared to global and society estimates of microbiology researchers. Additionally, manuscripts submitted by corresponding authors that were women received more negative outcomes than those submitted by men. These negative outcomes were somewhat mediated by whether or not the corresponding author was based in the United States and by the type of institution for United States-based authors. Nonetheless, the pattern for women corresponding authors to receive more negative outcomes on their submitted manuscripts held. We conclude with suggestions to improve the representation of women and decrease structural penalties against women. IMPORTANCE Barriers in science and academia have prevented women from becoming researchers and experts that are viewed as equivalent to their colleagues who are men. We evaluated the participation and success of women researchers at ASM journals to better understand their success in the field of microbiology. We found that women are underrepresented as expert scientists at ASM journals. This is, in part, due to a combination of both low submissions from senior women authors and more negative outcomes on submitted manuscripts for women compared to men.

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Women authorship in library and information science journals from 1981 to 2020: Is equitable representation being attained?

Journal of Information Science ◽

10.1177/01655515211050026 ◽

2021 ◽

pp. 016555152110500

Author(s):

Brady Lund ◽

Amrollah Shamsi

Keyword(s):

Gender Gap ◽

Information Science ◽

Library Science ◽

Library And Information Science ◽

Women Authors ◽

Significant Growth ◽

Representation Of Women ◽

Trends Over Time ◽

Over Time

This study examines the proportion of women as first authors in major library and information science (LIS) journals over the years 1981–2020. Author name and year data were collected for 10 LIS journals – five that are associated more with library topics and five with information science topics – and analysed using the genderize.io tool. Both general trends over time and comparisons of information science versus library science journals are presented. The findings indicate significant growth in the proportion of women authors among the LIS journals, but primarily concentrated only among the library science journals, with information science journals falling well behind. Representation of women authors (~60%) still lags well below the overall representation of women in librarianship (~80%). These findings suggest that there is still considerable growth needed to decrease the gender gap among authorship in top LIS journals.

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Heart Failure with Reduced Ejection Fraction—Does Sex Matter?

Current Heart Failure Reports ◽

10.1007/s11897-021-00533-y ◽

2021 ◽

Author(s):

Sascha Swaraj ◽

Rebecca Kozor ◽

Clare Arnott ◽

Belinda A. Di Bartolo ◽

Gemma A. Figtree

Keyword(s):

Heart Failure ◽

Clinical Trials ◽

Ejection Fraction ◽

Clinical Medicine ◽

Unmet Need ◽

Future Research ◽

Reduced Ejection Fraction ◽

Representation Of Women ◽

Diabetes And Obesity

Abstract Purpose of Review There is an increasing recognition of the importance of sex in susceptibility, clinical presentation, and outcomes for heart failure. This review focusses on heart failure with reduced ejection fraction (HFrEF), unravelling differences in biology, clinical and demographic features and evidence for diagnostic and therapeutic strategies. This is intended to inform clinicians and researchers regarding state-of-the-art evidence relevant to women, as well as areas of unmet need. Recent Findings Females are well recognised to be under-represented in clinical trials, but there have been some improvements in recent years. Data from the last 5 years reaffirms that women presenting with HFrEF women are older and have more comorbidities like hypertension, diabetes and obesity compared with men and are less likely to have ischaemic heart disease. Non-ischaemic aetiologies are more likely to be the cause of HFrEF in women, and women are more often symptomatic. Whilst mortality is less than in their male counterparts, HFrEF is associated with a bigger impact on quality of life in females. The implications of this for improved prevention, treatment and outcomes are discussed. Summary This review reveals distinct sex differences in HFrEF pathophysiology, types of presentation, morbidity and mortality. In light of this, in order for future research and clinical medicine to be able to manage HFrEF adequately, there must be more representation of women in clinical trials as well as collaboration for the development of sex-specific management guidelines. Future research might also elucidate the biochemical foundation of the sex discrepancy in HFrEF.

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Developing a Clinical Trials Infrastructure in the United States

NAM Perspectives ◽

10.31478/201205g ◽

2012 ◽

Vol 2 (5) ◽

Author(s):

Paul Eisenberg ◽

◽

Petra Kaufmann ◽

Ellen Sigal ◽

Janet Woodcock ◽

...

Keyword(s):

United States ◽

Clinical Trials ◽

The United States

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