Female authors underrepresented in HF randomized controlled trials
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Women have remained underrepresented as authors of HF randomized controlled trials from 2000 to 2019, researchers found in a systematic review.
The study, published in the Journal of the American College of Cardiology, also found that women were less likely to be lead authors of multicenter randomized controlled trials coordinated in North American or Europe that assessed drug interventions.
“These inequities are hurdles in the success of women who remain in research careers, thereby depriving younger investigators the opportunity to be mentored by senior women,” Harriette G.C. Van Spall, MD, MPH, FRCPC, associate professor of medicine and scientist at the Population Health Research Institute at McMaster University in Hamilton, Ontario, Canada, told Healio. “Another big factor is that women are underrepresented in the field of cardiology, and so there are less women who can subspecialize in areas such as heart failure and clinical cardiology research.”
20 years of HF trials
Sera Whitelaw, BSc, Master of Science candidate in the department of health research methods, evidence and impact at McMaster University, and colleagues analyzed data from 403 randomized controlled trials of adults with HF published between 2000 and May 7, 2019. These trials were published in medical journals with an impact factor of 10 or higher in 2019. Temporal trends were assessed in gender distribution of authors in the lead, middle, senior and corresponding positions.
In the included trials, women represented 15.6% of lead authors (95% CI, 12.2-19.6), 12.9% of senior authors (95% CI, 9.8-16.6) and 11.4% of corresponding authors (95% CI, 8.5-14.9). The proportion of women decreased numerically over time, although trends were not statistically significant for lead authors (P = .061), senior authors (P = .327) and corresponding authors (P = .624).
Women were less likely to be lead authors in multicenter trials compared with single-center trials (OR = 0.58; 95% CI, 0.18-0.96). This was also observed in trials coordinated in North America (OR = 0.21; 95% CI, 0.08-0.71) or Europe (OR = 0.33; 95% CI, 0.09-0.91) compared with Central and South America.
In addition, women were less likely to be lead authors in trials testing drug interventions vs. other interventions (OR = 0.42; 95% CI, 0.16-0.97), and in trials with men as the senior author (OR = 0.5; 95% CI, 0.21-0.93).
“While we did not test what interventions will improve these rates, our findings indicate that supporting the retention and career growth of existing women clinical trialists through equal opportunity in research institutes, gender-blinded processes during grant applications and journal peer reviews, and inclusion in national or international networks,” Van Spall said in an interview.
Implications of reducing gender disparities
In a related editorial, Michelle M. Kittleson, MD, PhD, professor of medicine and a cardiologist at Smidt Heart Institute at Cedars-Sinai, wrote: “When [addressing these issues] happens, women who decide against a career in cardiology will do so because their passion lies elsewhere rather than because of cardiology’s perceived lack of diversity and inflexible work-life balance. Women will not feel that they must work twice as hard as men to be considered half [as] good, but instead work hard simply to become great physicians.”
Reference:
For more information:
Harriette G.C. Van Spall, MD, MPH, FRCPC, can be reached at harriette.vanspall@phri.ca; Twitter: @hvanspall.
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