‘Stand up, speak up’ to increase female representation in trial leadership
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CHICAGO — Women continue to be underrepresented as leaders in clinical research and in clinical trials in particular, despite research showing female-led studies recruit more diverse participants, according to a speaker.
Female scientists are similarly “invisible” in some institutions, with persistent gaps in salary support, access to research data, protected research time, invitations to networking events, nominations for awards and research chairs, mentorships, sponsorship and even respect in the workplace, Harriette Van Spall, MD, MPH, associate professor in the division of cardiology at McMaster University and scientist with the Population Health Research Institute in Ontario, Canada, said during a presentation at the American Heart Association Scientific Sessions.
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Investigators from low- and middle-income countries are similarly underrepresented in research leadership and networks, and there is an intersectionality when it comes to gender and race or ethnicity, said Van Spall, a recipient of the Dr. Nanette K. Wenger Research Goes Red Award.
In an analysis of 403 randomized clinical HF trials published from 2000 to 2019, Van Spall and colleagues found that women represented 15.6%, 12.9%, and 11.4% of lead, senior and corresponding authors, respectively. The proportion of female authors has not changed over time. Women had lower odds of lead authorship in trials that were multicenter, were coordinated in North America or Europe, tested drug interventions, or had men as senior authors, Van Spall said. However, trials with women as senior leaders had twice the odds of women as first authors.
Additionally, data show female principal investigators recruit more female participants in their trials, as well as more participants who identify as “Black, Indigenous or people of color,” Van Spall said.
“We know that women investigators recruit more women participants in their trials,” Van Spall said. “Women principal investigators recruit more Black, Indigenous and people of color as participants in their trials, [leading to] about an 8% increase in the proportion of patients who identify as [Black, Indigenous and people of color]. There are many reasons for us to nurture and harness the potential of women as research leaders.”
Van Spall, who led a local position statement and task force to help close the gap in leadership, said women must turn their experiences into scientific investigations that help stop the trajectory of underrepresentation.
“I will say to everyone here, regardless of your focus, your gender, your nationality: Stand up, speak up,” Van Spall said. “Be an agent of change when you see inequities or hostilities in your environment. Navigate beyond the glass ceilings you have in your environment through networks you create. If you do not have a network, create one.
“My last lesson is, in the face of obstacles, we must soar with grit and gratitude,” Van Spall said. “It is that gratitude that brings us full circle.”
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Van Spall HCG. Annual Dr. Nanette K. Wenger Research Goes Red Award for best scientific article on cardiovascular disease and stroke in women. Presented at: American Heart Association Scientific Sessions; Nov. 5-7, 2022; Chicago (hybrid meeting).
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