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Tong IL. Diversity of Authorship in Clinical Practice Guidelines- Not There Yet. J Womens Health (Larchmt) 2024. [PMID: 38842431 DOI: 10.1089/jwh.2024.0489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2024] Open
Affiliation(s)
- Iris L Tong
- Department of Medicine, Alpert Medical School of Brown University, Providence, Rhode Island, USA
- Program in Liberal Medical Education, Brown University, Providence, Rhode Island, USA
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2
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Zlakishvili B, Horev A. Gender disparities in high-quality dermatology research over the past 15 years. Int J Womens Dermatol 2024; 10:e160. [PMID: 38884064 PMCID: PMC11177815 DOI: 10.1097/jw9.0000000000000160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Accepted: 05/14/2024] [Indexed: 06/18/2024] Open
Abstract
Background In the last 15 years, an increase in U.S. female dermatologists from 41 to 52.2% and a surge in female authorship (FAP) have been noted. Authorship is a pivotal objective measurement of academic productivity and, contribution as first or senior author, plays a major role in the promotion process of active physicians and faculty members. Objective To validate, analyze, and clarify trends in FAP in high-quality dermatology research in the last 15 years. Methods The Thomson Reuters Web of Science Journal Citation Reports 2021 was used to retrieve the 100 most-cited original articles from the top 5 dermatology journals (determined by 2021 impact factors) in 5 consecutive 3-year intervals between 2009 and 2023. Gender application programming interface, a gender algorithm, was used to identify FAP according to country of origin and first name. Monotonic trend test significance level was set at 5%. Results In total, 14,187 articles were retrieved and subdivided into the 100 most-cited in 3-year intervals. A total of 418 first and 447 senior authors' gender were identified. FAP was found in 43%, 31%, and 37% of the first, last, and total authors. Trend analysis revealed a decrease in the last 15 years (S = -4610, P = .068) in senior FAP. Similarly, the trend persists in the United States (S = -1606, P = .052). Limitations Due to the usage of a binary gender identification algorithm, Nonbinary gender could not be identified in this analysis. Conclusion The last 15 years show an inverse relationship, with an increase in female dermatologists and a decrease in senior FAP in high-quality journals in the general dermatology community.
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Affiliation(s)
- Barak Zlakishvili
- Dermatology Department, Soroka University Medical Center, Be'er-Sheva, Israel
| | - Amir Horev
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Be'er-Sheva, Israel
- Pediatric Dermatology Service, Soroka University Medical Center, Be'er-Sheva, Israel
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3
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Pan AA, Pham AT, Appelo B, Legault GL, Woreta FA, Justin GA. Utilizing a composite citation index for evaluating clinical ophthalmology research: insights into gender, nationality, and self-citation among top ophthalmology researchers. Eye (Lond) 2024; 38:1380-1385. [PMID: 38172579 PMCID: PMC11076492 DOI: 10.1038/s41433-023-02912-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 12/01/2023] [Accepted: 12/19/2023] [Indexed: 01/05/2024] Open
Abstract
OBJECTIVES To compare the performance of a composite citation score (c-score) and its six constituent citation indices, including H-index, in predicting winners of the Weisenfeld Award in ophthalmologic research. Secondary objectives were to explore career and demographic characteristics of the most highly cited researchers in ophthalmology. METHODS A publicly available database was accessed to compile a set of top researchers in the field of clinical ophthalmology and optometry based on Scopus data from 1996 to 2021. Each citation index was used to construct a multivariable model adjusted for author demographic characteristics. Using area under the receiver operating curve (AUC) analysis, each index's model was evaluated for its ability to predict winners of the Weisenfeld Award in Ophthalmology, a research distinction presented by the Association for Research in Vision and Ophthalmology (ARVO). Secondary analyses investigated authors' self-citation rates, career length, gender, and country affiliation over time. RESULTS Approximately one thousand unique authors publishing primarily in clinical ophthalmology/optometry were analyzed. The c-score outperformed all other citation indices at predicting Weisenfeld Awardees, with an AUC of 0.99 (95% CI: 0.97-1.0). The H-index had an AUC of 0.89 (95% CI: 0.83-0.96). Authors with higher c-scores tended to have longer career lengths and similar self-citation rates compared to other authors. Sixteen percent of authors in the database were identified as female, and 64% were affiliated with the United States of America. CONCLUSION The c-score is an effective metric for assessing research impact in ophthalmology, as seen through its ability to predict Weisenfeld Awardees.
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Affiliation(s)
- Annabelle A Pan
- Johns Hopkins University School of Medicine, Baltimore, MD, USA.
| | - Alex T Pham
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Ben Appelo
- Department of Ophthalmology, Wilford Hall Eye Center, San Antonio, TX, USA
| | - Gary L Legault
- Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | | | - Grant A Justin
- Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
- Department of Ophthalmology, Walter Reed National Military Medical Center, Bethesda, MD, USA
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4
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Picó-Pérez M, Marco EA, Thurston LT, Ambrosi V, Genon S, Bryant KL, Martínez AB, Ciccia L, Kaiser Trujillo A. Researchers' sex/gender identity influences how sex/gender question is investigated in neuroscience: an example from an OHBM meeting. Brain Struct Funct 2024; 229:741-758. [PMID: 38366123 PMCID: PMC10978731 DOI: 10.1007/s00429-023-02750-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 12/04/2023] [Indexed: 02/18/2024]
Abstract
Gender inequality and diversity in STEM is a challenging field of research. Although the relation between the sex/gender of the researcher and the scientific research practices has been previously examined, less interest has been demonstrated towards the relation between sex/gender of the researcher and the way sex/gender as a variable is explored. Here, we examine, from a neurofeminist perspective, both questions: whether sex/gender identity is related to the examination of sex/gender as a variable and whether different approaches towards examining sex/gender are being used in different topics of study within neuroscience. Using the database of submitted posters to the Organization of Human Brain Mapping 2022 annual conference, we identified abstracts examining a sex/gender-related research question. Among these target abstracts, we identified four analytical categories, varying in their degree of content-related complexity: (1) sex/gender as a covariate, (2) sex/gender as a binary variable for the study of sex/gender differences, (3) sex/gender with additional biological information, and (4) sex/gender with additional social information. Statistical comparisons between sex/gender of researcher and the target abstract showed that the proportion of abstracts from Non-binary or Other first authors compared to both Women and Men was lower for all submitted abstracts than for the target abstracts; that more researchers with sex/gender-identity other than man implemented analytical category of sex/gender with additional social information; and, for instance, that research involving cognitive, affective, and behavioural neuroscience more frequently fit into the sex/gender with additional social information-category. Word cloud analysis confirmed the validity of the four exploratorily identified analytical categories. We conclude by discussing how raising awareness about contemporary neurofeminist approaches, including perspectives from the global south, is critical to neuroscientific and societal progress.
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Affiliation(s)
- Maria Picó-Pérez
- Life and Health Sciences Research Institute, School of Medicine, University of Minho, Braga, Portugal
- ICVS/3B's, PT Government Associate Laboratory, Braga, Guimarães, Portugal
- Departamento de Psicología Básica, Clínica y Psicobiología, Universitat Jaume I, Castelló de la Plana, Spain
| | | | | | - Valerie Ambrosi
- Institute Technology and Education, University of Bremen, Bremen, Germany
| | - Sarah Genon
- Institute of Neuroscience and Medicine, Research Centre Jülich, Jülich, Germany
| | - Katherine L Bryant
- Laboratoire de Psychologie Cognitive, Université Aix-Marseille, Marseille, France
| | - Ana Belén Martínez
- Filosofía de la Biología, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Lu Ciccia
- Centro de Investigaciones y Estudios de Género, Universidad Nacional Autónoma de México, Ciudad de México, México
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5
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Johnson EE, Ode GE, Ireland ML, Middleton K, Hammoud S. Gender Equity Efforts in Sports Medicine. Clin Sports Med 2024; 43:221-232. [PMID: 38383105 DOI: 10.1016/j.csm.2023.06.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2024]
Abstract
Great progress has been made toward gender equality in athletics, whereas true equality has not yet been realized. Concurrently, women orthopedists along with advocate men have paved the way toward gender equity in orthopedics as a whole and more specifically in sports medicine. The barriers that contribute to gender disparities include lack of exposure, lack of mentorship, stunted career development, childbearing considerations and implicit gender bias and overt gender discrimination.
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Affiliation(s)
| | - Gabriella E Ode
- Department of Orthopaedics, Hospital for Special Surgery, New York, NY, USA
| | | | - Kellie Middleton
- Northside Hospital Orthopaedic Institute, Lawrenceville, GA, USA
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6
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Hakvoort K, Conzen-Dilger C, Gutzmann A, Losse E, Tauber SC, Chechko N, Höllig A. Is there a gender gap in clinical neurosciences? A cross-sectional analysis of female participation in academic neurology, neurosurgery, and psychiatry. Neurosci Biobehav Rev 2023; 155:105458. [PMID: 37931690 DOI: 10.1016/j.neubiorev.2023.105458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 10/03/2023] [Accepted: 11/01/2023] [Indexed: 11/08/2023]
Abstract
Gender equality or the lack thereof is a constantly recurring theme. Here, we sought to provide an overview of the status with respect to the participation and leadership of female doctors in clinical neuroscience analyzing different disciplines (neurosurgery, neurology and psychiatry). A total of 1910 articles published in six representative journals (07-12/2020) were reviewed. Of these, 1327 were original research papers, 145 invited publications and 303 letters/comments. Out of a total of 15,080 authors, 4365 (29%) were women. The percentage of female authors was found to differ significantly between the different specialties (19% in neurosurgery, 39% in neurology and 45% in psychiatry). Women were last authors in 9.5% of the papers in neurosurgery, 29% in neurology and 39% in psychiatry Based on these findings, it can be concluded that gender disparity in academic neuroscience is quite conspicuous. Our review seeks to address the reasons behind this phenomenon in the context of new publications as well as various cultural and historical underpinnings.
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Affiliation(s)
- K Hakvoort
- Department of Neurosurgery, University Hospital RWTH Aachen, Germany
| | - C Conzen-Dilger
- Department of Neurosurgery, University Hospital RWTH Aachen, Germany
| | - A Gutzmann
- Department of Neurology, University Hospital RWTH Aachen, Germany
| | - E Losse
- Department of Psychiatry, University Hospital RWTH Aachen, Germany
| | - S C Tauber
- Department of Neurology, University Hospital RWTH Aachen, Germany
| | - N Chechko
- Department of Psychiatry, University Hospital RWTH Aachen, Germany
| | - A Höllig
- Department of Neurosurgery, University Hospital RWTH Aachen, Germany.
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7
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Soomro QH, McCarthy A, Charytan AM, Keane C, Varela D, Ways J, Ramos G, Nicholson J, Charytan DM. Gender Disparities in Nephrology Trials: A Meta-Analysis of Enrollment Trends between 2000 and 2021. KIDNEY360 2023; 4:1545-1553. [PMID: 37889579 PMCID: PMC10695639 DOI: 10.34067/kid.0000000000000281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 10/11/2023] [Indexed: 10/29/2023]
Abstract
Key Points Women are under-represented in high-impact nephrology trials. Trends remain consistent over the past 20 years and on the basis of target condition. Addressing the imbalanced enrollment of women in trials could improve disparities in care and outcomes of kidney disease. Background Gender disparities in the incidence and complications of kidney diseases are well described. However, analysis to elucidate gender disparities in enrollment in nephrology randomized clinical trials (RCTs) has not been performed. Methods We performed a systematic review and meta-analysis of high-impact nephrology RCTs published between 2000 and 2021. We included RCTs enrolling participants aged 18 years and older in the following categories: (1 ) CKD, (2 ) AKI, (3 ) GN, (4 ) maintenance dialysis, and (5 ) kidney transplantation. We summarized trial characteristics according to reporting and enrollment of participants, enrollment site, publication year, trial category, and intervention type. Outcomes of interest include the proportion of enrolled male and female participants overall and according to trial category. In addition, we compared enrollment trends in the United States and globally to estimates of kidney disease prevalence. Results Most qualifying trials (373/380, 98%) reported the distribution of male and female participants. Enrollment was imbalanced overall with male participants accounting for 62% (n =215,850) of the enrolled participants and female participants for just 38% (n =133,082). Male participants formed most of trial cohorts in AKI (65%), CKD (62%), dialysis (55%), and transplant trials (65%), whereas women were majority enrollees in GN trials (61%). CKD trials under-represented women in both US trials and worldwide. Conclusions Women are under-represented in high-impact nephrology trials with the exception of GN trials. This imbalance may contribute to disparities in outcomes and gaps in the care of women with kidney disease.
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Affiliation(s)
- Qandeel H. Soomro
- Division of Nephrology, NYU Grossman School of Medicine, NYU Langone Health, New York, New York
| | - Angela McCarthy
- Division of Nephrology, NYU Grossman School of Medicine, NYU Langone Health, New York, New York
| | - Amalya M. Charytan
- Division of Nephrology, NYU Grossman School of Medicine, NYU Langone Health, New York, New York
| | - Colin Keane
- Division of Nephrology, NYU Grossman School of Medicine, NYU Langone Health, New York, New York
| | - Dalila Varela
- Division of Nephrology, NYU Grossman School of Medicine, NYU Langone Health, New York, New York
| | - Javaughn Ways
- Division of Nephrology, NYU Grossman School of Medicine, NYU Langone Health, New York, New York
| | - Giana Ramos
- Division of Nephrology, NYU Grossman School of Medicine, NYU Langone Health, New York, New York
| | - Joey Nicholson
- NYU Health Sciences Library, NYU Grossman School of Medicine, NYU Langone Health, New York, New York
| | - David M. Charytan
- Division of Nephrology, NYU Grossman School of Medicine, NYU Langone Health, New York, New York
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8
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Snyder RA, Burtness B, Cho M, Del Rivero J, Doroshow DB, Hitchcock KE, Kalyan A, Kim CA, Lukovic J, Parikh AR, Sanford NN, Singh B, Shen C, Shroff RT, Vijayvergia N, Goodman KA, Kunz PL. The room where it happens: addressing diversity, equity, and inclusion in National Clinical Trials Network clinical trial leadership. J Natl Cancer Inst 2023; 115:1132-1138. [PMID: 37364007 PMCID: PMC11009492 DOI: 10.1093/jnci/djad121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 06/09/2023] [Accepted: 06/22/2023] [Indexed: 06/28/2023] Open
Abstract
Many multicenter randomized clinical trials in oncology are conducted through the National Clinical Trials Network (NCTN), an organization consisting of 5 cooperative groups. These groups are made up of multidisciplinary investigators who work collaboratively to conduct trials that test novel therapies and establish best practice for cancer care. Unfortunately, disparities in clinical trial leadership are evident. To examine the current state of diversity, equity, and inclusion across the NCTN, an independent NCTN Task Force for Diversity in Gastrointestinal Oncology was established in 2021, the efforts of which serve as the platform for this commentary. The task force sought to assess existing data on demographics and policies across NCTN groups. Differences in infrastructure and policies were identified across groups as well as a general lack of data regarding the composition of group membership and leadership. In the context of growing momentum around diversity, equity, and inclusion in cancer research, the National Cancer Institute established the Equity and Inclusion Program, which is working to establish benchmark data regarding diversity of representation within the NCTN groups. Pending these data, additional efforts are recommended to address diversity within the NCTN, including standardizing membership, leadership, and publication processes; ensuring diversity of representation across scientific and steering committees; and providing mentorship and training opportunities for women and individuals from underrepresented groups. Intentional and focused efforts are necessary to ensure diversity in clinical trial leadership and to encourage design of trials that are inclusive and representative of the broad population of patients with cancer in the United States.
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Affiliation(s)
- Rebecca A Snyder
- Departments of Surgical Oncology and Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Barbara Burtness
- Department of Internal Medicine, Section of Medical Oncology, and Yale Cancer Center, Yale School of Medicine, New Haven, CT, USA
| | - May Cho
- Department of Medicine, Division of Hematology/Oncology, University of California, Irvine, Irvine, CA, USA
| | - Jaydira Del Rivero
- Developmental Therapeutics Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Deborah B Doroshow
- Department of Medicine, Division of Hematology and Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Kathryn E Hitchcock
- Department of Radiation Oncology, University of Florida, Gainesville, FL, USA
| | - Aparna Kalyan
- Department of Medicine, Division of Hematology & Oncology and Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL, USA
| | - Christina A Kim
- Department of Internal Medicine, Section of Medical Oncology and Hematology, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Jelena Lukovic
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network and Department of Radiation Oncology, University of Toronto, ON, Canada
| | - Aparna R Parikh
- Massachusetts General Cancer Center, Division of Hematology/Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Nina N Sanford
- Department of Radiation Oncology, The University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Bhuminder Singh
- Department of Medicine, Division of Gastroenterology, Hepatology, and Nutrition, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Chan Shen
- Departments of Surgery and Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA
| | - Rachna T Shroff
- Department of Medicine, Division of Hematology/Oncology, University of Arizona Cancer Center, Tucson, AZ, USA
| | - Namrata Vijayvergia
- Department of Hematology/Oncology, Fox Chase Cancer Center, Philadelphia, PA, USA
| | - Karyn A Goodman
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Pamela L Kunz
- Department of Internal Medicine, Section of Medical Oncology, and Yale Cancer Center, Yale School of Medicine, New Haven, CT, USA
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9
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Lee MO, Flores B, Fassiotto M, Hobgood C. Career Advancement Among Women Physicians in Nine Academic Medicine Specialties. J Womens Health (Larchmt) 2023; 32:1073-1079. [PMID: 37192448 DOI: 10.1089/jwh.2022.0464] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/18/2023] Open
Abstract
Objective: Gender parity lags in academic medicine. We applied the Rank Equity Index (REI) to compare the longitudinal progress of women's academic medicine careers. We hypothesized that women have different rank parity in promotion by specialty based on the proportion of women in the specialty. Materials and Methods: Aggregate data by sex for medical students, residents, assistant professors, associate professors, and professors in nine specialties were obtained from the Association of American Medical Colleges for 2019-2020. Specialties were clustered into terciles based on the proportion of women in the field: upper (obstetrics and gynecology, pediatrics, psychiatry), middle (internal medicine, emergency medicine, anesthesia), and lower (surgery, urology, and orthopedic surgery). We calculated the percentage representation by sex by specialty and rank to calculate REI. Specialty-specific REI comparisons between each rank were performed to assess parity in advancement. Results: Only specialties in the upper tercile recruited proportionally more women medical students to residency training. All specialties advanced women for the resident-to-assistant professor with psychiatry, internal medicine, emergency medicine, anesthesia, urology, and orthopedic surgery that promoted women faculty at rates above parity. No specialty demonstrated parity in advancement based on sex for the assistant professor-to-associate professor or associate professor-to-professor transitions. Conclusion: Gender inequity in advancement is evident in academic medicine starting at the assistant professor-to-associate professor stage, regardless of overall proportion of women in the specialty. This suggests a common set of barriers to career advancement of women faculty in academic medicine that must be addressed starting at the early career stage.
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Affiliation(s)
- Moon O Lee
- Department of Emergency Medicine, Stanford University School of Medicine, Stanford, California, USA
| | - Brenda Flores
- Office of Faculty Development and Diversity, Stanford University School of Medicine, Stanford, California, USA
| | - Magali Fassiotto
- Office of Faculty Development and Diversity, Stanford University School of Medicine, Stanford, California, USA
| | - Cherri Hobgood
- Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA
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10
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Brockhoven F, Raphael M, Currier J, Jäderholm C, Mody P, Shannon J, Starling B, Turner-Uaandja H, Pashayan N, Arteaga I. REPRESENT recommendations: improving inclusion and trust in cancer early detection research. Br J Cancer 2023; 129:1195-1208. [PMID: 37689805 PMCID: PMC10575902 DOI: 10.1038/s41416-023-02414-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 08/01/2023] [Accepted: 08/21/2023] [Indexed: 09/11/2023] Open
Abstract
Detecting cancer early is essential to improving cancer outcomes. Minoritized groups remain underrepresented in early detection cancer research, which means that findings and interventions are not generalisable across the population, thus exacerbating disparities in cancer outcomes. In light of these challenges, this paper sets out twelve recommendations to build relations of trust and include minoritized groups in ED cancer research. The Recommendations were formulated by a range of stakeholders at the 2022 REPRESENT consensus-building workshop and are based on empirical data, including a systematic literature review and two ethnographic case studies in the US and the UK. The recommendations focus on: Long-term relationships that build trust; Sharing available resources; Inclusive and accessible communication; Harnessing community expertise; Unique risks and benefits; Compensation and support; Representative samples; Demographic data; Post-research support; Sharing results; Research training; Diversifying research teams. For each recommendation, the paper outlines the rationale, specifications for how different stakeholders may implement it, and advice for best practices. Instead of isolated recruitment, public involvement and engagement activities, the recommendations here aim to advance mutually beneficial and trusting relationships between researchers and research participants embedded in ED cancer research institutions.
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Grants
- EICEDAAP\100011 Cancer Research UK
- Cancer Research UK (CRUK)
- The International Alliance for Cancer Early Detection, an alliance between Cancer Research UK [EICEDAAP\100011], Canary Center at Stanford University, the University of Cambridge, OHSU Knight Cancer Institute, University College London and the University of Manchester.
- This work was supported by the International Alliance for Cancer Early Detection, an alliance between Cancer Research UK [EICEDAAP\100011], Canary Center at Stanford University, the University of Cambridge, OHSU Knight Cancer Institute, University College London and the University of Manchester.
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Affiliation(s)
| | - Maya Raphael
- Department of Social Anthropology, University of Cambridge, Cambridge, UK
| | - Jessica Currier
- Division of Oncological Sciences, Oregon Health & Science University, Portland, OR, USA
| | - Christina Jäderholm
- School of Public Health, Oregon Health & Science University-Portland State University, Portland, OR, USA
| | - Perveez Mody
- Department of Social Anthropology, University of Cambridge, Cambridge, UK
| | - Jackilen Shannon
- Division of Oncological Sciences, Oregon Health & Science University, Portland, OR, USA
| | - Bella Starling
- Vocal, Manchester University NHS Foundation Trust, Manchester, UK
| | | | - Nora Pashayan
- Department of Applied Health Research, University College London, London, UK
| | - Ignacia Arteaga
- Department of Social Anthropology, University of Cambridge, Cambridge, UK.
- Early Cancer Institute, University of Cambridge, Cambridge, UK.
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11
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Paul RW, Sonnier JH, Johnson EE, Hall AT, Osman A, Connors GM, Freedman KB, Bishop ME. Inequalities in the Evaluation of Male Versus Female Athletes in Sports Medicine Research: A Systematic Review. Am J Sports Med 2023; 51:3335-3342. [PMID: 36453705 DOI: 10.1177/03635465221131281] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
BACKGROUND Female sports participation continues to rise; however, inequalities between male and female athletes still exist in many areas and may extend into medical research. PURPOSE The purpose of this study was to (1) compare the number of published studies evaluating male versus female athletes in various sports and (2) identify which co-ed sports currently underrepresent female athletes in the sports medicine literature. STUDY DESIGN Systematic review; Level of evidence, 4. METHODS All nonreview research studies published from 2017 to 2021 in 6 top sports medicine journals were considered for inclusion. Sports medicine studies were included that isolated athletes, reported study outcomes specific to male and/or female patients, provided study outcomes for specific sports, and evaluated ≤3 different sports. The total number of studies reporting on male and/or female athletes were compared for all sports, and odds ratios (ORs) were calculated. Comparisons of study design, level of sports participation, outcomes assessed, and study quality were also made according to participant sex. RESULTS Overall, 669 studies were included the systematic review. Most studies isolated male athletes (70.7%), while 8.8% isolated female athletes and 20.5% included male and female athletes. Female athletes were more frequently studied in softball and volleyball, while male athletes were more commonly researched in baseball, soccer, American football, basketball, rugby, hockey, and Australian football. Notably, male athletes were largely favored in baseball/softball (91% vs 5%; OR = 18.2), rugby (72% vs 5%; OR = 14.4), soccer (65% vs 15%; OR = 4.3), and basketball (58% vs 18%; OR = 3.2). CONCLUSION Sports medicine research has favored the evaluation of male athletes in most sports, including the majority of co-ed sports. Potential reasons for this inequality of research evaluation include availability of public data and database data, financial and promotional incentives, a high percentage of male sports medicine clinicians and researchers, and sex biases in sport. While the causes of these differences are multifaceted, researchers should consider both sexes for study inclusion whenever possible, and journals should support a more balanced representation of research publications regarding male and female athletes.
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Affiliation(s)
- Ryan W Paul
- Rothman Orthopaedic Institute, Philadelphia, Pennsylvania, USA
- Hackensack Meridian School of Medicine, Nutley, New Jersey, USA
| | | | - Emma E Johnson
- Rothman Orthopaedic Institute, Philadelphia, Pennsylvania, USA
| | - Anya T Hall
- Rothman Orthopaedic Institute, Egg Harbor Township, New Jersey, USA
| | - Alim Osman
- Eastern Virginia Medical School, Norfolk, Virginia, USA
| | - Gregory M Connors
- College of Medicine, Drexel University, Philadelphia, Pennsylvania, USA
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12
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Peters SAE, Woodward M. A roadmap for sex- and gender-disaggregated health research. BMC Med 2023; 21:354. [PMID: 37704983 PMCID: PMC10500779 DOI: 10.1186/s12916-023-03060-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 08/30/2023] [Indexed: 09/15/2023] Open
Abstract
Sex and gender are fundamental aspects of health and wellbeing. Yet many research studies fail to consider sex or gender differences, and even when they do this is often limited to merely cataloguing such differences in the makeup of study populations. The evidence on sex and gender differences is thus incomplete in most areas of medicine. This article presents a roadmap for the systematic conduct of sex- and gender-disaggregated health research. We distinguish three phases: the exploration of sex and gender differences in disease risk, presentation, diagnosis, treatment, and outcomes; explaining any found differences by revealing the underlying mechanisms; and translation of the implications of such differences to policy and practice. For each phase, we provide critical methodological considerations and practical examples are provided, taken primarily from the field of cardiovascular disease. We also discuss key overarching themes and terminology that are at the essence of any study evaluating the relevance of sex and gender in health. Here, we limit ourselves to binary sex and gender in order to produce a coherent, succinct narrative. Further disaggregation by sex and gender separately and which recognises intersex, non-binary, and gender-diverse identities, as well as other aspects of intersectionality, can build on this basic minimum level of disaggregation. We envision that uptake of this roadmap, together with wider policy and educational activities, will aid researchers to systematically explore and explain relevant sex and gender differences in health and will aid educators, clinicians, and policymakers to translate the outcomes of research in the most effective and meaningful way, for the benefit of all.
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Affiliation(s)
- Sanne A E Peters
- Julius Center for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands.
- School of Public Health, The George Institute for Global Health, Imperial College London, London, UK.
- The George Institute for Global Health, University of New South Wales, Sydney, Australia.
| | - Mark Woodward
- School of Public Health, The George Institute for Global Health, Imperial College London, London, UK
- The George Institute for Global Health, University of New South Wales, Sydney, Australia
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Pandit A, Tran TB, Letton M, Cowley E, Gibbs M, Wewege MA, Hagstrom AD. Data Informing Governing Body Resistance-Training Guidelines Exhibit Sex Bias: An Audit-Based Review. Sports Med 2023; 53:1681-1691. [PMID: 37382828 PMCID: PMC10432356 DOI: 10.1007/s40279-023-01878-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/12/2023] [Indexed: 06/30/2023]
Abstract
The objective of this review was to examine the ratio of female and male participants utilised in data informing consensus statements and position stands in the field of resistance training (RT). In order to achieve this objective, we conducted an 'audit' style review. We accessed three databases: SPORTDiscus, MEDLINE and Google Scholar utilising the following search terms: resistance or strength training AND consensus statements or position statements/stands. Eligibility criteria included consensus statements and position stands for RT in youth, adults and older adults. In this paper we have used the term 'female' to describe biological sex. Gender is a social construct and often describes roles and behaviours that society assigns to men or women. In this paper we have used the term 'women' to describe gender. Reference lists from each guideline were screened with the number of male and female participants extracted from each study. We also extracted data on the gender of the authors of the statements. We located 11 guidelines encompassing a total of 104,251,363 participants. Youth guidelines were comprised of 69% male participants. There were 287 studies that included both sexes, 205 male-only and 92 female-only studies. Adult guidelines were comprised of 70% male participants. There were 104 studies that included both sexes, 240 male-only and 44 female-only studies. Older adult guidelines were comprised of 54% female participants. There were 395 studies that included both sexes, 112 male-only and 83 female-only studies. Women authors comprised 13% of all authors of position stands and consensus statements. These results demonstrate an under-representation of females and women as both participants and as authors. It is imperative to ensure that data informing governing body guidelines and consensus statements are representative of the population they aim to inform. If this is not possible, guidelines should clearly state when their data and recommendations are based primarily upon one sex.
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Affiliation(s)
- Anurag Pandit
- Faculty of Medicine and Health, School of Health Sciences, University of New South Wales, Sydney, NSW, Australia
| | - Thai Binh Tran
- Faculty of Medicine and Health, School of Health Sciences, University of New South Wales, Sydney, NSW, Australia
- Faculty of Medicine and Health, School of Medical, Indigenous and Health Sciences, University of Wollongong, Wollongong, NSW, Australia
| | - Meg Letton
- Faculty of Medicine and Health, School of Health Sciences, University of New South Wales, Sydney, NSW, Australia
| | - Emma Cowley
- Department of Exercise and Sport Science, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Mitchell Gibbs
- Faculty of Medicine and Health, School of Health Sciences, University of New South Wales, Sydney, NSW, Australia
| | - Michael A Wewege
- Faculty of Medicine and Health, School of Health Sciences, University of New South Wales, Sydney, NSW, Australia
- Centre for Pain IMPACT, Neuroscience Research Australia, Sydney, NSW, Australia
| | - Amanda D Hagstrom
- Faculty of Medicine and Health, School of Health Sciences, University of New South Wales, Sydney, NSW, Australia.
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Nguyen AXL, Joly-Chevrier M, Wu AY. American Academy of Ophthalmology Clinical Practice Guidelines and Financial Disclosures-Where Is the Money Going?-Reply. JAMA Ophthalmol 2023; 141:805. [PMID: 37471067 DOI: 10.1001/jamaophthalmol.2023.3110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/21/2023]
Affiliation(s)
- Anne Xuan-Lan Nguyen
- Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada
| | | | - Albert Y Wu
- Department of Ophthalmology, Stanford University School of Medicine, Stanford, California
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15
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Marrie RA, Chataway J, Bierer BE, Finlayson M, Martinez-Lapiscina EH, Panagoulias J, Sormani MP, Williams MJ, Amezcua L. Enhancing diversity of clinical trial populations in multiple sclerosis. Mult Scler 2023; 29:1174-1185. [PMID: 37555490 PMCID: PMC10413791 DOI: 10.1177/13524585231189677] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 04/19/2023] [Accepted: 05/02/2023] [Indexed: 08/10/2023]
Abstract
BACKGROUND Demographic characteristics, social determinants of health (SDoH), health inequities, and health disparities substantially influence the general and disease-specific health outcomes of people with multiple sclerosis (MS). Participants in clinical trials do not represent all people with MS treated in practice. OBJECTIVE To provide recommendations for enhancing diversity and inclusion in clinical trials in MS. METHODS We held an international workshop under the Auspices of the International Advisory Committee on Clinical Trials in MS (the "Committee") to develop recommendations regarding diversity and inclusivity of participants of clinical trials in MS. Workshop attendees included members of the Committee as well as external participants. External participants were selected based on expertise in trials, SDoH, health equity and regulatory science, and diversity with respect to gender, race, ethnicity, and geography. RESULTS Recommendations include use of diversity plans, community engagement and education, cultural competency training, biologically justified rather than templated eligibility criteria, adaptive designs that allow broadening of eligibility criteria over the course of a trial, and logistical and practical adjustments to reduce study participant burden. Investigators should report demographic and SDoH characteristics of participants. CONCLUSION These recommendations provide sponsors and investigators with methods of improving diversity and inclusivity of clinical trial populations in MS.
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Affiliation(s)
- Ruth Ann Marrie
- Departments of Internal Medicine and Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Jeremy Chataway
- Queen Square Multiple Sclerosis Centre, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London, London, UK/National Institute for Health Research, University College London Hospitals, Biomedical Research Centre, London, UK/Medical Research Council Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, University College London, London, UK
| | - Barbara E Bierer
- The Multi-Regional Clinical Trials Center of Brigham and Women’s Hospital and Harvard, Cambridge, MA, USA/Harvard Medical School, Boston, MA, USA
| | - Marcia Finlayson
- School of Rehabilitation Therapy, Faculty of Health Sciences, Queen’s University, Kingston, ON, Canada
| | - Elena H Martinez-Lapiscina
- Center of Neuroimmunology, Laboratory of Advanced Imaging in Neuroimmunological Diseases, Hospital Clinic Barcelona, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain/Office of Therapies for Neurological and Psychiatric Disorders, Human Medicines Division, European Medicines Agency, Amsterdam, The Netherlands
| | | | | | | | - Lilyana Amezcua
- Department of Neurology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
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16
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Lin Z, Li N. Contextualizing Gender Disparity in Editorship in Psychological Science. PERSPECTIVES ON PSYCHOLOGICAL SCIENCE 2023; 18:887-907. [PMID: 36375172 DOI: 10.1177/17456916221117159] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/20/2023]
Abstract
Discourse on gender diversity tends to overlook differences across levels of hierarchy (e.g., students, faculty, and editors) and critical dimensions (e.g., subdisciplines and geographical locations). Further ignored is its intersection with global diversity-representation from different countries. Here we document and contextualize gender disparity from perspectives of equal versus expected representation in journal editorship, by analyzing 68 top psychology journals in 10 subdisciplines. First, relative to ratios as students and faculty, women are underrepresented as editorial-board members (41%) and-unlike previous results based on one subfield-as editors-in-chief (34%) as well. Second, female ratios in editorship vary substantially across subdisciplines, genres of scholarship (higher in empirical and review journals than in method journals), continents/countries/regions (e.g., higher in North America than in Europe), and journal countries of origin (e.g., higher in American journals than in European journals). Third, under female (vs. male) editors-in-chief, women are much better represented as editorial-board members (47% vs. 36%), but the geographical diversity of editorial-board members and authorship decreases. These results reveal new local and broad contexts of gender diversity in editorship in psychology, with policy implications. Our approach also offers a methodological guideline for similar disparity research in other fields.
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Affiliation(s)
- Zhicheng Lin
- School of Humanities and Social Science, The Chinese University of Hong Kong, Shenzhen
| | - Ningxi Li
- School of Humanities and Social Science, The Chinese University of Hong Kong, Shenzhen
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17
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Pasin C, Consiglio CR, Huisman J, de Lange AMG, Peckham H, Vallejo-Yagüe E, Abela IA, Islander U, Neuner-Jehle N, Pujantell M, Roth O, Schirmer M, Tepekule B, Zeeb M, Hachfeld A, Aebi-Popp K, Kouyos RD, Bonhoeffer S. Sex and gender in infection and immunity: addressing the bottlenecks from basic science to public health and clinical applications. ROYAL SOCIETY OPEN SCIENCE 2023; 10:221628. [PMID: 37416827 PMCID: PMC10320357 DOI: 10.1098/rsos.221628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 06/14/2023] [Indexed: 07/08/2023]
Abstract
Although sex and gender are recognized as major determinants of health and immunity, their role is rarely considered in clinical practice and public health. We identified six bottlenecks preventing the inclusion of sex and gender considerations from basic science to clinical practice, precision medicine and public health policies. (i) A terminology-related bottleneck, linked to the definitions of sex and gender themselves, and the lack of consensus on how to evaluate gender. (ii) A data-related bottleneck, due to gaps in sex-disaggregated data, data on trans/non-binary people and gender identity. (iii) A translational bottleneck, limited by animal models and the underrepresentation of gender minorities in biomedical studies. (iv) A statistical bottleneck, with inappropriate statistical analyses and results interpretation. (v) An ethical bottleneck posed by the underrepresentation of pregnant people and gender minorities in clinical studies. (vi) A structural bottleneck, as systemic bias and discriminations affect not only academic research but also decision makers. We specify guidelines for researchers, scientific journals, funding agencies and academic institutions to address these bottlenecks. Following such guidelines will support the development of more efficient and equitable care strategies for all.
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Affiliation(s)
- Chloé Pasin
- Collegium Helveticum, 8092 Zurich, Switzerland
- Institute of Medical Virology, University of Zurich, 8057 Zurich, Switzerland
- Department of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, 8091 Zurich, Switzerland
| | - Camila R. Consiglio
- Department of Women's and Children's Health, Karolinska Institutet, 17165 Stockholm, Sweden
| | - Jana S. Huisman
- Institute of Integrative Biology, ETH Zurich, 8092 Zurich, Switzerland
- Physics of Living Systems, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - Ann-Marie G. de Lange
- Department of Clinical Neurosciences, Lausanne University Hospital (CHUV) and University of Lausanne, 1011 Lausanne, Switzerland
- Department of Psychology, University of Oslo, 0373 Oslo, Norway
- Department of Psychiatry, University of Oxford, Oxford OX3 7JX, UK
| | - Hannah Peckham
- Centre for Adolescent Rheumatology Versus Arthritis at UCL, UCLH and GOSH, London WC1E 6JF, UK
| | | | - Irene A. Abela
- Institute of Medical Virology, University of Zurich, 8057 Zurich, Switzerland
- Department of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, 8091 Zurich, Switzerland
| | - Ulrika Islander
- Department of Rheumatology and Inflammation Research, University of Gothenburg, 40530 Gothenburg, Sweden
- SciLifeLab, University of Gothenburg, 40530 Gothenburg, Sweden
| | - Nadia Neuner-Jehle
- Institute of Medical Virology, University of Zurich, 8057 Zurich, Switzerland
- Department of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, 8091 Zurich, Switzerland
| | - Maria Pujantell
- Institute of Immunology, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany
- Leibniz Institute of Virology, 20251 Hamburg, Germany
| | - Olivia Roth
- Marine Evolutionary Biology, Zoological Institute, Christian-Albrechts-University Kiel, 24118 Kiel, Germany
| | - Melanie Schirmer
- Emmy Noether Group for Computational Microbiome Research, ZIEL – Institute for Food and Health, Technical University of Munich, 85354 Freising, Germany
| | - Burcu Tepekule
- Institute of Medical Virology, University of Zurich, 8057 Zurich, Switzerland
- Department of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, 8091 Zurich, Switzerland
| | - Marius Zeeb
- Institute of Medical Virology, University of Zurich, 8057 Zurich, Switzerland
- Department of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, 8091 Zurich, Switzerland
| | - Anna Hachfeld
- Department of Infectious Diseases, University Hospital and University of Bern, 3012 Bern, Switzerland
| | - Karoline Aebi-Popp
- Department of Infectious Diseases, University Hospital and University of Bern, 3012 Bern, Switzerland
- Department of Obstetrics and Gynecology, Lindenhofspital, 3012 Bern, Switzerland
| | - Roger D. Kouyos
- Institute of Medical Virology, University of Zurich, 8057 Zurich, Switzerland
- Department of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, 8091 Zurich, Switzerland
| | - Sebastian Bonhoeffer
- Collegium Helveticum, 8092 Zurich, Switzerland
- Institute of Integrative Biology, ETH Zurich, 8092 Zurich, Switzerland
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18
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Affiliation(s)
- Liisa Am Galea
- Centre for Addiction and Mental Health, Department of Psychiatry, Pharmacology and Toxicology, University of Toronto, Toronto, Canada
| | - Rulan S Parekh
- Departments of Medicine, Paediatrics, Epidemiology, and Health Policy and Management Evaluation at Women's College Hospital, Hospital for Sick Children, and University of Toronto, Toronto, Canada
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Zhang J, Torchet R, Julienne H. Gender-based disparities and biases in science: An observational study of a virtual conference. PLoS One 2023; 18:e0286811. [PMID: 37285372 DOI: 10.1371/journal.pone.0286811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 05/23/2023] [Indexed: 06/09/2023] Open
Abstract
Success in STEM (Science, Technology, Engineering, and Math) remains influenced by race, gender, and socioeconomic status. Here, we focus on the impact of gender on question-asking behavior during the 2021 JOBIM virtual conference (Journées Ouvertes en Biologie et Mathématiques). We gathered quantitative and qualitative data including : demographic information, question asking motivations, live observations and interviews of participants. Quantitative analyses include unprecedented figures such as the fraction of the audience identifying as LGBTQIA+ and an increased attendance of women in virtual conferences. Although parity was reached in the audience, women asked half as many questions as men. This under-representation persisted after accounting for seniority of the asker. Interviews of participants highlighted several barriers to oral expression encountered by women and gender minorities : negative reactions to their speech, discouragement to pursue a career in research, and gender discrimination/sexual harassment. Informed by the study, guidelines for conference organizers have been written. The story behind the making of this study has been highlighted in a Nature Career article.
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Affiliation(s)
- Junhanlu Zhang
- European Synchrotron Radiation Facility, Grenoble, France
| | - Rachel Torchet
- Bioinformatics and Biostatistics Hub, Université Paris Cité, Institut Pasteur, Paris, France
| | - Hanna Julienne
- Bioinformatics and Biostatistics Hub, Université Paris Cité, Institut Pasteur, Paris, France
- Statistical Genetic Units, Université Paris Cité, Institut Pasteur, Paris, France
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20
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Curtis LM. Strategies to achieve gender equity in nephrology. Nat Rev Nephrol 2023:10.1038/s41581-023-00703-2. [PMID: 37016092 DOI: 10.1038/s41581-023-00703-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/06/2023]
Affiliation(s)
- Lisa M Curtis
- University of Alabama at Birmingham, Birmingham, AL, USA.
- Division of Nephrology, University of Alabama at Birmingham, Birmingham, AL, USA.
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21
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Nguyen AXL, Joly-Chevrier M, Nguyen DD, Wu AY. Financial Disclosures Reported by Industry Among Authors of the American Academy of Ophthalmology Clinical Practice Guidelines. JAMA Ophthalmol 2023; 141:378-383. [PMID: 36928457 PMCID: PMC10020930 DOI: 10.1001/jamaophthalmol.2023.0267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Accepted: 01/24/2023] [Indexed: 03/18/2023]
Abstract
Importance Recommendations of clinical guidelines affect physicians' care delivery. Potential bias and undeclared conflicts of interests (COIs) among guideline authors can impact clinical practice decisions. Objective To assess financial disclosures reported by physician authors of the American Academy of Ophthalmology (AAO) Practice Pattern Guidelines compared with those reported by industry to evaluate the disclosures' accuracy. Design, Setting, and Participants In this cross-sectional study, all clinical guidelines in the AAO Preferred Practice Patterns (PPP) since 2013 (first year with publicly available industry payment reports) were reviewed on May 1, 2022. Guideline physician authors' name and their reported COI disclosure were extracted from the guideline publication. Payments to physician authors reported by industry were retrieved from the US Centers for Medicare & Medicaid Open Payments database. Physician authors serving on the AAO guideline committee were included. Main Outcomes and Measures The primary outcome measure was the accuracy of authors' COIs disclosure. Secondary outcome measures were payments to physician authors reported by industry, the types of payments, and authors' gender. Results A total of 24 AAO guidelines released between 2016 and 2020 were included. Per guideline, there was a mean (SD) of 7.83 (2.24) physician authors. After removing 14 nonphysician authors, 188 physician author names remained, including 83 names assigned as women (44.1%) and 105 names assigned as men (55.9%). Authors could be counted multiple times in these 188 names. According to the Open Payments database, industry reported that 112 of 188 physician authors (59.6%) had at least received 1 payment while serving on the guideline committee, with a payment mean (SD) of $29 849.35 ($54 131.56). According to AAO guidelines, 149 authors (79.3%) had no financial disclosures while serving on the guideline committee. Among these 149 authors, most authors (81 [54.4%]) had payments reported by industry on the Open Payments database not disclosed within the guideline reports. Women physicians were paid significantly more than men for total payments (median [IQR] payments, $15 265 [$598.47-$41 104.67] vs $301.48 [$218.85-$14 615.09]; difference, $14 963.52; P = .003). Conclusions and Relevance Industry reported physician guideline authors to have received significant industry payments, some of which were not disclosed within information of the guidelines. To strengthen author transparency regarding these reported disclosures, the authors may want to review and resolve such potential discrepancies during the review and subsequent publication of guidelines.
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Affiliation(s)
- Anne Xuan-Lan Nguyen
- Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada
| | | | - David-Dan Nguyen
- Division of Urology, Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Albert Y. Wu
- Department of Ophthalmology, Stanford University School of Medicine, Stanford, California
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Shalit A, Vallely L, Nguyen R, Bohren M, Wilson A, Homer CSE, Vogel J. The representation of women on Australian clinical practice guideline panels, 2010-2020. Med J Aust 2023; 218:84-88. [PMID: 36599458 PMCID: PMC10953318 DOI: 10.5694/mja2.51831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 10/19/2022] [Accepted: 10/26/2022] [Indexed: 01/06/2023]
Abstract
OBJECTIVES To assess the composition by gender of Australian clinical practice guideline development panels; to explore guideline development-related factors that influence the composition of panels. DESIGN, SETTING, PARTICIPANTS Survey of clinical guidelines published in Australia during 2010-2020 that observed the 2016 NHMRC Standards for Guidelines, identified (June 2021) in the NHMRC Clinical Practice Guideline Portal or by searching the Guideline International Network guidelines library, the Trip medical database, and PubMed. The gender of contributors to guideline development was inferred from gendered titles (guideline documents) or pronouns (online biographies). MAIN OUTCOME MEASURES The overall proportion of guideline panel members - the guideline contributors who formally considered evidence and formulated recommendations (ie, guideline panel chairs and members) - who were women. RESULTS Of 406 eligible guidelines, 335 listed the names of people who contributed to their development (82%). Of 7472 named contributors (including 511 guideline panel chairs [6.8%] and 5039 guideline panel members [67.4%]), 3514 were men (47.0%), 3345 were women (44.8%), and gender could not be determined for 612 (8.2%). A total of 215 guideline panel chairs were women (42.1%), 280 were men (54.8%); 2566 guideline panel members were men (50.9%), 2071 were women (41.1%). The proportion of female guideline panel members was smaller than 40% for 179 guidelines (53%) and larger than 60% for 71 guidelines (21%). The median guideline proportion of female panel members was smaller than 50% for all but two years (2017, 2018). CONCLUSIONS The representation of women in health leadership roles in Australia does not reflect their level of participation in the health care workforce. In particular, clinical guideline development bodies should develop transparent policies for increasing the participation of women in guideline development panels.
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Affiliation(s)
| | | | | | - Meghan Bohren
- Melbourne School of Population and Global HealthUniversity of MelbourneMelbourneVIC
| | | | | | - Joshua Vogel
- The Burnet InstituteMelbourneVIC
- Cochrane AustraliaMonash UniversityMelbourneVIC
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Carcel C, Woodward M. Gender diversity of clinical practice guideline panels in Australia: important opportunities for progress. Med J Aust 2023; 218:73-74. [PMID: 36625366 DOI: 10.5694/mja2.51832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 11/29/2022] [Accepted: 11/30/2022] [Indexed: 01/11/2023]
Affiliation(s)
- Cheryl Carcel
- The George Institute for Global Health, University of New South Wales, Sydney, NSW
| | - Mark Woodward
- The George Institute for Global Health, University of New South Wales, Sydney, NSW
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Let's Have Some Clarity on Academic Parity. Am J Gastroenterol 2023; 118:185-187. [PMID: 36563303 DOI: 10.14309/ajg.0000000000002104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Accepted: 11/14/2022] [Indexed: 12/25/2022]
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The sex gap in sports and exercise medicine research: who does research on females? Scientometrics 2023. [DOI: 10.1007/s11192-023-04641-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
AbstractFemales are underrepresented in sports and exercise medicine research, both as authors and as research participants. The aim of this study was therefore to explore who does sports and exercise medicine research on females. All original research articles with female-only samples published in six major sports and exercise medicine journals over a 7-year period (2014–2020; n = 334) were examined. Out of the 2027 authors of the articles in question, 1149 were categorized as male (56.7%) and 850 were categorized as female (41.9%; 28 [1.4%] could not be categorized). A slight majority of the articles had a female as first author (51.5%), while the majority of the last authors were male (62.3%). Binomial tests of proportions revealed that females were overrepresented in all author roles in this sample compared to the field at large, while chi-square tests of proportions indicated minimal variations in female authorship across the studied period. These findings indicate that females are relatively more likely to do research on females than males are, and that the rate of female authorship remained relatively constant over time.
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Carrillo MJ, Martín U, Bacigalupe A. Gender Inequalities in Publications about COVID-19 in Spain: Authorship and Sex-Disaggregated Data. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2025. [PMID: 36767391 PMCID: PMC9916323 DOI: 10.3390/ijerph20032025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 01/17/2023] [Accepted: 01/18/2023] [Indexed: 06/18/2023]
Abstract
Gender inequalities in biomedical literature have been widely reported in authorship as well as the scarcity of results that are stratified by sex in the studies. We conducted a bibliometric review of articles on COVID-19 published in the main Spanish medical journals between April 2020 and May 2021. The purpose of this study was to analyse differences in authorship order and composition by sex and their evolution over time, as well as the frequency of sex-disaggregated empirical results and its relationship with the author sex in articles on COVID-19 in the main Spanish biomedical journals. We identified 914 articles and 4921 authors, 57.5% men and 42.5% women. Women accounted for 36.7% of first authors and for 33.7% of last authors. Monthly variation in authorship over the course of the pandemic indicates that women were always less likely to publish as first authors. Only 1.0% of the articles broke down empirical results by sex. Disaggregation of results by sex was significantly more frequent when women were first authors and when women were the majority in the authorship. It is important to make gender inequalities visible in scientific dissemination and to promote gender-sensitive research, which can help to reduce gender bias in clinical studies as well as to design public policies for post-pandemic recovery that are more gender-equitable.
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Affiliation(s)
- Marta Jiménez Carrillo
- Social Determinants of Health and Demographic Change, Opik Research Group, University of the Basque Country (UPV/EHU), 48080 Leioa, Spain
- Doctoral Program in Public Health, Department of Preventive Medicine and Public Health, University of the Basque Country (UPV/EHU), 48080 Leioa, Spain
- Department of Sociology and Social Work, University of the Basque Country (UPV/EHU), 48080 Leioa, Spain
| | - Unai Martín
- Social Determinants of Health and Demographic Change, Opik Research Group, University of the Basque Country (UPV/EHU), 48080 Leioa, Spain
- Department of Sociology and Social Work, University of the Basque Country (UPV/EHU), 48080 Leioa, Spain
| | - Amaia Bacigalupe
- Social Determinants of Health and Demographic Change, Opik Research Group, University of the Basque Country (UPV/EHU), 48080 Leioa, Spain
- Department of Sociology and Social Work, University of the Basque Country (UPV/EHU), 48080 Leioa, Spain
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Vengeliene V, Qin L. Editorial: Women in translational pharmacology: 2021. Front Pharmacol 2023; 14:1162722. [PMID: 36891276 PMCID: PMC9986602 DOI: 10.3389/fphar.2023.1162722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 02/14/2023] [Indexed: 02/22/2023] Open
Affiliation(s)
- Valentina Vengeliene
- Department of Neurobiology and Biophysics, Institute of Biosciences, Life Sciences Center, Vilnius University, Vilnius, Lithuania
| | - Lu Qin
- Heart and Vascular Institute, The Pennsylvania State University College of Medicine, Hershey, PA, United States
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Liu S, Song L, Dai W, Liu M, Zhang H, Zhang X, Li H, Liu X, Lv Y, Hu Y. Worldwide productivity and research trend of publications concerning electroactive materials and spinal cord injury: A bibliometric study. Front Bioeng Biotechnol 2023; 11:1094059. [PMID: 36923456 PMCID: PMC10009169 DOI: 10.3389/fbioe.2023.1094059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 02/09/2023] [Indexed: 03/02/2023] Open
Abstract
Purpose: We investigated the current state and trends in the area during the previous 10 years using bibliometric approaches to evaluate the global scientific output of research on electroactive materials and spinal cord injury. Methods: Studies on spinal cord injury in electroactive materials that were published between 2012 and 2022 were located using the Web of science (WOS) datebase. The software programs bibliometrix R-package and CiteSpace were used to do quantitative analyses of annual publications, nation, author, institution, journal source, co-cited references, and keywords. The studies were categorized by the research's main points using a qualitative analysis, and publications having more than 10 citations each year. Results: In the final analysis, 1,330 relevant papers or reviews were included. There is an increased tendency in both the average annual citation rate and the number of publications in the discipline. The United States and the University of Toronto are the countries and institutions that have contributed the most to this discipline, respectively. The majority of authors are from the China and United States. Zhang Y is the author with the most published articles and holds the top position in the cited author h-index species. The journal with the highest number of published articles is "Disability and rehabilitation"; the journal is divided into four main areas including physics, materials, chemistry, molecular, and biology. The keyword analysis revealed a shift in research hotspots from schwann cell, fracture, and urinary disorders to carbon-based materials, functional recovery, and surgery. Analysis of qualitative data revealed that the role and mechanism of injectable conductive hydrogels in spinal cord healing after damage is a hot topic of current study, with the mechanism primarily focusing on the inhibition of oxidative stress (Nrf2) and apoptosis (Casepase 3). Conclusion: Our bibliometric analysis indicates that research on electroactive materials for spinal cord injury remains an active field of study. Moreover, contemporary research is concentrated on carbon-based materials, functional rehabilitation, and surgery.
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Affiliation(s)
- Sirui Liu
- Beijing Institute of Dental Research, Beijing Stomatological Hospital, Capital Medical University, Beijing, China
| | - Lin Song
- Beijing Institute of Dental Research, Beijing Stomatological Hospital, Capital Medical University, Beijing, China.,Department of Periodontology, Beijing Stomatological Hospital, Capital Medical University, Beijing, China
| | - Weishu Dai
- Beijing Institute of Dental Research, Beijing Stomatological Hospital, Capital Medical University, Beijing, China
| | - Mengdie Liu
- The Third Medical Center of PLA General Hospital, Beijing, China.,The First Medical Center of PLA General Hospital, Beijing, China
| | - Huijing Zhang
- Beijing Institute of Dental Research, Beijing Stomatological Hospital, Capital Medical University, Beijing, China.,Department of Periodontology, Beijing Stomatological Hospital, Capital Medical University, Beijing, China
| | - Xueyan Zhang
- Beijing Institute of Dental Research, Beijing Stomatological Hospital, Capital Medical University, Beijing, China
| | - Hongyu Li
- Beijing Institute of Dental Research, Beijing Stomatological Hospital, Capital Medical University, Beijing, China
| | - Xiu Liu
- Beijing Institute of Dental Research, Beijing Stomatological Hospital, Capital Medical University, Beijing, China
| | - Yan Lv
- Beijing Institute of Dental Research, Beijing Stomatological Hospital, Capital Medical University, Beijing, China
| | - Ying Hu
- Beijing Institute of Dental Research, Beijing Stomatological Hospital, Capital Medical University, Beijing, China
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29
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Riche CT, Reif LK, Nguyen NT, Alakiu GR, Seo G, Mathad JS, McNairy ML, Cordeiro AA, Kinikar A, Walsh KF, Deschamps MM, Nerette S, Nimkar S, Kayange N, Jaka H, Mwaisungu HM, Morona D, Peter TY, Suryavanshi N, Fitzgerald DW, Downs JA, Hokororo A. "Mobilizing our leaders": A multi-country qualitative study to increase the representation of women in global health leadership. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0000646. [PMID: 36962949 PMCID: PMC10021821 DOI: 10.1371/journal.pgph.0000646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 12/21/2022] [Indexed: 02/01/2023]
Abstract
INTRODUCTION Women play an essential role in health care delivery, and it is vital that they have equal representation in health leadership for equity, innovation, and the strengthening of health systems globally. Yet women remain vastly underrepresented in global health leadership positions, providing a clear example of the deeply rooted power imbalances that are central to the calls to decolonize global health. We conducted a multi-country study in Haiti, Tanzania, India, and the USA to examine gender-based challenges to career advancement for women in the global health workforce. Quantitative data on the type and prevalence of gender-based challenges has been previously reported. In this study, we analyze qualitative data collected through focus group discussions and in-depth interviews to understand women's experiences of gender-based obstacles to career advancement, their perceptions of underlying drivers, and perspectives on effective solutions. Guided by an adaptation of the Social Action Theory, we conducted focus group discussions and in-depth interviews with women at 4 major academic centers for clinical care and research in Haiti, India, Tanzania, and the United States. In total, 85 women participated in focus groups and 15 also participated in in-depth interviews. Discussions and interviews were conducted in the local language, by an experienced local facilitator unaffiliated with the participating institution, between 2017 and 2018. Discussions were recorded, transcribed, and translated. Data were analyzed by interpretive phenomenological methods for emergent themes. Three transcendent themes on gender-based challenges were identified: 1) cultural power imbalance, referring to the prevailing norms and engrained assumptions that women are less capable than men and that women's primary responsibility should be to their families; 2) institutional power imbalance, referring to the systematic gender bias upheld by existing leadership and power structures, and ranging from exclusion from career development opportunities to sexual harassment and assault; and 3) restricted agency, referring to women's limited ability to change their circumstances because of unequal cultural and institutional structures. Participants also described local, actionable solutions to address these barriers. These included: 1) formal reporting systems for sexual harassment and assault; 2) peer support and mentorship; and 3) accessible leadership training and mandatory gender equity training. Participants proposed feasible strategies to address gender-based challenges that could improve women's retention in health careers and foster their rise to leadership. Increasing the representation of women in global health leadership positions responds directly to efforts to decolonize global health and is integral to strengthening health systems and improving health outcomes for women and children worldwide.
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Affiliation(s)
- Claudia T Riche
- The Haitian Group for the Study of Kaposi's Sarcoma and Opportunistic Infections (GHESKIO), Port-au-Prince, Haiti
| | - Lindsey K Reif
- Department of Medicine, Center for Global Health, Weill Cornell Medicine, New York, New York, United States of America
| | - Natalie T Nguyen
- Department of Medicine, Center for Global Health, Weill Cornell Medicine, New York, New York, United States of America
| | - G Rinu Alakiu
- Department of Medicine, Center for Global Health, Weill Cornell Medicine, New York, New York, United States of America
| | - Grace Seo
- Department of Medicine, Center for Global Health, Weill Cornell Medicine, New York, New York, United States of America
| | - Jyoti S Mathad
- Department of Medicine, Center for Global Health, Weill Cornell Medicine, New York, New York, United States of America
- Department of Medicine, Division of General Internal Medicine, Weill Cornell Medicine, New York, New York, United States of America
| | - Margaret L McNairy
- Department of Medicine, Center for Global Health, Weill Cornell Medicine, New York, New York, United States of America
- Department of Medicine, Division of General Internal Medicine, Weill Cornell Medicine, New York, New York, United States of America
| | - Alexandra A Cordeiro
- Department of Medicine, Center for Global Health, Weill Cornell Medicine, New York, New York, United States of America
| | - Aarti Kinikar
- BJ Government Medical College and Sassoon Hospital, Pune, India
| | - Kathleen F Walsh
- Department of Medicine, Center for Global Health, Weill Cornell Medicine, New York, New York, United States of America
- Department of Medicine, Division of General Internal Medicine, Weill Cornell Medicine, New York, New York, United States of America
| | - Marie Marcelle Deschamps
- The Haitian Group for the Study of Kaposi's Sarcoma and Opportunistic Infections (GHESKIO), Port-au-Prince, Haiti
| | - Sandy Nerette
- The Haitian Group for the Study of Kaposi's Sarcoma and Opportunistic Infections (GHESKIO), Port-au-Prince, Haiti
| | - Smita Nimkar
- BJ Government Medical College-Johns Hopkins University Clinical Trials Unit, Pune, India
| | - Neema Kayange
- Department of Pediatrics, Bugando Medical Centre and Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - Hyasinta Jaka
- Department of Medicine, Bugando Medical Centre and Catholic University of Health and Allied Sciences, Mwanza, Tanzania
- Department of Internal Medicine, Mwanza College of Health and Allied Sciences, Mwanza, Tanzania
| | - Halima M Mwaisungu
- Department of Medical Ethics, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - Domenica Morona
- School of Public Health, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - Thandiwe Yvonne Peter
- Department of Administration, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - Nishi Suryavanshi
- BJ Government Medical College-Johns Hopkins University Clinical Trials Unit, Pune, India
| | - Daniel W Fitzgerald
- Department of Medicine, Center for Global Health, Weill Cornell Medicine, New York, New York, United States of America
| | - Jennifer A Downs
- Department of Medicine, Center for Global Health, Weill Cornell Medicine, New York, New York, United States of America
- Department of Medicine, Bugando Medical Centre and Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - Adolfine Hokororo
- Department of Pediatrics, Bugando Medical Centre and Catholic University of Health and Allied Sciences, Mwanza, Tanzania
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30
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Antequera A, Cuadrado-Conde MA, Roy-Vallejo E, Montoya-Martínez M, León-García M, Madrid-Pascual O, Calderón-Larrañaga S. Lack of sex-related analysis and reporting in Cochrane Reviews: a cross-sectional study. Syst Rev 2022; 11:281. [PMID: 36572932 PMCID: PMC9791738 DOI: 10.1186/s13643-021-01867-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 12/02/2021] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Sex-specific analysis and reporting may allow a better understanding of intervention effects and can support the decision-making process. Well-conducted systematic reviews (SRs), like those carried out by the Cochrane Collaboration, provide clinical responses transparently and stress gaps of knowledge. This study aimed to describe the extent to which sex is analysed and reported in a cross-section of Cochrane SRs of interventions, and assess the association with the gender of main authorships. METHODS We searched SRs published during 2018 within the Cochrane Database of Systematic Reviews. An investigator appraised the sex-related analysis and reporting across sections of SRs and collected data on gender and country of affiliation of the review first and last authors, and a second checked for accuracy. We conducted descriptive statistics and bivariate logistic regression to explore the association between the gender of the authors and sex-related analysis and reporting. RESULTS Six hundred and ten Cochrane SRs were identified. After removing those that met no eligibility criteria, 516 reviews of interventions were included. Fifty-six reviews included sex-related reporting in the abstract, 90 considered sex in their design, 380 provided sex-disaggregated descriptive data, 142 reported main outcomes or performed subgroup analyses by sex, and 76 discussed the potential impact of sex or the lack of such on the interpretations of findings. Women represented 53.1 and 42.2% of first and last authorships, respectively. Women authors (in first and last position) had a higher possibility to report sex in at least one of the review sections (OR 2.05; CI 95% 1.12-3.75, P=0.020) than having none. CONCLUSIONS Sex consideration amongst Cochrane SRs was frequently missing. Structured guidance to sex-related analysis and reporting is needed to enhance the external validity of findings. Likewise, including gender diversity within the research workforce and relevant authorship positions may foster equity in the evidence generated.
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Affiliation(s)
- Alba Antequera
- Biomedical Research Institute Sant Pau, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
| | | | - Emilia Roy-Vallejo
- Internal Medicine Department, Hospital Universitario de La Princesa, Madrid, Spain
| | - María Montoya-Martínez
- Servicio Murciano de Salud, Coordinación Estratégica para la Cronicidad Avanzada y Atención Sociosanitaria, Murcia, Spain
| | - Montserrat León-García
- Biomedical Research Institute Sant Pau, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
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31
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Daitch V, Turjeman A, Poran I, Tau N, Ayalon-Dangur I, Nashashibi J, Yahav D, Paul M, Leibovici L. Underrepresentation of women in randomized controlled trials: a systematic review and meta-analysis. Trials 2022; 23:1038. [PMID: 36539814 PMCID: PMC9768985 DOI: 10.1186/s13063-022-07004-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 12/12/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Although regulatory changes towards correcting the underrepresentation of women in randomized controlled trials (RCTs) occurred (National Institutes of Health 1994), concerns exist about whether an improvement is taking place. In this systematic review and meta-analysis, we aimed to assess the inclusion rates of women in recent RCTs and to explore the potential barriers for the enrollment of women. METHODS RCTs published in 2017 examining any type of intervention in adults were searched in PubMed and Cochrane Library. The following predefined medical fields were included: cardiovascular diseases, neoplasms, endocrine system diseases, respiratory tract diseases, bacterial and fungal infections, viral diseases, digestive system diseases, and immune system diseases. Studies were screened independently by two reviewers, and an equal number of studies was randomly selected per calendric month. The primary outcome was the enrollment rate of women, calculated as the number of randomized women patients divided by the total number of randomized patients. Rates were weighted by their inverse variance; statistical significance was tested using general linear models (GLM). RESULTS Out of 398 RCTs assessed for eligibility, 300 RCTs were included. The enrollment rate of women in all the examined fields was lower than 50%, except for immune system diseases [median enrollment rate of 68% (IQR 46 to 81)]. The overall median enrollment rate of women was 41% (IQR 27 to 54). The median enrollment rate of women decreased with older age of the trials' participants [mean age of trials' participants ≤ 45 years: 47% (IQR 30-64), 46-55 years: 46% (IQR 33-58), 56-62 years: 38% (IQR 27-50), ≥ 63 years: 33% (IQR 20-46), p < 0.001]. Methodological quality characteristics showed no significant association with the enrollment rates of women. Out of the 300 included RCTs, eleven did not report on the number of included women. There was no significant difference between these studies and the studies included in the analysis. CONCLUSIONS Women are being inadequately represented, in the selected medical fields analyzed in our study, in recent RCTs. Older age is a potential barrier for the enrollment of women in clinical trials. Low inclusion rates of elderly women might create a lack of crucial knowledge in the adverse effects and the benefit/risk profile of any given treatment. Factors that might hinder the participation of women should be sought and addressed in the design of the study.
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Affiliation(s)
- Vered Daitch
- grid.413156.40000 0004 0575 344XDepartment of Medicine E, Rabin Medical Center, Beilinson Hospital, 39 Jabotinski Road, 49100 Petah Tikva, Israel ,grid.12136.370000 0004 1937 0546Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Adi Turjeman
- grid.413156.40000 0004 0575 344XDepartment of Medicine E, Rabin Medical Center, Beilinson Hospital, 39 Jabotinski Road, 49100 Petah Tikva, Israel ,grid.12136.370000 0004 1937 0546Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Itamar Poran
- grid.413156.40000 0004 0575 344XDepartment of Medicine E, Rabin Medical Center, Beilinson Hospital, 39 Jabotinski Road, 49100 Petah Tikva, Israel ,grid.12136.370000 0004 1937 0546Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Noam Tau
- grid.12136.370000 0004 1937 0546Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel ,grid.413795.d0000 0001 2107 2845Department of Diagnostic Imaging, Sheba Medical Center, Ramat Gan, Israel
| | - Irit Ayalon-Dangur
- grid.413156.40000 0004 0575 344XDepartment of Medicine E, Rabin Medical Center, Beilinson Hospital, 39 Jabotinski Road, 49100 Petah Tikva, Israel
| | - Jeries Nashashibi
- grid.413731.30000 0000 9950 8111Department of Internal Medicine D, Rambam Health Care Campus, Haifa, Israel
| | - Dafna Yahav
- grid.12136.370000 0004 1937 0546Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel ,grid.413156.40000 0004 0575 344XInfectious Diseases Unit, Rabin Medical Center, Beilinson Hospital, Petah Tikva, Israel
| | - Mical Paul
- grid.413731.30000 0000 9950 8111Infectious Diseases Institute, Rambam Health Care Campus, Haifa, Israel ,grid.6451.60000000121102151The Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Leonard Leibovici
- grid.413156.40000 0004 0575 344XDepartment of Medicine E, Rabin Medical Center, Beilinson Hospital, 39 Jabotinski Road, 49100 Petah Tikva, Israel ,grid.12136.370000 0004 1937 0546Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Sex and Gender Bias as a Mechanistic Determinant of Cardiovascular Disease Outcomes. Can J Cardiol 2022; 38:1865-1880. [PMID: 36116747 DOI: 10.1016/j.cjca.2022.09.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 08/21/2022] [Accepted: 09/11/2022] [Indexed: 12/14/2022] Open
Abstract
Defined as a prejudice either for or against something, biases at the provider, patient, and societal level all contribute to differences in cardiovascular disease recognition and treatment, resulting in outcome disparities between sexes and genders. Provider bias in the under-recognition of female-predominant cardiovascular disease and risks might result in underscreened and undertreated patients. Furthermore, therapies for female-predominant phenotypes including nonobstructive coronary artery disease and heart failure with preserved ejection fraction are less well researched, contributing to undertreated female patients. Conversely, women are less likely to seek urgent medical attention, potentially related to societal bias to put others first, which contributes to diagnostic delays. Furthermore, women are less likely to have discussions around risk factors for coronary artery disease compared with men, partially because they are less likely to consider themselves at risk for heart disease. Provider bias in interpreting a greater number of presenting symptoms, some of which have been labelled as "atypical," can lead to mislabelling presentations as noncardiovascular. Furthermore, providers might avoid discussions around certain therapies including thrombolysis for stroke, and cardiac resynchronization therapy in heart failure, because it is incorrectly assumed that women are not interested in pursuing options deemed more invasive. To mitigate bias, organizations should aim to increase the visibility and involvement of women in research, health promotion, and clinical and leadership endeavours. More research needs to be done to identify effective interventions to mitigate sex and gender bias and the resultant cardiovascular outcome discrepancies.
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Social Media and Cardiovascular Health: Implications for Women. Curr Atheroscler Rep 2022; 24:901-913. [PMID: 36441421 PMCID: PMC10017051 DOI: 10.1007/s11883-022-01069-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/03/2022] [Indexed: 11/29/2022]
Abstract
PURPOSE OF REVIEW Cardiovascular disease (CVD) is the leading cause of mortality in adult women in the USA, yet CVD is underrecognized in women. Disparities in care are further pronounced in women of racial/ethnic minority backgrounds. In this review, we discuss the role of social media (SoMe) as a tool to (i) promote women's cardiovascular (CV) health and (ii) address and potentially reduce gaps in care, particularly in general cardiology (targeting atherosclerotic cardiovascular disease), cardio-oncology, and cardio-obstetrics. We also briefly discuss women's CV health as a common, although not unique, focus of women in cardiology on SoMe. RECENT FINDINGS Studies have suggested the utility of social media to help advance subspecialties of cardiology. Leaders within general cardiology, cardio-oncology, and cardio-obstetrics have curated social media strategies to advance their respective fields and call attention to cardiovascular health disparities in female populations and racial/ethnic minorities. In addition to these types of uses, women in cardiology also frequently use SoMe to encourage a career in cardiology and to share experiences, challenges, and resources for support and career advancement as healthcare professionals; men in cardiology and especially those who are allies for sex and racial/ethnic minorities also use SoMe for these means. Herein, we highlight the role and myriad applications of social media in the promotion of women's cardiovascular health. We discuss five primary roles of social media: increasing public awareness, disseminating medical literature in a rapid and accessible fashion, facilitating professional networking, serving as a platform for medical conferences, and empowering patients. These core strategies are discussed through the lens of general cardiology, cardio-oncology, and cardio-obstetrics. We also demonstrate how these applications can be leveraged to increase representation of women in cardiology, also supporting an increased focus on women's cardiovascular health.
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Chen CY, Kahanamoku SS, Tripati A, Alegado RA, Morris VR, Andrade K, Hosbey J. Systemic racial disparities in funding rates at the National Science Foundation. eLife 2022; 11:83071. [PMID: 36444975 PMCID: PMC9708090 DOI: 10.7554/elife.83071] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 10/28/2022] [Indexed: 11/30/2022] Open
Abstract
Concerns about systemic racism at academic and research institutions have increased over the past decade. Here, we investigate data from the National Science Foundation (NSF), a major funder of research in the United States, and find evidence for pervasive racial disparities. In particular, white principal investigators (PIs) are consistently funded at higher rates than most non-white PIs. Funding rates for white PIs have also been increasing relative to annual overall rates with time. Moreover, disparities occur across all disciplinary directorates within the NSF and are greater for research proposals. The distributions of average external review scores also exhibit systematic offsets based on PI race. Similar patterns have been described in other research funding bodies, suggesting that racial disparities are widespread. The prevalence and persistence of these racial disparities in funding have cascading impacts that perpetuate a cumulative advantage to white PIs across all of science, technology, engineering, and mathematics.
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Affiliation(s)
- Christine Yifeng Chen
- Chemical and Isotopic Signatures Group, Division of Nuclear and Chemical Sciences, Lawrence Livermore National Laboratory, Livermore, United States.,Center for Diverse Leadership in Science, University of California, Los Angeles, Berkeley, California, United States
| | - Sara S Kahanamoku
- Department of Integrative Biology and Museum of Paleontology, University of California, Berkeley, Berkeley, United States
| | - Aradhna Tripati
- Center for Diverse Leadership in Science, University of California, Los Angeles, Berkeley, California, United States.,Department of Earth, Planetary, and Space Sciences, Department of Atmospheric and Oceanic Sciences, Institute of the Environment and Sustainability, and American Indian Studies Center, University of California, Los Angeles, Los Angeles, United States.,Department of Earth Sciences, University of Bristol, Bristol, United Kingdom
| | - Rosanna A Alegado
- Department of Oceanography and Sea Grant College Program, Daniel K Inouye Center for Microbial Oceanography: Research and Education, University of Hawai'i at Mānoa, Honolulu, United States
| | - Vernon R Morris
- School of Mathematical and Natural Sciences, New College of Interdisciplinary Arts and Sciences, Arizona State University, Phoenix, United States
| | - Karen Andrade
- Center for Diverse Leadership in Science, University of California, Los Angeles, Berkeley, California, United States
| | - Justin Hosbey
- Department of City and Regional Planning, College of Environmental Design, University of California, Berkeley, Berkeley, United States
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van den Hurk L, Hiltner S, Oertelt-Prigione S. Operationalization and Reporting Practices in Manuscripts Addressing Gender Differences in Biomedical Research: A Cross-Sectional Bibliographical Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14299. [PMID: 36361177 PMCID: PMC9653596 DOI: 10.3390/ijerph192114299] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 10/24/2022] [Accepted: 10/25/2022] [Indexed: 06/16/2023]
Abstract
Historically, authors in the biomedical field have often conflated the terms sex and gender in their research significantly limiting the reproducibility of the reported results. In the present study, we investigated current reporting practices around gender in biomedical publications that claim the identification of "gender differences". Our systematic research identified 1117 articles for the year 2019. After random selection of 400 publications and application of inclusion criteria, 302 articles were included for analysis. Using a systematic evaluation grid, we assessed the provided methodological detail in the operationalization of gender and the provision of gender-related information throughout the manuscript. Of the 302 articles, 69 (23%) solely addressed biological sex. The remaining articles investigated gender, yet only 15 (6.5%) offered reproducible information about the operationalization of the gender dimension studied. Followingly, these manuscripts also provided more detailed gender-specific background, analyses and discussions compared to the ones not detailing the operationalization of gender. Overall, our study demonstrated persistent inadequacies in the conceptual understanding and methodological operationalization of gender in the biomedical field. Methodological rigor correlated with more nuanced and informative reporting, highlighting the need for appropriate training to increase output quality and reproducibility in the field.
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Affiliation(s)
- Lori van den Hurk
- Department of Primary and Community Care, Radboud University Medical Center, 6500HB Nijmegen, The Netherlands
| | - Sarah Hiltner
- Department of Primary and Community Care, Radboud University Medical Center, 6500HB Nijmegen, The Netherlands
| | - Sabine Oertelt-Prigione
- Department of Primary and Community Care, Radboud University Medical Center, 6500HB Nijmegen, The Netherlands
- AG10 Sex- and Gender-Sensitive Medicine, Medical Faculty OWL, University of Bielefeld, 33615 Bielefeld, Germany
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36
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Hobgood CD, Draucker C. Barriers, Challenges, and Solutions: What Can We Learn About Leadership in Academic Medicine From a Qualitative Study of Emergency Medicine Women Chairs? ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2022; 97:1656-1664. [PMID: 35703191 DOI: 10.1097/acm.0000000000004772] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
PURPOSE Women have made significant gains in leadership across all disciplines in academic medicine but have not yet achieved leadership parity as department chairs. The authors investigated the challenges experienced by one cohort of women department chairs in emergency medicine (EM) and the solutions they proposed to address these challenges. METHOD The authors conducted a qualitative descriptive study of 19 of 20 possible current and emeritus emergency medicine women department chairs at academic medical centers between April and December 2020. Participant interviews elicited self-reported demographic characteristics and narrative responses to a semistructured interview template that focused on the role of gender in their leadership and career trajectories. Interviews were transcribed, blinded, and iteratively coded and categorized. RESULTS The analysis demonstrated 4 common challenges and 5 enacted or proposed solutions. The challenges discussed by the participants were: feeling unprepared for the role of department chair, being one of few women in leadership, inheriting unhealthy department cultures, and facing negative faculty reactions. The individual- and institutional-level solutions discussed by the participants were: gaining and maintaining confidence (individual), maintaining accountability and mission alignment (individual), facilitating teamwork (individual), supporting women's leadership (institution), and creating safe leadership cultures (institution). CONCLUSIONS Women department chairs in EM were successful academic leaders despite confronting several challenges to their leadership. Considering the study findings through the lens of the concept of second-generation gender bias further illuminates the influence of gender on leadership in academic medicine. These findings suggest several possible strategies that can combat gender bias, increase gender parity among academic medicine's leadership, and improve the leadership experience for women leaders.
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Affiliation(s)
- Cherri D Hobgood
- C.D. Hobgood is professor of emergency medicine, Indiana University School of Medicine, Indianapolis, Indiana; ORCID: http://orcid.org/0000-0003-4860-1385
| | - Claire Draucker
- C. Draucker is the Angela Barron McBride Professor of Psychiatric Nursing, Indiana University School of Nursing, Indianapolis, Indiana; ORCID: http://orcid.org/0000-0001-9844-351X
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Ovseiko PV, Afsar AP, Fazal ZZ, Coates LC, Gupta L. Gender representation on editorial boards of rheumatology journals. THE LANCET. RHEUMATOLOGY 2022; 4:e663-e664. [PMID: 38265963 DOI: 10.1016/s2665-9913(22)00157-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 05/06/2022] [Accepted: 05/11/2022] [Indexed: 10/16/2022]
Affiliation(s)
- Pavel V Ovseiko
- Radcliffe Department of Medicine, University of Oxford, Oxford, UK
| | | | - Zoha Zahid Fazal
- Medical College, Aga Khan University Hospital, National Stadium Road, Karachi, Pakistan
| | - Laura C Coates
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Latika Gupta
- Department of Rheumatology, Royal Wolverhampton Hospitals NHS Trust, Wolverhampton WV10 0QP, UK; City Hospital, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK; Division of Musculoskeletal and Dermatological Sciences, Centre for Musculoskeletal Research, School of Biological Sciences, The University of Manchester, Manchester, UK.
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Gender Parity in Geriatrics Editorial Boards. Geriatrics (Basel) 2022; 7:geriatrics7050090. [PMID: 36136799 PMCID: PMC9498408 DOI: 10.3390/geriatrics7050090] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 08/31/2022] [Accepted: 09/01/2022] [Indexed: 11/17/2022] Open
Abstract
Gender equality, with an emphasis on female education, has been designated by the United Nations as one of the 17 Sustainable Development Goals (SDGs) to be completed by 2030, since gender disparity is a major impediment to scientific and economic progress. This study was carried out in an effort to address the gender gaps that can be seen in academic and scientific publications. The purpose of this study is to describe the gender distribution of editorial board members and editors-in-chief across geriatrics journals with high impact factors. Clarivate Journal Citation Reports (JCR) 2021 were used to guide the selection of geriatric and gerontology journals utilizing Scopus All Science Journal Classification Codes. The genders of the editors-in-chief and editorial board members were determined and analyzed using publicly accessible data. A total of 47 geriatric journals with an average impact factor of 4.27 were examined. Of the 65 editors-in-chief, 21 (32%) were women, whereas 876 female editorial members were found out of a total of 2414, which constitutes 36% in total. Despite making up 60% of the geriatric medical workforce, women are still underrepresented on editorial boards and as chief editors in well-known geriatric periodicals.
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Ovseiko PV, Gossec L, Andreoli L, Kiltz U, van Mens L, Hassan N, van der Leeden M, Siddle HJ, Alunno A, McInnes IB, Damjanov NS, Apparailly F, Ospelt C, van der Horst-Bruinsma IE, Nikiphorou E, Druce KL, Szekanecz Z, Sepriano A, Avcin T, Bertsias G, Schett G, Keenan AM, Pololi LH, Coates LC. Gender equity in academic rheumatology, current status and potential for improvement: a cross-sectional study to inform an EULAR task force. RMD Open 2022; 8:rmdopen-2022-002518. [PMID: 35940824 PMCID: PMC9367178 DOI: 10.1136/rmdopen-2022-002518] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 07/13/2022] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVES Evidence on the current status of gender equity in academic rheumatology in Europe and potential for its improvement is limited. The EULAR convened a task force to obtain empirical evidence on the potential unmet need for support of female rheumatologists, health professionals and non-clinical scientists in academic rheumatology. METHODS This cross-sectional study comprised three web-based surveys conducted in 2020 among: (1) EULAR scientific member society leaders, (2) EULAR and Emerging EULAR Network (EMEUNET) members and (3) EULAR Council members. Statistics were descriptive with significance testing for male/female responses assessed by χ2 test and t-test. RESULTS Data from EULAR scientific member societies in 13 countries indicated that there were disproportionately fewer women in academic rheumatology than in clinical rheumatology, and they tended to be under-represented in senior academic roles. From 324 responses of EULAR and EMEUNET members (24 countries), we detected no gender differences in leadership aspirations, self-efficacy in career advancement and work-life integration as well as the share of time spent on research, but there were gender differences in working hours and the levels of perceived gender discrimination and sexual harassment. There were gender differences in the ranking of 7 of 26 factors impacting career advancement and of 8 of 24 potential interventions to aid career advancement. CONCLUSIONS There are gender differences in career advancement in academic rheumatology. The study informs a EULAR task force developing a framework of potential interventions to accelerate gender-equitable career advancement in academic rheumatology.
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Affiliation(s)
- Pavel V Ovseiko
- Radcliffe Department of Medicine, University of Oxford, Oxford, UK.,NIHR Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Laure Gossec
- Institut Pierre Louis d'Epidémiologie et de Santé Publique, INSERM, Sorbonne Universite, Paris, France.,Rheumatology Department, APHP.Sorbonne Universite, Hopital Universitaire Pitie Salpetriere, Paris, France
| | - Laura Andreoli
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.,Unit of Rheumatology and Clinical Immunology, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Uta Kiltz
- Department of Rheumatology, Rheumazentrum Ruhrgebiet, Ruhr-University Bochum, Herne, Germany
| | - Leonieke van Mens
- Department of Clinical Immunology and Rheumatology, Amsterdam Rheumatology and Immunology Center, Amsterdam, The Netherlands
| | - Neelam Hassan
- Department of Rheumatology, Southmead Hospital, North Bristol NHS Trust, Bristol, UK.,Musculoskeletal Research Unit, University of Bristol, Bristol, UK
| | - Marike van der Leeden
- Department of Rehabilitation Medicine, Amsterdam Movement Sciences, Reade Centre for Rehabilitation and Rheumatology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Heidi J Siddle
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK.,NIHR Leeds Musculoskeletal Biomedical Research Centre, Leeds, UK
| | - Alessia Alunno
- Internal Medicine and Nephrology Unit, Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Iain B McInnes
- Institute of Infection, Immunity and Inflammation, University of Glasgow, Glasgow, UK
| | - Nemanja S Damjanov
- University of Belgrade School of Medicine, Medigroup Hospital, Rheumatology, Belgrade, Serbia
| | | | - Caroline Ospelt
- Center of Experimental Rheumatology, Department of Rheumatology, University Hospital Zurich, Zurich, Switzerland.,University of Zurich, Zurich, Switzerland
| | | | - Elena Nikiphorou
- Rheumatology Department, King's College Hospital, London, UK.,Centre for Rheumatic Diseases, School of Immunology and Microbial Sciences, King's College London, London, UK
| | - Katie L Druce
- Centre for Epidemiology Versus Arthritis, Division of Musculoskeletal and Dermatological Sciences, The University of Manchester, Manchester, UK
| | - Zoltán Szekanecz
- Department of Rheumatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Alexandre Sepriano
- Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands.,NOVA Medical School, Universidade Nova de Lisboa, Lisbon, Portugal
| | - Tadej Avcin
- Department of Allergology, Rheumatology and Clinical Immunology, University Children's Hospital, University Medical Center Ljubljana, Ljubljana, Slovenia
| | - George Bertsias
- Department of Rheumatology, Clinical Immunology and Allergy, University of Crete Medical School, Heraklion, Greece
| | - Georg Schett
- Deutsches Zentrum für Immuntherapie, Friedrich-Alexander-University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany.,Department of Internal Medicine 3, Friedrich-Alexander-University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Anne-Maree Keenan
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK.,School of Healthcare, University of Leeds, Leeds, UK.,NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds, UK
| | - Linda H Pololi
- National Initiative on Gender, Culture and Leadership in Medicine: C-Change, Women's Studies Research Center, Brandeis University, Waltham, Massachusetts, USA
| | - Laura C Coates
- NIHR Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, UK .,Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
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40
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Tremblay MC. Strengthening the gendered health promotion agenda. Health Promot Int 2022; 37:6680027. [PMID: 36047635 DOI: 10.1093/heapro/daac122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Marie-Claude Tremblay
- Department of Family Medicine and Emergency Medicine, Université Laval, 1050, de la médecine, 2881-F, Quebec, QC G1V 0A6, Canada
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van Daalen KR, Chowdhury M, Dada S, Khorsand P, El-Gamal S, Kaidarova G, Jung L, Othman R, O'Leary CA, Ashworth HC, Socha A, Olaniyan D, Azeezat FT, Abouhala S, Abdulkareem T, Dhatt R, Rajan D. Does global health governance walk the talk? Gender representation in World Health Assemblies, 1948-2021. BMJ Glob Health 2022; 7:bmjgh-2022-009312. [PMID: 35998979 PMCID: PMC9403126 DOI: 10.1136/bmjgh-2022-009312] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Accepted: 07/20/2022] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND While an estimated 70%-75% of the health workforce are women, this is not reflected in the leadership roles of most health organisations-including global decision-making bodies such as the World Health Assembly (WHA). METHODS We analysed gender representation in WHA delegations of Member States, Associate Members and Observers (country/territory), using data from 10 944 WHA delegations and 75 815 delegation members over 1948-2021. Delegates' information was extracted from WHO documentation. Likely gender was inferred based on prefixes, pronouns and other gendered language. A gender-to-name algorithm was used as a last resort (4.6%). Time series of 5-year rolling averages of the percentage of women across WHO region, income group and delegate roles are presented. We estimated (%) change ±SE of inferred women delegation members at the WHA per year, and estimated years±SE until gender parity from 2010 to 2019 across regions, income groups, delegate roles and countries. Correlations with these measures were assessed with countries' gender inequality index and two Worldwide Governance indicators. RESULTS While upwards trends could be observed in the percentage of women delegates over the past 74 years, men remained over-represented in most WHA delegations. Over 1948-2021, 82.9% of delegations were composed of a majority of men, and no WHA had more than 30% of women Chief Delegates (ranging from 0% to 30%). Wide variation in trends over time could be observed across different geographical regions, income groups and countries. Some countries may take over 100 years to reach gender parity in their WHA delegations, if current estimated trends continue. CONCLUSION Despite commitments to gender equality in leadership, women remain gravely under-represented in global health governance. An intersectional approach to representation in global health governance, which prioritises equity in participation beyond gender, can enable transformative policymaking that fosters transparent, accountable and just health systems.
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Affiliation(s)
- Kim Robin van Daalen
- Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, Cambridge University, Cambridge, UK
| | | | - Sara Dada
- UCD Centre for Interdisciplinary Research, Education and Innovation in Health Systems, School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland
| | | | | | | | - Laura Jung
- Medical Faculty, Department for Infectious Diseases and Tropical Medicine, Leipzig University, Leipzig, Germany
| | | | | | - Henry Charles Ashworth
- Highland Hospital, Department of Emergency Medicine, Alameda Health System, Oakland, California, USA
| | - Anna Socha
- Systems for Health Research Group, Swiss Tropical and Public Health Institute, Basel, Switzerland
| | - Dolapo Olaniyan
- Institute of Development Studies, University of Sussex, Brighton, UK
| | | | - Siwaar Abouhala
- Department of Community Health, Tufts University, Medford, Massachusetts, USA
| | | | - Roopa Dhatt
- Women in Global Health, Washington, District of Columbia, USA.,Medstar, Georgetown University Hospital, Washington, District of Columbia, USA
| | - Dheepa Rajan
- Department of Health System Governance and Financing, WHO, Geneve, Switzerland
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Becher E, Oertelt-Prigione S. History and development of sex- and gender sensitive medicine (SGSM). INTERNATIONAL REVIEW OF NEUROBIOLOGY 2022; 164:1-25. [PMID: 36038201 DOI: 10.1016/bs.irn.2022.06.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Sex- and gender-sensitive medicine has evolved from a feminist approach into an innovative cross-cutting approach to doing medicine. In the present chapter we define what sex and gender are in the context of biomedical research and describe the history of the development of this scientific approach. Looking back at crucial events in the U.S.A., Canada and Europe, we will outline how a structural framework has been established, ready to be filled with clinical and applied knowledge and to change the practice of medicine for decades to come.
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Affiliation(s)
- Eva Becher
- Sex- and Gender-Sensitive Medicine Unit, Medical Faculty OWL, Bielefeld University, Bielefeld, Germany
| | - Sabine Oertelt-Prigione
- Sex- and Gender-Sensitive Medicine Unit, Medical Faculty OWL, Bielefeld University, Bielefeld, Germany; Gender Unit, Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, Netherlands.
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Hallam L, McKenzie BL, Gong J, Carcel C, Hockham C. Contextualising sex and gender research to improve women's health: An early- and mid-career researcher perspective. Front Glob Womens Health 2022; 3:942876. [PMID: 35928054 PMCID: PMC9343614 DOI: 10.3389/fgwh.2022.942876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 06/27/2022] [Indexed: 11/13/2022] Open
Abstract
The field of sex and gender research in health and medicine is growing, and many early- and mid-career researchers (EMCRs) are developing skills in this area. As EMCRs specialising in sex and gender research, we aim to better understand sex- and gender-based determinants of human health, challenge long-standing and pervasive gender biases, and contribute to improving the evidence base upon which clinical guidelines and policy interventions are developed. To effectively achieve these goals, we believe that EMCRs would benefit from understanding the challenges of working in this space and participate in driving change in three key areas. First, in creating greater links between the goals of sex and gender research and addressing systemic bias against women and gender minorities, to effectively translate knowledge about sex and gender differences into improved health outcomes. Second, in expanding the reach of sex and gender research to address women's health in an intersectional way and ensure that it also benefits the health of men, transgender and gender-diverse people and those who are intersex. Third, in working with others in the scientific community to improve methods for sex and gender research, including updating data collection practises, ensuring appropriate statistical analyses and shifting scientific culture to recognise the importance of null findings. By improving focus on these three areas, we see greater potential to translate this research to improve women's health and reduce health inequities for all.
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Affiliation(s)
- Laura Hallam
- The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia
- Australian Human Rights Institute, University of New South Wales, Sydney, NSW, Australia
- *Correspondence: Laura Hallam
| | - Briar L. McKenzie
- The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia
| | - Jessica Gong
- The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia
| | - Cheryl Carcel
- The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia
| | - Carinna Hockham
- The George Institute for Global Health, Imperial College London, London, United Kingdom
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McShane A, Mole SE. Sex bias and omission exists in Batten disease research: Systematic review of the use of animal disease models. Biochim Biophys Acta Mol Basis Dis 2022; 1868:166489. [PMID: 35840041 DOI: 10.1016/j.bbadis.2022.166489] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 07/06/2022] [Accepted: 07/07/2022] [Indexed: 11/17/2022]
Abstract
Batten disease, also known as the neuronal ceroid lipofuscinoses (NCL), is a group of inherited neurodegenerative disorders mainly affecting children. NCL are characterised by seizures, loss of vision, and progressive motor and cognitive decline, and are the most common form of childhood dementia. At least one type of Batten disease and three types of mouse disease models show sex differences in their severity and progression. Scientific research has a recognised prevalent omission of female animals when using model organisms for basic and preclinical research. Sex bias and omission in research using animal models of Batten disease may affect understanding and treatment development. We conducted a systematic review of research publications since the first identification of NCL genes in 1995, identifying those using animal models. We found that <10 % of these papers considered sex as a biological variable. There was consistent omission of female model organisms in studies. This varied over the period but is improving; one third of papers considered sex as a biological variable in the last decade, and there is a noticeable increase in the last 5 years. The wide-ranging reasons for this published sex bias are discussed, including misunderstanding regarding oestrogen, impact on sample size, and the underrepresentation of female scientists. Their implications for Batten disease and future research are considered. Recommendations going forward support requirements by funders for consideration of sex in all stages of experimental design and implementation, and a role for publishers, families and others with a particular interest in Batten disease.
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Affiliation(s)
- Annie McShane
- Division of Biosciences, University College London, London WC1E 6BT, UK
| | - Sara E Mole
- MRC Laboratory for Molecular Cell Biology and Great Ormond Street Institute of Child Health, University College London, London WC1E 6BT, UK.
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Jalal SK, Mukhopadhyay P. Gender differences, data carpentry and bibliometric studies in Mathematics. COLLNET JOURNAL OF SCIENTOMETRICS AND INFORMATION MANAGEMENT 2022. [DOI: 10.1080/09737766.2022.2090873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Samir Kumar Jalal
- Deputy Librarian, IIT Kharagpur, Kharagpur 721302, West Bengal, India
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Wright K, Meyers DE, Chisamore TM, McInnes MD, Sismondo S, Gyawali B, Prasad V, Booth CM. Industry Relationships With Medical Oncologists: Who Are the High-Payment Physicians? JCO Oncol Pract 2022; 18:e1164-e1169. [DOI: 10.1200/op.21.00756] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE: Many oncologists have relationships with industry. Previous work has shown that these payments are usually modest; however, there exist a subset of medical oncologists who receive more than $100,000 US dollars (USD) annually. Here, we describe the characteristics of these physicians. METHODS: This retrospective cohort study used the Open Payments data set to identify all US-based medical oncologists/hematologists who received $100,000+ USD in general payments linked to cancer medications in 2018. Open Payments and a web-based search were used to identify physician characteristics, demographics, research profile, and leadership positions. RESULTS: One hundred thirty-nine medical oncologists received > $100,000 USD in general payments. The median payment was $154,613 USD, and the total payment was $24.2 million USD. These high-payment physicians represent 1% of all US medical oncologists (N = 10,620) yet account for 37% of all industry payments in 2018. Sixty percent (84 of 139) and 21% (29 of 139) of these high-payment physicians hold hospital and specialty association leadership roles, respectively. One quarter (24%, 33 of 139) serve on journal editorial boards, and 10% (14 of 139) have authored clinical practice guidelines; 72% (100 of 139) hold faculty appointments. CONCLUSION: A small number of medical oncologists receive very high payments from the pharmaceutical industry. These physicians hold major leadership roles within oncology. Further work is needed to understand the extent to which these conflicts of interest may shape clinical practice and policy.
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Affiliation(s)
- Kristin Wright
- Department of Medicine, Queen's University, Kingston, Canada
- Division of Cancer Care and Epidemiology, Queen's University Cancer Research Institute, Kingston, Canada
| | | | - Timothy M. Chisamore
- Division of Cancer Care and Epidemiology, Queen's University Cancer Research Institute, Kingston, Canada
| | | | - Sergio Sismondo
- Department of Philosophy, Queen's University, Kingston, Canada
| | - Bishal Gyawali
- Division of Cancer Care and Epidemiology, Queen's University Cancer Research Institute, Kingston, Canada
- Department of Oncology, Queen's University, Kingston, Canada
- Department of Public Health Sciences, Queen's University, Kingston, Canada
| | - Vinay Prasad
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA
| | - Christopher M. Booth
- Department of Medicine, Queen's University, Kingston, Canada
- Division of Cancer Care and Epidemiology, Queen's University Cancer Research Institute, Kingston, Canada
- Department of Oncology, Queen's University, Kingston, Canada
- Department of Public Health Sciences, Queen's University, Kingston, Canada
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Jarman AF, Hobgood CD, Madsen TE. Moving Beyond Gender Disparities: A Call to Action for Gender Parity and Equity. Ann Emerg Med 2022; 80:65-67. [PMID: 35717113 PMCID: PMC10046989 DOI: 10.1016/j.annemergmed.2022.05.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Indexed: 11/17/2022]
Affiliation(s)
- Angela F Jarman
- Department of Emergency Medicine, University of California-Davis School of Medicine, Sacramento, CA.
| | - Cherri D Hobgood
- Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis, IN
| | - Tracy E Madsen
- Department of Emergency Medicine, Alpert Medical School of Brown University, Providence, RI
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Female Representation on Radiology Journal Editorial Boards Around the World: Geographical Differences and Temporal Trends. Acad Radiol 2022; 29:755-762. [PMID: 32782220 DOI: 10.1016/j.acra.2020.07.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 07/09/2020] [Accepted: 07/10/2020] [Indexed: 11/22/2022]
Abstract
RATIONALE AND OBJECTIVES We examined the status of women's representation on radiology journal editorial boards around the world and evaluated temporal trends in female board representation. MATERIALS AND METHODS Data on the gender of editorial board members, deputy editors, and editors-in-chief of top general radiology journals from the United States and from five continents outside North America was collected, based on listings in mastheads of each journal at 5-year intervals from 1998 to 2018. Female editorial board representation was compared to female membership in national professional radiology organizations and national physician registries. RESULTS One of 42 editors-in-chief (2.4%), 24 of 135 deputy editors (17.8%), and 345 of 2545 (13.6%) editorial board members were female for the 20-year period. The overall percentage of female editorial board members increased from 9.7% (41 of 423) in 1998 to 17.0% (97 of 569) in 2018 (p < 0.0001). In 2018, women were less represented on the editorial boards than female professional society membership for all geographic regions except Australia/New Zealand; this difference reached statistical significance in Korea, Brazil, Europe, and China. Female editorial board representation ranged from 11.3% to 33.3%, with no significant difference between the United States (21.5%) and other countries. CONCLUSION Although the proportion of female editorial board members of radiology journals worldwide has increased over the past two decades, female editorial board composition generally underrepresents the percentage of female radiologists. Editorial board female representation does not differ significantly between the United States and other countries.
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50
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An analysis of neuroscience and psychiatry papers published from 2009 and 2019 outlines opportunities for increasing discovery of sex differences. Nat Commun 2022; 13:2137. [PMID: 35440664 PMCID: PMC9018784 DOI: 10.1038/s41467-022-29903-3] [Citation(s) in RCA: 67] [Impact Index Per Article: 33.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 04/07/2022] [Indexed: 12/12/2022] Open
Abstract
Sex differences exist in many neurological and psychiatric diseases, but these have not always been addressed adequately in research. In order to address this, it is necessary to consider how sex is incorporated into the design (e.g. using a balanced design) and into the analyses (e.g. using sex as a covariate) in the published literature. We surveyed papers published in 2009 and 2019 across six journals in neuroscience and psychiatry. In this sample, we find a 30% increase in the percentage of papers reporting studies that included both sexes in 2019 compared with 2009. Despite this increase, in 2019 only 19% of papers in the sample reported using an optimal design for discovery of possible sex differences, and only 5% of the papers reported studies that analysed sex as a discovery variable. We conclude that progress to date has not been sufficient to address the importance of sex differences in research for discovery and therapeutic potential for neurological and psychiatric disease. Sex differences occur in many neurological and psychiatric diseases, and yet research is not always designed optimally to identify these. Here the authors perform a study of how sex was incorporated into the design and analyses of papers published six journals in neuroscience and psychiatry in 2009 compared with 2019.
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