1
|
Martin AA, Jacobs JW, Armijo PR, Allan JM, Booth GS, Spector ND, Overholser B, Silver JK. Analysis of Pediatric Clinical Practice Guideline Authors by Gender, Race, and Ethnicity. J Womens Health (Larchmt) 2024. [PMID: 38842430 DOI: 10.1089/jwh.2023.1132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2024] Open
Abstract
Background and Objectives: Clinical practice guidelines (CPGs) have significantly influenced medical practice worldwide. Nevertheless, the authorship of CPGs produced by several medical societies has not been representative of the field and population they address, as women and individuals from racial and ethnic minority groups have been underrepresented as authors. We hypothesized that women and individuals from minoritized racial and ethnic groups would also be underrepresented as authors of CPGs produced by the American Academy of Pediatrics (AAP). Methods: In this cross-sectional study, the gender, race, and ethnic composition of authors and subcommittee participants of AAP-produced CPGs published from January 2010 through May 2023 were analyzed and compared to the 2010 and 2021 U.S. population and 2010 and 2022 U.S. medical school pediatric faculty. Results: Women (39.7%, 127/320 of all positions, and 42.5%, 85/200 of named author positions) and women physicians (35.2%, 101/287 of all positions, and 36.4%, 64/176 of named author positions) were significantly underrepresented-while men and men physicians were significantly overrepresented-from their respective composition in the U.S. Census and pediatric faculty. Women and women physicians from all racial and ethnic groups and men and men physicians from minority racial and ethnic groups were significantly underrepresented-from their respective composition in the U.S. Census and pediatric faculty. No Black man was identified as an author. Conclusions: Medical societies that produce CPGs should be cognizant of these inequities and ensure appropriate authorship diversity.
Collapse
Affiliation(s)
- Amarilis A Martin
- Renaissance School of Medicine at Stony Brook University, Stony Brook, New York, USA
- Stony Brook Children's Hospital, Stony Brook, New York, USA
| | | | | | - Jessica M Allan
- Palo Alto Medical Foundation, Palo Alto, California, USA
- Stanford University School of Medicine, Palo Alto, California, USA
| | - Garrett S Booth
- Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Nancy D Spector
- Executive Leadership in Academic Medicine®, Drexel University College of Medicine, Philadelphia, Pennsylvania, USA
| | - Barbara Overholser
- Executive Leadership in Academic Medicine, Drexel University College of Medicine, Philadelphia, Pennsylvania, USA
| | - Julie K Silver
- Harvard Medical School, Boston, Massachusetts, USA
- Massachusetts General Hospital, Boston, Massachusetts, USA
- Brigham and Women's Hospital, Boston, Massachusetts, USA
- Spaulding Rehabilitation Hospital, Boston, Massachusetts, USA
| |
Collapse
|
2
|
Rong LQ, Martinez AP, Rahouma M, Lopes AJ, Lee JY, Wright DN, Demetres M, Kachulis B, O'Shaughnessy SM. Gender Differences in Authorship and Quality of Anesthesia Clinical Practice Guidelines From 2016 to 2020 Using the Appraisal of Guidelines for Research and Evaluation II Instrument. Anesth Analg 2024:00000539-990000000-00820. [PMID: 38768071 DOI: 10.1213/ane.0000000000006803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/22/2024]
Abstract
INTRODUCTION Women continue to be underrepresented in academic anesthesiology. This study assessed guidelines in anesthesia journals over the past 5 years, evaluating differences in woman-led versus man-led guidelines in terms of author gender, quality, and changes over time. We hypothesized that anesthesia guidelines would be predominately man-led, and that there would be differences in quality between woman-led versus man-led guidelines. METHODS All clinical practice guidelines published in the top 10 anesthesia journals were identified as per Clarivate Analytics Impact Factor between 2016 and 2020. Fifty-one guidelines were included for author, gender, and quality analysis using the Appraisal of Guidelines for Research & Evaluation (AGREE) II instrument. Each guideline was assessed across 6 domains and 23 items and given an overall score, overall quality score, and overall rating/recommendation. Stratified and trend analyses were performed for woman-led versus man-led guidelines. RESULTS Fifty out of 51 guidelines were included: 1 was excluded due to unidentifiable first-author gender. In total, 255 of 1052 (24%) authors were women, and woman-led guidelines (woman-first author) represented 12 of 50 (24%) overall guidelines. Eighteen percent (9 of 50) of guidelines had all-male authors, and a majority (26 of 50, 52%) had less than one-third of female authors. The overall number and percentage of woman-led guidelines did not change over time. There was a significantly higher percentage of female authors in woman-led versus man-led guidelines, median 39% vs 20% (P = .012), as well as a significantly higher number of female coauthors in guidelines that were woman-led median 3.5 vs 1.0, P = .049. For quality, there was no significant difference in the overall rating or objective quality of woman- versus man-led guidelines. However, there was a significant increase in the overall rating of all the guidelines over time (P = .010), driven by the increase in overall rating among man-led guidelines, P = .002. The overall score of guidelines did not increase over time; however, they increased in man-led but not woman-led guidelines. There was no significant correlation between the percentage of female authors per guideline and either overall score or overall rating. CONCLUSIONS There is a substantial disparity in the number of women leading and contributing to guidelines which has not improved over time. Woman-led guidelines included more women and a higher percentage of women. There was no difference in quality of guidelines by first-author gender or percentage of female authors. Further systematic and quota-driven sponsorship is needed to promote gender equity, diversity, and inclusion in anesthesia guidelines.
Collapse
Affiliation(s)
- Lisa Q Rong
- From the Department of Anesthesiology, Weill Cornell Medicine, New York, New York
| | - Andrew P Martinez
- From the Department of Anesthesiology, Weill Cornell Medicine, New York, New York
| | - Mohamed Rahouma
- Department of Cardiothoracic Surgery, Weill Cornell Medicine, New York, New York
| | - Alexandra J Lopes
- University of California San Francisco School of Medicine, San Francisco, California
| | - Jerry Y Lee
- From the Department of Anesthesiology, Weill Cornell Medicine, New York, New York
| | - Drew N Wright
- Samuel J. Wood Library & C.V. Starr Biomedical Information Center, Weill Cornell Medicine, New York, New York
| | - Michelle Demetres
- Samuel J. Wood Library & C.V. Starr Biomedical Information Center, Weill Cornell Medicine, New York, New York
| | - Bessie Kachulis
- From the Department of Anesthesiology, Weill Cornell Medicine, New York, New York
| | | |
Collapse
|
3
|
Martin AA, Walker SC, Wheeler AP, Jacobs JW, Booth GS, Silver JK. Representation of Authors by Gender, Race, and Ethnicity in Pathology Clinical Practice Guidelines. Arch Pathol Lab Med 2024; 148:230-241. [PMID: 37134229 DOI: 10.5858/arpa.2022-0351-oa] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/08/2023] [Indexed: 05/05/2023]
Abstract
CONTEXT.— United States' clinical practice guidelines (CPGs) are often produced by professional societies and used worldwide in daily medical practice. However, studies in various medical specialties demonstrate underrepresentation of women and racial and ethnic minority groups in CPGs. The representation of authors by gender, race, and ethnicity of US pathology CPGs has not been previously evaluated. OBJECTIVE.— To assess if women and individuals from racial and ethnic minority groups are underrepresented as authors of pathology CPGs. DESIGN.— The gender, race, ethnicity, and terminal degrees of authors of 18 CPGs from the College of American Pathologists were coded by using photographs and other available information online and compared to their representation in academic pathology per Association of American Medical Colleges benchmark data. RESULTS.— Two hundred seventy-five author positions (202 physician author positions) were analyzed. Women overall (119 of 275; 43.3%) and women physicians (65 of 202; 32.2%) held fewer positions than all men and men physicians. Women physicians were significantly underrepresented in physician author positions, while White men physicians were significantly overrepresented in all, first, senior, and corresponding authorship roles when compared to the proportion of women and White men physicians among pathology faculty, respectively. Asian men and women physicians were underrepresented as compared to their representation among pathology faculty. CONCLUSIONS.— Men, particularly White men physicians, are overrepresented among pathology CPG author positions, while women physicians and some physicians from racial and ethnic minority groups are underrepresented. Further research is needed to understand the impact of these findings on the careers of underrepresented physicians and the content of guidelines.
Collapse
Affiliation(s)
- Amarilis A Martin
- From the Department of Pediatrics, Renaissance School of Medicine at Stony Brook University, Stony Brook, New York (Martin)
- the Division of Pediatric Critical Care Medicine, Stony Brook Children's Hospital, Stony Brook, New York (Martin)
| | - Shannon C Walker
- the Department of Pathology, Microbiology & Immunology, Vanderbilt University Medical Center, Nashville, Tennessee (Walker, Wheeler, Booth)
| | - Allison P Wheeler
- the Department of Pathology, Microbiology & Immunology, Vanderbilt University Medical Center, Nashville, Tennessee (Walker, Wheeler, Booth)
| | - Jeremy W Jacobs
- the Department of Laboratory Medicine, Yale School of Medicine, New Haven, Connecticut (Jacobs)
| | - Garrett S Booth
- the Department of Pathology, Microbiology & Immunology, Vanderbilt University Medical Center, Nashville, Tennessee (Walker, Wheeler, Booth)
| | - Julie K Silver
- the Department of Physical Medicine, Harvard Medical School, Boston, Massachusetts (Silver)
- the Department of Physical Medicine, Massachusetts General Hospital, Boston (Silver)
- the Department of Physical Medicine, Brigham and Women's Hospital, Boston, Massachusetts (Silver)
- the Department of Physical Medicine, Spaulding Rehabilitation Hospital, Boston, Massachusetts (Silver)
| |
Collapse
|
4
|
Mavedatnia D, Yi G, Wener E, Davidson J, Chan Y, Graham ME. Gender Differences in North American and International Otolaryngology Clinical Practice Guideline Authorship: A 17-Year Analysis. Ann Otol Rhinol Laryngol 2023; 132:1669-1678. [PMID: 37334913 PMCID: PMC10571373 DOI: 10.1177/00034894231181752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/21/2023]
Abstract
OBJECTIVE To analyze gender differences in authorship of North American (Canadian and American) and international published otolaryngology-head and neck surgery (OHNS) clinical practice guidelines (CPG) over a 17-year period. METHODS Clinical practice guidelines published between 2005 and 2022 were identified through the Canadian Agency for Drugs and Technology in Health (CADTH) search strategy in MEDLINE and EMBASE. Studies were included if they were original studies, published in the English language, and encompassed Canadian, American, or international OHNS clinical practice guidelines. RESULTS A total of 145 guidelines were identified, encompassing 661 female authors (27.4%) and 1756 male authors (72.7%). Among OHNS authors, women and men accounted for 21.2% and 78.8% of authors, respectively. Women who were involved in guideline authorship were 31.0% less likely to be an otolaryngologist compared to men. There were no gender differences across first or senior author and by subspeciality. Female otolaryngologist representation was the greatest in rhinology (28.3%) and pediatrics (26.7%). American guidelines had the greatest proportion of female authors per guideline (34.1%) and the greatest number of unique female authors (33.2%). CONCLUSION Despite the increasing representation of women in OHNS, gender gaps exist with regards to authorship within clinical practice guidelines. Greater gender diversity and transparency is required within guideline authorship to help achieve equitable gender representation and the development of balanced guidelines with a variety of viewpoints.
Collapse
Affiliation(s)
| | - Grace Yi
- Department of Otolaryngology—Head and Neck Surgery, University of Toronto, Toronto, ON, Canada
| | - Emily Wener
- Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Jacob Davidson
- Division of Pediatric Surgery, Children’s Hospital at London Health Sciences Center, Schulich School of Medicine, London, ON, Canada
| | - Yvonne Chan
- Department of Otolaryngology—Head and Neck Surgery, University of Toronto, Toronto, ON, Canada
| | - M. Elise Graham
- Department of Otolaryngology—Head and Neck Surgery, Children’s Hospital at London Health Sciences Center, Schulich School of Medicine, London, ON, Canada
| |
Collapse
|
5
|
Mattioli AV, Doltra A, Prieto C, Gallina S. Editorial: Women in cardiovascular imaging. Front Cardiovasc Med 2023; 10:1249983. [PMID: 37600041 PMCID: PMC10434246 DOI: 10.3389/fcvm.2023.1249983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 07/24/2023] [Indexed: 08/22/2023] Open
Affiliation(s)
- Anna Vittoria Mattioli
- Department of Medical and Surgical Sciences for Children and Adults, University of Modena and Reggio Emilia, Modena, Italy
| | - Adelina Doltra
- Non-invasive Imaging Section, Cardiovascular Institute Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Claudia Prieto
- King's College London, London, United Kingdom
- Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Sabina Gallina
- Department of Neuroscience, Imaging and Clinical Sciences, G. D'Annunzio University, Chieti, Italy
| |
Collapse
|
6
|
Yamashita Y, Nakayama A, Oi M, Sugioka S, Nakano Y, Naka M, Yasuda S, Onishi M, Yamamoto E, Ono K. Sex Differences in the Japanese Circulation Society Guideline Writing Committee Authorship Between 2008 and 2022. Circ Cardiovasc Qual Outcomes 2023; 16:e010029. [PMID: 37339193 DOI: 10.1161/circoutcomes.123.010029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Accepted: 05/05/2023] [Indexed: 06/22/2023]
Affiliation(s)
- Yugo Yamashita
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Japan (Y.Y., M.N., S.Y., M.O., E.Y., K.O.)
| | - Atsuko Nakayama
- Department of Cardiovascular Medicine, Sakakibara Heart Institute, Fuchu, Japan (A.N.)
| | - Maki Oi
- Department of Cardiology, Japanese Red Cross Otsu Hospital, Japan (M.O.)
| | - Sachiko Sugioka
- Department of Cardiology, Kishiwada City Hospital, Japan (S.S.)
| | - Yukiko Nakano
- Department of Cardiology, Gakken City Hospital, Seika, Japan (Y.N.)
| | - Misaki Naka
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Japan (Y.Y., M.N., S.Y., M.O., E.Y., K.O.)
| | - Sara Yasuda
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Japan (Y.Y., M.N., S.Y., M.O., E.Y., K.O.)
| | - Mei Onishi
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Japan (Y.Y., M.N., S.Y., M.O., E.Y., K.O.)
| | - Erika Yamamoto
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Japan (Y.Y., M.N., S.Y., M.O., E.Y., K.O.)
| | - Koh Ono
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Japan (Y.Y., M.N., S.Y., M.O., E.Y., K.O.)
| |
Collapse
|
7
|
Ross L, Hassett C, Brown P, Spurgeon E, Mathew R, Bal G, Hussain MS, Martin A, Silver JK, Rensel M. Gender Representation Among Physician Authors of Practice Guidelines Developed, Endorsed, or Affirmed by the American Academy of Neurology. Neurology 2023; 100:e465-e472. [PMID: 35680419 DOI: 10.1212/wnl.0000000000200567] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Accepted: 03/04/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND AND OBJECTIVES To assess American Academy of Neurology (AAN)-recommended Practice Guidelines (PGs) for equity in gender representation among physician authors. METHODS This cross-sectional study included AAN-recommended PG publications from January 1, 2015, to December 31, 2020. Author degrees and gender were identified by 2 reviewers using the publication and/or online searches. Gender was determined from pronouns or photographs. Gender representation was compared with Association of American Medical Colleges (AAMC) data on academic neurologists. Data were analyzed using Z tests of 2 proportions and descriptive statistics. RESULTS AAMC benchmarks report academic women neurologists represented 35% of the specialty in 2015, 38% in 2018, and 39% in 2020. We identified 68 unique PG publications with 709 physician authors, 31% (223) women, 68% (484) men, and 0.3% (2) gender could not be identified. Representation of women physicians was low among PG authors across all benchmarks, significantly so for 2018 and 2020 (p < 0.01). Among physician first authors, women were significantly underrepresented across all benchmarks (18% [12/65], p < 0.01). Representation of women physicians was lower when men physicians were first authors vs women physicians (31% [161/524] vs 43% [50/118], p = 0.02). Among subspecialties with 10+ PGs, women physician authorship was highest in child neurology (48% [57/120]) and lowest in stroke and vascular neurology (16% [18/113]). DISCUSSION We found that women physicians were underrepresented as authors of AAN-recommended PGs. This suggests a missed opportunity for neurology because PGs that include expertise from women physicians may improve care and translation into practice. In addition, women physicians lose out on professional development from authorship. Further research is needed to understand causality and address gaps.
Collapse
Affiliation(s)
- Lindsay Ross
- From the Mellen Center for Multiple Sclerosis Treatment and Research (L.R., M.R.), Cerebrovascular Center (C.H., M.S.H.), Center for General Neurology (P.B.), Epilepsy Center (E.S.), Neurological Institute (R.M., G.B.), Cleveland Clinic, Cleveland, OH; Division of Pediatric Critical Care Medicine (A.M.), Department of Pediatrics, Central Michigan University, Detroit; and Department of Physical Medicine and Rehabilitation (J.K.S.), Harvard Medical School, Boston, MA.
| | - Catherine Hassett
- From the Mellen Center for Multiple Sclerosis Treatment and Research (L.R., M.R.), Cerebrovascular Center (C.H., M.S.H.), Center for General Neurology (P.B.), Epilepsy Center (E.S.), Neurological Institute (R.M., G.B.), Cleveland Clinic, Cleveland, OH; Division of Pediatric Critical Care Medicine (A.M.), Department of Pediatrics, Central Michigan University, Detroit; and Department of Physical Medicine and Rehabilitation (J.K.S.), Harvard Medical School, Boston, MA
| | - Peter Brown
- From the Mellen Center for Multiple Sclerosis Treatment and Research (L.R., M.R.), Cerebrovascular Center (C.H., M.S.H.), Center for General Neurology (P.B.), Epilepsy Center (E.S.), Neurological Institute (R.M., G.B.), Cleveland Clinic, Cleveland, OH; Division of Pediatric Critical Care Medicine (A.M.), Department of Pediatrics, Central Michigan University, Detroit; and Department of Physical Medicine and Rehabilitation (J.K.S.), Harvard Medical School, Boston, MA
| | - Elizabeth Spurgeon
- From the Mellen Center for Multiple Sclerosis Treatment and Research (L.R., M.R.), Cerebrovascular Center (C.H., M.S.H.), Center for General Neurology (P.B.), Epilepsy Center (E.S.), Neurological Institute (R.M., G.B.), Cleveland Clinic, Cleveland, OH; Division of Pediatric Critical Care Medicine (A.M.), Department of Pediatrics, Central Michigan University, Detroit; and Department of Physical Medicine and Rehabilitation (J.K.S.), Harvard Medical School, Boston, MA
| | - Rachael Mathew
- From the Mellen Center for Multiple Sclerosis Treatment and Research (L.R., M.R.), Cerebrovascular Center (C.H., M.S.H.), Center for General Neurology (P.B.), Epilepsy Center (E.S.), Neurological Institute (R.M., G.B.), Cleveland Clinic, Cleveland, OH; Division of Pediatric Critical Care Medicine (A.M.), Department of Pediatrics, Central Michigan University, Detroit; and Department of Physical Medicine and Rehabilitation (J.K.S.), Harvard Medical School, Boston, MA
| | - Gabriella Bal
- From the Mellen Center for Multiple Sclerosis Treatment and Research (L.R., M.R.), Cerebrovascular Center (C.H., M.S.H.), Center for General Neurology (P.B.), Epilepsy Center (E.S.), Neurological Institute (R.M., G.B.), Cleveland Clinic, Cleveland, OH; Division of Pediatric Critical Care Medicine (A.M.), Department of Pediatrics, Central Michigan University, Detroit; and Department of Physical Medicine and Rehabilitation (J.K.S.), Harvard Medical School, Boston, MA
| | - Muhammad Shazam Hussain
- From the Mellen Center for Multiple Sclerosis Treatment and Research (L.R., M.R.), Cerebrovascular Center (C.H., M.S.H.), Center for General Neurology (P.B.), Epilepsy Center (E.S.), Neurological Institute (R.M., G.B.), Cleveland Clinic, Cleveland, OH; Division of Pediatric Critical Care Medicine (A.M.), Department of Pediatrics, Central Michigan University, Detroit; and Department of Physical Medicine and Rehabilitation (J.K.S.), Harvard Medical School, Boston, MA
| | - Amarilis Martin
- From the Mellen Center for Multiple Sclerosis Treatment and Research (L.R., M.R.), Cerebrovascular Center (C.H., M.S.H.), Center for General Neurology (P.B.), Epilepsy Center (E.S.), Neurological Institute (R.M., G.B.), Cleveland Clinic, Cleveland, OH; Division of Pediatric Critical Care Medicine (A.M.), Department of Pediatrics, Central Michigan University, Detroit; and Department of Physical Medicine and Rehabilitation (J.K.S.), Harvard Medical School, Boston, MA
| | - Julie K Silver
- From the Mellen Center for Multiple Sclerosis Treatment and Research (L.R., M.R.), Cerebrovascular Center (C.H., M.S.H.), Center for General Neurology (P.B.), Epilepsy Center (E.S.), Neurological Institute (R.M., G.B.), Cleveland Clinic, Cleveland, OH; Division of Pediatric Critical Care Medicine (A.M.), Department of Pediatrics, Central Michigan University, Detroit; and Department of Physical Medicine and Rehabilitation (J.K.S.), Harvard Medical School, Boston, MA
| | - Mary Rensel
- From the Mellen Center for Multiple Sclerosis Treatment and Research (L.R., M.R.), Cerebrovascular Center (C.H., M.S.H.), Center for General Neurology (P.B.), Epilepsy Center (E.S.), Neurological Institute (R.M., G.B.), Cleveland Clinic, Cleveland, OH; Division of Pediatric Critical Care Medicine (A.M.), Department of Pediatrics, Central Michigan University, Detroit; and Department of Physical Medicine and Rehabilitation (J.K.S.), Harvard Medical School, Boston, MA
| |
Collapse
|
8
|
A roadmap of strategies to support cardiovascular researchers: from policy to practice. Nat Rev Cardiol 2022; 19:765-777. [PMID: 35577952 DOI: 10.1038/s41569-022-00700-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/27/2022] [Indexed: 02/03/2023]
Abstract
Cardiovascular disease remains the leading cause of death worldwide. Cardiovascular research has therefore never been more crucial. Cardiovascular researchers must be provided with a research environment that enables them to perform at their highest level, maximizing their opportunities to work effectively with key stakeholders to address this global issue. At present, cardiovascular researchers face a range of challenges and barriers, including a decline in funding, job insecurity and a lack of diversity at senior leadership levels. Indeed, many cardiovascular researchers, particularly women, have considered leaving the sector, highlighting a crucial need to develop strategies to support and retain researchers working in the cardiovascular field. In this Roadmap article, we present solutions to problems relevant to cardiovascular researchers worldwide that are broadly classified across three key areas: capacity building, research funding and fostering diversity and equity. This Roadmap provides opportunities for research institutions, as well as governments and funding bodies, to implement changes from policy to practice, to address the most important factors restricting the career progression of cardiovascular researchers.
Collapse
|
9
|
Verduzco-Gutierrez M, Katz NB, Fleming TK, Silver EM, Hunter TL, El Sayed N, Escalon MX, Lorello GR, Silver JK. Author Diversity on Clinical Practice Guideline Committees. Am J Phys Med Rehabil 2022; 101:493-503. [PMID: 34775456 DOI: 10.1097/phm.0000000000001932] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT Reports have demonstrated that women overall and women physicians, in particular, are underrepresented as authors of clinical practice guidelines. This analysis used publicly available information to explore the diversity of rehabilitation-related clinical practice guideline authors by gender, race, and ethnicity. Primary analysis identified authors' gender, race, ethnicity, and visible minority status. Two sets were analyzed: (1) clinical practice guidelines by Department of Veterans Affairs (VA) categorized as "Rehabilitation" or "Pain" (n = 7; VA clinical practice guidelines) and (2) a set (n = 10) published in the United States (US) from 2019 to 2021 that were selected because of low numbers of inclusion at less than 20% women authors. Key findings include that among physician authors, both the VA and US clinical practice guidelines underrepresented women (15 [24.2%] and 27 [16.7%], respectively) and those coded as a racial or ethnic minority were particularly underrepresented. Notably, women authors overall were equally represented (92 [50.0%]) in the VA clinical practice guidelines. The US clinical practice guidelines had women authors who were underrepresented (36 [19.0%]). Secondary analysis of the entire set of VA clinical practice guidelines (n = 21) found gaps in diversity-related content. Clinical practice guidelines have far-reaching health and economic impacts, and addressing disparities in the diversity of author teams and/or gaps in diversity-related content is of paramount importance.
Collapse
Affiliation(s)
- Monica Verduzco-Gutierrez
- From the Department of Rehabilitation Medicine, Joe R. and Teresa Lozano Long School of Medicine at UT Health San Antonio, San Antonio, Texas (MV-G); Department of Internal Medicine, Mount Auburn Hospital, Cambridge, Massachusetts (NBK); JFK Johnson Rehabilitation Institute at Hackensack Meridian Health, Edison, New Jersey (TKF); Department of Physical Medicine and Rehabilitation, Rutgers Robert Wood Johnson Medical School, Piscataway, New Jersey (TKF); Department of Physical Medicine and Rehabilitation, Hackensack Meridian School of Medicine, Nutley, New Jersey (TKF); Department of Psychology, Integrative Neuroscience, University of Chicago, Chicago, Illinois (EMS); Department of Internal Medicine, Kaiser Permanente Oakland Medical Center, Oakland, California (TLH); Joslin Diabetes Center, Boston, Massachusetts (NES); Department of Medicine, Harvard Medical School, Boston, Massachusetts (NES); Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York, New York (MXE); Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, Ontario, Canada (GRL); Department of Anesthesia and Pain Management, Toronto Western Hospital-University Health Network, Toronto, Ontario, Canada (GRL); The Wilson Centre, University Health Network, Toronto, Ontario, Canada (GRL); Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada (GRL); Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, Massachusetts (JKS); Massachusetts General Hospital, Boston, Massachusetts (JKS); Brigham and Women's Hospital, Boston, Massachusetts (JKS); and Spaulding Rehabilitation Hospital, Boston, Massachusetts (JKS)
| | | | | | | | | | | | | | | | | |
Collapse
|
10
|
Rai D, Kumar A, Waheed SH, Pandey R, Guerriero M, Kapoor A, Tahir MW, Zahid S, Hajra A, Balmer-Swain M, Castelletti S, Maas AHEM, Grapsa J, Mulvagh S, Zieroth S, Kalra A, Michos ED, Gulati M. Gender Differences in International Cardiology Guideline Authorship: A Comparison of the US, Canadian, and European Cardiology Guidelines From 2006 to 2020. J Am Heart Assoc 2022; 11:e024249. [PMID: 35189693 PMCID: PMC9075085 DOI: 10.1161/jaha.121.024249] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Women continue to be underrepresented in cardiology and even more so in leadership positions. We evaluated the trends and gender differences in the guideline writing groups of the American College of Cardiology/American Heart Association (ACC/AHA), Canadian Cardiovascular Society (CCS), and European Society of Cardiology (ESC) guidelines from 2006 to 2020. Methods and Results We extracted all guidelines authors from 2006 to 2020, assessed their gender from publicly available profiles, and compared differences based on subspecialties and specific societies. Stratified and trend analyses were performed using χ2 and average annual percentage change/average 5 year percentage change. A total of 80 ACC/AHA (1288 authors [28% women]), 64 CCS (988 authors [26% women]), and 59 ESC (1157 authors [16% women]) guidelines were analyzed. A significant increase in inclusion of women was seen in ACC/AHA (12.6% [2006] to 42.6% [2020]; average annual percentage change, 6.6% [2.3% to 11.1%]; P=0.005) and ESC (7.1% [2006] to 25.8% [2020]; average annual percentage change, 6.6% [0.2% to 13.5%]; P=0.04), but the trend remained similar in CCS (20.6% [2006] to 36.3% [2020]; average annual percentage change, -0.1% (-3.7% to 3.5%); P=0.94), guideline authors. More women were coauthors in the ACC/AHA and ESC guidelines when women were chairs of guidelines. There was a persistent disparity of women among guideline authors for general cardiology and all subspecialties, except for pediatric cardiology and heart failure guidelines. The appointment of women authors as a chair was significantly low in all societies (22.4% [ACC/AHA], 16.9% [CCS], and 7.2% [ESC]; P=0.008). Conclusions There is a significant disparity in the inclusion of women on all national guideline committees, in addition to serving as a chair of cardiology guidelines. Further advocacy is required to promote equity, diversity, and inclusion in our cardiology guidelines globally.
Collapse
Affiliation(s)
- Devesh Rai
- Department of Cardiology Sands-Constellation Heart InstituteRochester Regional Health Rochester NY
| | - Ashish Kumar
- Department of Internal Medicine Cleveland Clinic Akron General Akron OH
| | - Syed Hamza Waheed
- Department of Internal Medicine Rochester General Hospital Rochester NY
| | - Ritambhara Pandey
- Department of Internal Medicine Rochester General Hospital Rochester NY
| | | | - Ankita Kapoor
- Department of Internal Medicine Rochester General Hospital Rochester NY
| | | | - Salman Zahid
- Department of Internal Medicine Rochester General Hospital Rochester NY
| | - Adrija Hajra
- Department of Internal Medicine Jacobi Medical Center/Albert Einstein College of Medicine Bronx NY
| | - Mallory Balmer-Swain
- Department of Cardiology Sands-Constellation Heart InstituteRochester Regional Health Rochester NY
| | - Silvia Castelletti
- Center for Cardiac Arrhythmias of Genetic Origin IRCCS Istituto Auxologico Italiano Milan Italy
| | - Angela H E M Maas
- Department of Cardiology Radbound University Medical Center Nijmegen the Netherlands
| | - Julia Grapsa
- Cardiology Department St. Thomas Hospital Hospital London United Kingdom
| | - Sharon Mulvagh
- Division of Cardiology Dalhousie University Halifax NS Canada
| | - Shelley Zieroth
- Section of Cardiology University of Manitoba Winnipeg Manitoba Canada
| | - Ankur Kalra
- Department of Cardiology Cleveland Clinic Foundation Cleveland OH
| | - Erin D Michos
- Ciccarone Center for the Prevention of Cardiovascular Disease Johns Hopkins University School of Medicine Baltimore MD
| | - Martha Gulati
- Division of Cardiology University of Arizona Phoenix AZ
| |
Collapse
|
11
|
Viswanath A, Ahmad M. Letter by Viswanath and Ahmad Regarding Article, "National Trends of Sex Disparity in the American College of Cardiology/American Heart Association Guideline Writing Committee Authors Over 15 Years". Circ Cardiovasc Qual Outcomes 2021; 14:e008001. [PMID: 34162220 DOI: 10.1161/circoutcomes.121.008001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
12
|
Rai D, Waqas Tahir M, Hamza Waheed S, Kapoor A, Pandey R, Barssoum K, Hajra A, Balmer-Swain M, Michos ED, Gulati M. Response by Rai et al to Letter Regarding Article, "National Trends of Sex Disparity in the American College of Cardiology/American Heart Association Guideline Writing Committee Authors Over 15 Years". Circ Cardiovasc Qual Outcomes 2021; 14:e008115. [PMID: 34162219 DOI: 10.1161/circoutcomes.121.008115] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Devesh Rai
- Department of Internal Medicine, Rochester General Hospital, NY (D.R., M.W.T., S.H.W., A.K., R.P., K.B.)
| | - Muhammad Waqas Tahir
- Department of Internal Medicine, Rochester General Hospital, NY (D.R., M.W.T., S.H.W., A.K., R.P., K.B.)
| | - Syed Hamza Waheed
- Department of Internal Medicine, Rochester General Hospital, NY (D.R., M.W.T., S.H.W., A.K., R.P., K.B.)
| | - Ankita Kapoor
- Department of Internal Medicine, Rochester General Hospital, NY (D.R., M.W.T., S.H.W., A.K., R.P., K.B.)
| | - Ritambhara Pandey
- Department of Internal Medicine, Rochester General Hospital, NY (D.R., M.W.T., S.H.W., A.K., R.P., K.B.)
| | - Kirolos Barssoum
- Department of Internal Medicine, Rochester General Hospital, NY (D.R., M.W.T., S.H.W., A.K., R.P., K.B.)
| | - Adrija Hajra
- Department of Internal Medicine, Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, NY (A.H.)
| | - Mallory Balmer-Swain
- Department of Cardiology, Sands-Constellation Heart Institute, Rochester Regional Health, NY (M.B.-S.)
| | - Erin D Michos
- Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, MD (E.D.M.)
| | - Martha Gulati
- Division of Cardiology, University of Arizona, Phoenix (M.G.)
| |
Collapse
|