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Piani F, Baffoni L, Strocchi E, Borghi C. Gender-Specific Medicine in the European Society of Cardiology Guidelines from 2018 to 2023: Where Are We Going? J Clin Med 2024; 13:4026. [PMID: 39064064 PMCID: PMC11278282 DOI: 10.3390/jcm13144026] [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: 06/09/2024] [Revised: 07/08/2024] [Accepted: 07/09/2024] [Indexed: 07/28/2024] Open
Abstract
Background/Objectives: Evidence-based medicine (EBM) shapes most clinical guidelines. Although the advent of EBM marked a significant advancement, failure to include sex differences in the study design and analysis of most trials leads to an under-representation of gender-specific medicine (GM) in EBM-directed guidelines. In this review, we evaluated how the topic of GM was developed in the guidelines produced by the European Society of Cardiology (ESC) from 2018 to 2023. Methods: Two independent reviewers evaluated 24 ESC guidelines. Significant mentions of GM were counted and divided between epidemiology, diagnosis, and therapeutics. The qualitative and semi-quantitative analysis of information relating to GM was performed. Data on the number of citations of papers with a title concerning GM and the prevalence and role of women in guidelines' authorship were also analyzed. Results: Less than 50% of guidelines had a section dedicated to GM. Only nine guidelines were led by a woman, and 144/567 authors were female. In the most recent guidelines and in those with at least 30% of female authors, there was an increased mention of GM. On average, guidelines had four significant mentions of GM regarding epidemiology, two regarding diagnosis, and one regarding therapy. Articles with titles concerning GM made up, on average, 1.5% of the total number of citations. Conclusions: Although sex differences play a significant role in most clinical scenarios, ESC guidelines still do not sufficiently account for this. The problem does not seem to solely lie in the guidelines, but in the lack of attention to GM in research needed for their preparation.
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Affiliation(s)
- Federica Piani
- Hypertension and Cardiovascular Risk Research Center, Medical and Surgical Sciences Department, Alma Mater Studiorum University of Bologna, 40138 Bologna, Italy
| | - Laura Baffoni
- Center for Gender Medicine OMCEO Rimini, 47923 Rimini, Italy
| | - Enrico Strocchi
- Hypertension and Cardiovascular Risk Research Center, Medical and Surgical Sciences Department, Alma Mater Studiorum University of Bologna, 40138 Bologna, Italy
| | - Claudio Borghi
- Hypertension and Cardiovascular Risk Research Center, Medical and Surgical Sciences Department, Alma Mater Studiorum University of Bologna, 40138 Bologna, Italy
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2
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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.
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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
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3
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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.
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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
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Prichard R, Maneze D, Straiton N, Inglis SC, McDonagh J. Strategies for improving diversity, equity, and inclusion in cardiovascular research: a primer. Eur J Cardiovasc Nurs 2024; 23:313-322. [PMID: 38190724 DOI: 10.1093/eurjcn/zvae002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Accepted: 01/02/2024] [Indexed: 01/10/2024]
Abstract
This paper aims to empower cardiovascular (CV) researchers by promoting diversity, equity, and inclusion (DE&I) principles throughout the research cycle. It defines DE&I and introduces practical strategies for implementation in recruitment, retention, and team dynamics within CV research. Evidence-based approaches supporting underrepresented populations' participation are outlined for each research phase. Emphasizing the significance of inclusive research environments, the paper offers guidance and resources. We invite CV researchers to actively embrace DE&I principles, enhancing research relevance and addressing longstanding CV health disparities.
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Affiliation(s)
- Roslyn Prichard
- Faculty of Health, University of the Sunshine Coast, 90 Sippy Downs Drive, Sippy Downs, 4556 Queensland, Australia
| | - Della Maneze
- School of Nursing, Faculty of Science, Medicine, and Health, University of Wollongong, Wollongong, New South Wales, Australia
| | - Nicola Straiton
- St Vincent's Health Network, Nursing Research Institute, Australian Catholic University, Sydney, New South Wales, Australia
| | - Sally C Inglis
- IMPACCT, Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Julee McDonagh
- School of Nursing, Faculty of Science, Medicine, and Health, University of Wollongong, Wollongong, New South Wales, Australia
- Centre for Chronic and Complex Care Research, Blacktown Hospital, Blacktown, New South Wales, Australia
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Ortega-Paz L, Mehran R, Angiolillo DJ. North American perspective on the 2023 European Society of Cardiology guidelines for the management of acute coronary syndromes. EUROPEAN HEART JOURNAL. ACUTE CARDIOVASCULAR CARE 2024; 13:165-172. [PMID: 38092517 DOI: 10.1093/ehjacc/zuad153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 12/08/2023] [Indexed: 02/10/2024]
Affiliation(s)
- Luis Ortega-Paz
- Division of Cardiology, University of Florida College of Medicine, 655 West 8th Street, Jacksonville, FL 32209, USA
| | - Roxana Mehran
- The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, NewYork, NY, USA
| | - Dominick J Angiolillo
- Division of Cardiology, University of Florida College of Medicine, 655 West 8th Street, Jacksonville, FL 32209, USA
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6
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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.
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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)
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7
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Lohana AC, Rahaman Z, Mohammed YN, Samreen SD, Gulati A, Shivani F, Khurana S, Kumar D, Kirshan Kumar S. A Systematic Review of Gender Disparity in the Authorship of Clinical Trials and Clinical Practice Guidelines in Various Medicine Subspecialties. Cureus 2024; 16:e54165. [PMID: 38496166 PMCID: PMC10941234 DOI: 10.7759/cureus.54165] [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: 02/13/2024] [Indexed: 03/19/2024] Open
Abstract
Authorship in clinical trials and clinical practice guidelines is considered prestigious and is associated with broader peer recognition. This systematic review investigated female representation among studies reporting authorship trends in clinical trials or clinical practice guidelines in different medicine subspecialties. Our search strategy yielded 836 articles, of which 30 met the inclusion criteria. Our findings indicate that females are severely underrepresented in authorship of clinical trials and clinical practice guidelines. Although the proportions of females may have improved in the past decade, the gains are marginal. Notably, studies in this domain predominantly focus on first/last authorship positions, and whether females are underrepresented in other positions as collaborative partners is currently unknown. Also, authorship trends in clinical trials or clinical practice guidelines of most medicine subspecialties besides cardiovascular medicine remain under-researched. Hence, standardizing the methodology for studying gender disparity in research output for comparative analysis between different subspecialties is as urgent as addressing the gender disparity in authorship.
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Affiliation(s)
- Abhi C Lohana
- Internal Medicine, West Virginia University (WVU) / Camden Clark Medical Center, Parkersburg, USA
| | - Zubair Rahaman
- Internal Medicine, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, USA
| | - Yaqub N Mohammed
- Internal Medicine, Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, USA
| | | | - Amit Gulati
- Cardiology, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Fnu Shivani
- Internal Medicine, Ascension Saint Joseph, Chicago, USA
| | - Sakshi Khurana
- Radiology, NewYork-Presbyterian/Columbia University Irving Medical Center, New York, USA
| | - Danesh Kumar
- Internal Medicine, Henry Ford Jackson Hospital, Jackson, USA
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8
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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: 3] [Impact Index Per Article: 3.0] [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.
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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
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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
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Dakhil ZA, Al-Jorani MS, Cader FA. Representation in Authorship of European Society of Cardiology Guidelines: Sex Differences, Temporal Trends, and Geographic Perspective. CARDIOVASCULAR REVASCULARIZATION MEDICINE 2023; 52:99-101. [PMID: 36842932 DOI: 10.1016/j.carrev.2023.02.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 02/12/2023] [Accepted: 02/14/2023] [Indexed: 02/25/2023]
Affiliation(s)
| | | | - F Aaysha Cader
- Department of Cardiology, Ibrahim Cardiac Hospital & Research Institute, Dhaka, Bangladesh.
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11
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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.)
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12
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Ravioli S, Oberle J, Haidinger M, Lindner G. Gender equality in national cardiology societies: a cross-sectional study. Am J Med 2023; 136:585-591. [PMID: 36906170 DOI: 10.1016/j.amjmed.2023.02.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 02/03/2023] [Indexed: 03/11/2023]
Abstract
BACKGROUND Higher productivity and team stability has been shown for gender diverse teams. However, there is a relevant and well-known gender gap in clinical and academic cardiovascular medicine. So far, no data concerning gender distribution in presidents and executive boards of national cardiology societies exist. METHODS In this cross-sectional analysis, gender equality in presidents and representatives of all national cardiology societies, which are members of or affiliated with the European Society of Cardiology (ESC) in 2022 was analyzed. In addition, representatives of the American Heart Association (AHA) were evaluated. RESULTS A total of 106 national societies were screened of which 104 were included in the final analysis. Overall, in these 104 societies, 90 out of 106 (85%) presidents were men while 14 (13%) were women. In the analysis of board members and executives, a total of 1128 individuals were included. Overall, 809 (72%) board members were men, 258 (23%) women and 61 (5%) of unknown gender. Except for society presidents in Australia, women were relevantly outnumbered by men in all world regions. CONCLUSION Women were globally underrepresented in leading positions of national cardiology societies in all world regions. As national societies are important regional stakeholders, improving gender equality in executive boards might create women role models, help foster careers and narrow the global cardiology gender gap.
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Affiliation(s)
- Svenja Ravioli
- Department of Emergency Medicine, King's College Hospital NHS Foundation Trust, London SE5 9RS, UK
| | - Jolanda Oberle
- Department of Internal and Emergency Medicine, Buergerspital Solothurn, Switzerland
| | - Michael Haidinger
- Department of Internal and Emergency Medicine, Buergerspital Solothurn, Switzerland
| | - Gregor Lindner
- Department of Emergency Medicine, Inselspital, University Hospital Bern and University of Bern, Switzerland.
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Shaver N, Bennett A, Beck A, Skidmore B, Traversy G, Brouwers M, Little J, Moher D, Moore A, Persaud N. Health equity considerations in guideline development: a rapid scoping review. CMAJ Open 2023; 11:E357-E371. [PMID: 37171906 PMCID: PMC10139082 DOI: 10.9778/cmajo.20220130] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/14/2023] Open
Abstract
BACKGROUND Systematic guidance for considering health equity in guidelines is lacking. This scoping review aims to synthesize current best practices for integrating health equity into guideline development and the benefits or drawbacks of these practices. METHODS We searched Ovid MEDLINE ALL and Embase Classic+Embase on the Ovid platform, CINAHL on EBSCO, and Web of Science (Core Collection) from 2010 to 2022. We searched grey literature from 2015 to 2022, using the Canadian Agency for Drugs and Technologies in Health Grey Matters checklist and searches of potentially relevant websites. Articles were screened independently by 1 reviewer. Proposed best practices, advantages and disadvantages, and tools were extracted independently by 1 reviewer and qualitatively synthesized based on the relevant steps of a comprehensive checklist covering the stages of guideline development. RESULTS We included 26 articles that proposed best practices for incorporating health equity within the guideline development process. These practices were organized under different stages of the development process, including guideline planning, evidence review, guideline development and dissemination. Included studies provided best practices from guideline producers, articles discussing health equity in current guidelines, articles addressing strategies to increase equity in the guideline implementation process, and literature reviews of promising health equity practices. INTERPRETATION Our scoping review identified best practices to incorporate health equity considerations at each phase of guideline development. Identified practices may be used to inform equity-promoting strategies with the guideline development process; however, guideline producers should carefully consider the advantages and disadvantages of best practices when integrating health equity.
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Affiliation(s)
- Nicole Shaver
- School of Epidemiology and Public Health, Faculty of Medicine (Shaver, Bennett, Beck, Brouwers, Little, Moher), University of Ottawa; Skidmore Research & Information Consulting (Skidmore); Centre for Chronic Disease Prevention and Health Equity (Traversy), Public Health Agency of Canada; Clinical Epidemiology Program (Moher), Ottawa Hospital Research Institute, Ottawa, Ont.; Department of Family Medicine (Moore), McMaster University, Hamilton, Ont.; Department of Family and Community Medicine (Persaud), St. Michael's Hospital, Toronto, Ont
| | - Alexandria Bennett
- School of Epidemiology and Public Health, Faculty of Medicine (Shaver, Bennett, Beck, Brouwers, Little, Moher), University of Ottawa; Skidmore Research & Information Consulting (Skidmore); Centre for Chronic Disease Prevention and Health Equity (Traversy), Public Health Agency of Canada; Clinical Epidemiology Program (Moher), Ottawa Hospital Research Institute, Ottawa, Ont.; Department of Family Medicine (Moore), McMaster University, Hamilton, Ont.; Department of Family and Community Medicine (Persaud), St. Michael's Hospital, Toronto, Ont.
| | - Andrew Beck
- School of Epidemiology and Public Health, Faculty of Medicine (Shaver, Bennett, Beck, Brouwers, Little, Moher), University of Ottawa; Skidmore Research & Information Consulting (Skidmore); Centre for Chronic Disease Prevention and Health Equity (Traversy), Public Health Agency of Canada; Clinical Epidemiology Program (Moher), Ottawa Hospital Research Institute, Ottawa, Ont.; Department of Family Medicine (Moore), McMaster University, Hamilton, Ont.; Department of Family and Community Medicine (Persaud), St. Michael's Hospital, Toronto, Ont
| | - Becky Skidmore
- School of Epidemiology and Public Health, Faculty of Medicine (Shaver, Bennett, Beck, Brouwers, Little, Moher), University of Ottawa; Skidmore Research & Information Consulting (Skidmore); Centre for Chronic Disease Prevention and Health Equity (Traversy), Public Health Agency of Canada; Clinical Epidemiology Program (Moher), Ottawa Hospital Research Institute, Ottawa, Ont.; Department of Family Medicine (Moore), McMaster University, Hamilton, Ont.; Department of Family and Community Medicine (Persaud), St. Michael's Hospital, Toronto, Ont
| | - Gregory Traversy
- School of Epidemiology and Public Health, Faculty of Medicine (Shaver, Bennett, Beck, Brouwers, Little, Moher), University of Ottawa; Skidmore Research & Information Consulting (Skidmore); Centre for Chronic Disease Prevention and Health Equity (Traversy), Public Health Agency of Canada; Clinical Epidemiology Program (Moher), Ottawa Hospital Research Institute, Ottawa, Ont.; Department of Family Medicine (Moore), McMaster University, Hamilton, Ont.; Department of Family and Community Medicine (Persaud), St. Michael's Hospital, Toronto, Ont
| | - Melissa Brouwers
- School of Epidemiology and Public Health, Faculty of Medicine (Shaver, Bennett, Beck, Brouwers, Little, Moher), University of Ottawa; Skidmore Research & Information Consulting (Skidmore); Centre for Chronic Disease Prevention and Health Equity (Traversy), Public Health Agency of Canada; Clinical Epidemiology Program (Moher), Ottawa Hospital Research Institute, Ottawa, Ont.; Department of Family Medicine (Moore), McMaster University, Hamilton, Ont.; Department of Family and Community Medicine (Persaud), St. Michael's Hospital, Toronto, Ont
| | - Julian Little
- School of Epidemiology and Public Health, Faculty of Medicine (Shaver, Bennett, Beck, Brouwers, Little, Moher), University of Ottawa; Skidmore Research & Information Consulting (Skidmore); Centre for Chronic Disease Prevention and Health Equity (Traversy), Public Health Agency of Canada; Clinical Epidemiology Program (Moher), Ottawa Hospital Research Institute, Ottawa, Ont.; Department of Family Medicine (Moore), McMaster University, Hamilton, Ont.; Department of Family and Community Medicine (Persaud), St. Michael's Hospital, Toronto, Ont
| | - David Moher
- School of Epidemiology and Public Health, Faculty of Medicine (Shaver, Bennett, Beck, Brouwers, Little, Moher), University of Ottawa; Skidmore Research & Information Consulting (Skidmore); Centre for Chronic Disease Prevention and Health Equity (Traversy), Public Health Agency of Canada; Clinical Epidemiology Program (Moher), Ottawa Hospital Research Institute, Ottawa, Ont.; Department of Family Medicine (Moore), McMaster University, Hamilton, Ont.; Department of Family and Community Medicine (Persaud), St. Michael's Hospital, Toronto, Ont
| | - Ainsley Moore
- School of Epidemiology and Public Health, Faculty of Medicine (Shaver, Bennett, Beck, Brouwers, Little, Moher), University of Ottawa; Skidmore Research & Information Consulting (Skidmore); Centre for Chronic Disease Prevention and Health Equity (Traversy), Public Health Agency of Canada; Clinical Epidemiology Program (Moher), Ottawa Hospital Research Institute, Ottawa, Ont.; Department of Family Medicine (Moore), McMaster University, Hamilton, Ont.; Department of Family and Community Medicine (Persaud), St. Michael's Hospital, Toronto, Ont
| | - Navindra Persaud
- School of Epidemiology and Public Health, Faculty of Medicine (Shaver, Bennett, Beck, Brouwers, Little, Moher), University of Ottawa; Skidmore Research & Information Consulting (Skidmore); Centre for Chronic Disease Prevention and Health Equity (Traversy), Public Health Agency of Canada; Clinical Epidemiology Program (Moher), Ottawa Hospital Research Institute, Ottawa, Ont.; Department of Family Medicine (Moore), McMaster University, Hamilton, Ont.; Department of Family and Community Medicine (Persaud), St. Michael's Hospital, Toronto, Ont
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14
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Sierra-Galan LM, Aggarwal NR, Stojanovska J, Raman SV, Han Y, Ferreira VM, Thomas K, Seiberlich N, Parwani P, Bucciarelli-Ducci C, Baldassarre LA, Mavrogeni S, Ordovas K, Schulz-Menger J, Bandettini WP. Women physicians in cardiovascular magnetic resonance: Past, present, and future. Front Cardiovasc Med 2023; 9:984326. [PMID: 36684587 PMCID: PMC9848434 DOI: 10.3389/fcvm.2022.984326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 12/12/2022] [Indexed: 01/06/2023] Open
Abstract
Women's engagement in medicine, and more specifically cardiovascular imaging and cardiovascular MRI (CMR), has undergone a slow evolution over the past several decades. As a result, an increasing number of women have joined the cardiovascular imaging community to contribute their expertise. This collaborative work summarizes the barriers that women in cardiovascular imaging have overcome over the past several years, the positive interventions that have been implemented to better support women in the field of CMR, and the challenges that still remain, with a special emphasis on women physicians.
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Affiliation(s)
- Lilia M. Sierra-Galan
- Cardiology Department of the Cardiovascular Division at the American British Cowdray Medical Center, Mexico City, Mexico
| | - Niti R. Aggarwal
- Department of Cardiovascular Disease, Mayo Clinic, Rochester, MN, United States
| | | | - Subha V. Raman
- Indiana University School of Medicine, Indianapolis, IN, United States
| | - Yuchi Han
- The Ohio State University Wexner Medical Center, Columbus, OH, United States
| | - Vanessa M. Ferreira
- University of Oxford Centre for Clinical Magnetic Resonance Research, Oxford British Heart Foundation Centre of Research Excellence, The National Institute for Health Research Oxford Biomedical Research Centre at the Oxford University Hospitals NHS Foundation Trust, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Katharine Thomas
- University of Oxford Centre for Clinical Magnetic Resonance Research, Oxford British Heart Foundation Centre of Research Excellence, The National Institute for Health Research Oxford Biomedical Research Centre at the Oxford University Hospitals NHS Foundation Trust, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Nicole Seiberlich
- Department of Radiology, University of Michigan, Ann Arbor, MI, United States
| | - Purvi Parwani
- Division of Cardiology, Department of Medicine, Loma Linda University Health, Loma Linda, CA, United States
| | | | - Lauren A. Baldassarre
- Section of Cardiovascular Medicine, Yale School of Medicine, New Haven, CT, United States
| | | | - Karen Ordovas
- Department of Radiology, University of Washington, Seattle, WA, United States
| | - Jeanette Schulz-Menger
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, ECRC Cardiology, Helios-Clinics Berlin-Buch, Clinic of Cardiology and Nephrology, DZHK Partnersite Berlin, Berlin, Germany
| | - W. Patricia Bandettini
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, United States
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15
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Burgess SN, Mamas MA. Narrowing disparities in PCI outcomes in women; From risk assessment, to referral pathways and outcomes. AMERICAN HEART JOURNAL PLUS : CARDIOLOGY RESEARCH AND PRACTICE 2022; 24:100225. [PMID: 38560635 PMCID: PMC10978432 DOI: 10.1016/j.ahjo.2022.100225] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 10/23/2022] [Accepted: 10/26/2022] [Indexed: 04/04/2024]
Abstract
This review evaluates published data regarding outcomes for women with ACS undergoing PCI. Data is discussed from a patient centred perspective and timeline, beginning with sex-based differences in perception of risk, time to presentation, time to treatment, access to angiography, access to angioplasty, the impact of incomplete revascularization, prescribing practices, under-representation of women in randomized controlled trials and in cardiology physician workforces. The objective of the review is to identify factors contributing to outcome disparities for women with ACS, and to discuss potential solutions to close this outcome gap.
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Affiliation(s)
- Sonya N. Burgess
- Department of Cardiology, Nepean Hospital, Sydney, Australia
- University of Sydney, NSW, Australia
| | - Mamas A. Mamas
- Keele Cardiovascular Research Group, Keele University, Stoke on Trent, UK
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16
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Bhat V, Ozair A, Bellur S, Subhash NR, Kumar A, Majmundar M, Kalra A. Inequities in Country- and Gender-Based Authorship Representation in Cardiology-Related Cochrane Reviews. JACC. ADVANCES 2022; 1:100140. [PMID: 38939467 PMCID: PMC11198072 DOI: 10.1016/j.jacadv.2022.100140] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/29/2024]
Affiliation(s)
| | | | | | | | | | | | - Ankur Kalra
- Franciscan Health, 3900 St. Francis Way, Suite 200, Lafayette, Indiana 47905, USA
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17
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Villela PB. The First Step. Arq Bras Cardiol 2022; 119:968-969. [PMID: 36541992 PMCID: PMC9814807 DOI: 10.36660/abc.20220807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Affiliation(s)
- Paolo Blanco Villela
- Universidade Federal do Rio de JaneiroRio de JaneiroRJBrasilUniversidade Federal do Rio de Janeiro, Rio de Janeiro, RJ – Brasil,Correspondência: Paolo Blanco Villela • Universidade Federal do Rio de Janeiro – Rua Professor Rodolpho Paulo Rocco, 255 / 8o. Andar. CEP 21941-913, Rio de Janeiro, RJ – Brasil, E-mail:
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18
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Dakhil ZA. Representation of Women in the Writing Committees and Task Forces in International Arrhythmia-Related Guidelines. Circ Arrhythm Electrophysiol 2022; 15:e010740. [PMID: 35763434 DOI: 10.1161/circep.121.010740] [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] [Indexed: 11/16/2022]
Affiliation(s)
- Zainab Atiyah Dakhil
- Department of Cardiology, Ibn Al-Bitar Cardiac Centre & Department of Medicine, Al-Kindy College of Medicine, University of Baghdad, Iraq
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19
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Affiliation(s)
- Tracy Y Wang
- Duke Clinical Research Institute, Duke University, Durham NC
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20
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Cushman M. Women Authorship in Cardiovascular Science: A Call to Track and Report to Achieve Equity. J Am Heart Assoc 2022; 11:e025456. [PMID: 35191323 PMCID: PMC9075083 DOI: 10.1161/jaha.122.025456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Mary Cushman
- Department of Medicine Larner College of Medicine at the University of Vermont Burlington VT
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