Gender Disparities in Cardiac Surgery Trials: Leadership, Authorship, and Patient Enrollment.
Review
Overview
abstract
BACKGROUND: Studies have highlighted the paucity of women-led randomized controlled trials (RCTs) in cardiovascular medicine. Whether this finding also applies to cardiac surgery has not been evaluated. In this study, we evaluate women authorship, leadership, and women enrollment in cardiac surgery RCTs. METHODS: A systematic literature search was conducted to identify RCTs comparing two or more adult cardiac surgical procedures published from 2000 to 2022. Women-led RCTs were defined as those with a woman either as a first or last author. Linear regression and correlation analyses were used. RESULTS: Of fifty-eight RCTs, eight (13.8%) were women-led. Seventeen (29.3%) RCTs had no women authors. Overall, 17.9% of all authors were women, but only 1.2% of all authors were women cardiac surgeons and only 19% of the RCTs had a women cardiac surgeon among the authors. The median proportion of women authors was 14.3% by RCT, which was significantly higher in women- compared to men-led RCTs (28.6% vs 11.8%, P=0.01). No significant change in the proportion of women authors was observed over the study period. North American RCTs had a higher proportion of women authors compared to other geographical regions (28.6% vs 12.5%, P=0.01). No correlation was found between the proportion of women authors and the proportion of women participants enrolled in individual RCTs. CONCLUSIONS: Over the last two decades, only a minority of cardiac surgery RCTs were women-led and no significant increase in women authorship occurred. There are important geographical differences in women authorship.
