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  • Item type:Publication,
    Trends in Women Authoring Editorials in Cardiothoracic Surgery Journals. Open PDF 
    (2026-05-01)
    Lee, Emily Hyunmin
    ;
    Gomes, Zoya
    ;
    Kim, Jinny Minji
    ;
    Liblik, Kiera
    ;
    Travis, Nicole
    INTRODUCTION: Women have historically been underrepresented in leadership positions and academia in cardiothoracic surgery, creating barriers to career advancement and limiting role models for trainees. While publications are used to measure success in academia, invited articles such as editorials often represent a formal recognition of expertise. The objective of this study was to identify trends in the gender of editorial authors published in cardiothoracic surgery journals. METHODS: Editorials published between 2018 and 2022 across 16 peer-reviewed cardiothoracic surgery journals were analyzed. Author gender was estimated using a validated tool (https://gender-api.com/) with additional verification using available institutional profiles. RESULTS: In total, 806 editorials were published with a total of 1,858 authors (293 women, 16%). Women authors were predominantly from the United States of America (45%) followed by India (9%) and Germany (8%). The percentage of women first authors increased between 2018 and 2022 (P < 0.001); 9% in 2018, 9% in 2019, 17% in 2020, 16% in 2021, and 23% in 2022. A similar trend was observed for women senior authorship (P < 0.0001) (6% in 2018, 9% in 2019, 14% in 2020, 15% in 2021, and 18% in 2022) as well as for editorials with all-women authorship (P < 0.0001), increasing steadily from 9% in 2018 to 20% in 2022. CONCLUSION: Women authorship in editorials published in cardiothoracic surgery journals has steadily increased in recent years. Despite progress, women still make up less than a quarter of first and senior authors, highlighting a critical gap in gender equity in academic leadership that must be urgently addressed.
  • Item type:Publication,
    Sex Disparities in Authorship Order of Cardiology Scientific Publications Open PDF 
    (2018)
    Ouyang, David
    ;
    Sing, David
    ;
    Shah, Sonia
    ;
    Hu, Jiaqi
    ;
    Duvernoy, Claire
    BACKGROUND: Despite advances in the representation of women in medical training, women continue to be underrepresented in cardiology, academic medicine, and more specifically, in senior positions within academic medicine. Identifying disparities in research productivity and acknowledgment can highlight barriers to female representation in academic cardiology leadership, as well as in academic promotion. METHODS AND RESULTS: This bibliometric analysis included all authors of original research articles between 1980 and 2017 from 3 high-impact cardiology journals ( Journal of the American College of Cardiology, Circulation, and European Heart Journal). We identified 71 345 unique authors of 55 085 primary research articles during our study period. Female authors accounted for 33.1% of all authors; however, they represented only 26.7% of first authors and 19.7% of senior authors. Looking at the most prolific authors within this time period, female authors were not well represented, accounting for only 5% of the top 100 authors. Articles with a female senior author had more female middle authors than articles with a male senior author (mean 1.41 versus 0.97, P<0.001) and were more likely to have a female first author (0.37 versus 0.18, P<0.001). There was an increased representation of female authors as first and senior authors compared with the total number of articles with female authors over time ( P<0.001 for trend); however, female senior authorship rates continued to lag first authorship rates. CONCLUSIONS: Using a large database of published manuscripts, we found that female representation in published cardiology research has increased over the past 4 decades. However, women continue to be not well represented as first authors, senior authors, and in the number of publications. When women were senior authors, they published more articles with female first authors and had more female authors. In addition to recruiting more women into the field of cardiology, additional work is needed to identify and address barriers to academic advancement for female physician-scientists.
  • Item type:Publication,
    Characteristics of Heart Failure Trials Associated With Under-Representation of Women as Lead Authors Open PDF 
    (2020)
    Whitelaw, Sera
    ;
    Thabane, Lehana
    ;
    Mamas, Mamas A.
    ;
    Reza, Nosheen
    ;
    Breathett, Khadijah
    BACKGROUND: Clinical trials change practice in cardiology, and leading them requires research training, mentorship, sponsorship, and networking. Women report challenges in obtaining these opportunities. OBJECTIVES: The purpose of this review was to evaluate temporal trends in representation of women as authors in heart failure (HF) randomized controlled trials (RCTs) published in high-impact medical journals and explore RCT characteristics associated with women as lead authors. METHODS: We searched MEDLINE, EMBASE, and CINAHL for HF RCTs published in journals with an impact factor ≥10 between January 1, 2000, and May 7, 2019. We assessed temporal trends in the gender distribution of authors, and used multivariable logistic regression to determine characteristics associated with women as lead authors. RESULTS: We identified 10,596 unique articles, of which 403 RCTs met inclusion criteria. Women represented 15.6% (95% confidence interval [CI]: 12.2% to 19.6%), 12.9% (95% CI: 9.8% to 16.6%), and 11.4% (95% CI: 8.5% to 14.9%) of lead, senior, and corresponding authors, respectively. The proportion of women authors has not changed over time. Women had lower odds of lead authorship in RCTs that were multicenter (odds ratio [OR]: 0.58; 95% CI: 0.18 to 0.96; p = 0.037), were coordinated in North America (OR: 0.21; 95% CI: 0.08 to 0.70; p = 0.011) or Europe (OR: 0.33; 95% CI: 0.09 to 0.91; p = 0.039), tested drug interventions (OR: 0.42; 95% CI: 0.16 to 0.97; p = 0.043), or had men as the senior author (OR: 0.50; 95% CI: 0.21 to 0.93; p = 0.043). CONCLUSIONS: Women are under-represented as authors of HF RCTs, with no change in temporal trends. Women had lower odds of lead authorship in RCTs that were multicenter, were coordinated in North America or Europe, tested drug interventions, or had men as senior authors.
  • Item type:Publication,
    Ending Gender Inequality in Cardiovascular Clinical Trial Leadership: JACC Review Topic of the Week Open PDF 
    (2021)
    Van Spall, Harriette G. C.
    ;
    Lala, Anuradha
    ;
    Deering, Thomas F.
    ;
    Casadei, Barbara
    ;
    Zannad, Faiez
    Women are under-represented as leaders of cardiovascular randomized controlled trials, representing 1 in 10 lead authors of cardiovascular trials published in high-impact journals. Although the proportion of cardiovascular specialists who are women has increased in recent years, the proportion of cardiovascular clinical trialists who are women has not. This gap, underpinned by systemic sexism, has not been adequately addressed. The benefits of diverse randomized controlled trial leadership extend to patients and professionals. In this position statement, we present strategies adopted by some organizations to end gender inequality in research leadership. We offer an actionable roadmap for early-career researchers, scientists, academic institutions, professional societies, trial sponsors, and journals to follow, with the goal of harnessing the strength of women and under-represented groups as research leaders and facilitating a just culture in the cardiovascular clinical trial enterprise.
  • Item type:Publication,
    Gender gap in cardiothoracic surgery randomized controlled trial and post-hoc analysis of randomized controlled trial authorship from 2014 to 2020 Open PDF 
    (2024)
    Shariff, Mariam
    ;
    Kumar, Ashish
    ;
    Stulak, John
    ;
    Naumann, Kathryn E.
    ;
    Blackmon, Shanda H.
    OBJECTIVES: To estimate gender disparities among first and last authorships in cardiothoracic randomized controlled trials (RCTs) and association of gender with publications in high-impact journals. METHODS: PubMed/MEDLINE database was searched from 1 January 2014 to 31 December 2020 using R statistical software via the 'easyPubMed' package to retrieve pertinent data. The 'gender' package was utilized to determine gender using the United States Social Security Administration Baby Name Data. The percentage of female first and last authors were computed along with determining the uniqueness of the names. The association of gender and publication in high-impact peer-reviewed journals was delineated. Jonckheere's trend was computed. RESULTS: The database search retrieved a total of 4820 RCTs, of which gender was encoded for the first author in 3247 (67%) RCTs, among which 911 (28%) studies had women as first authors, with a similar trend across 7 years (P = 0.23). Gender was encoded for the last author of 3204 (66%) RCTs, of which 622 (19%) studies had women as last authors, with a similar trend across 7 years (P = 0.45). A total of 627 studies were published in high-impact-factor journals, among which 79 (16%) studies had female first authors and 67 (13%) studies had female last authors. CONCLUSIONS: There is an obvious gender disparity of first and last authors in cardiothoracic surgery-related RCTs, with a similar trend across 7 years. However, the post-hoc analysis did demonstrate a positive trend with an increase in the number of female first authors, demonstrating progress.
  • Item type:Publication,
    Gender Parity in High Impact Cardiology Journals Open PDF 
    (2023)
    Petrechko, Oksana
    ;
    Faturos, Andrew S.
    ;
    Pal, Suman
    ;
    Khan, Umair
    ;
    Majeed, Harris
    Despite increased female representation in medical training, women physicians continue to be under-represented in academic cardiology, particularly in senior roles of authorship and leadership. We analyzed the top 20 most-cited cardiology journals (31,540 total articles) between January 1, 2018 and October 31, 2021 for gender distribution of editorial staff and authorship. Our data demonstrated that only 27% of articles had women as first authors and 20% as senior authors. Women constituted 23% of editorial staff. There is a statistically significant negative correlation (R = 0.67, P = 0.0011) between the percentage of women as first authors and the percentage of men on editorial boards. Overall, female authorship increased from 26% first and 19% senior authors in 2018, to 29% first and 22% senior authors in 2021. Women authors are significantly under-represented in academic cardiology publications, and additional work is needed to identify and address barriers to publishing and academic advancement for women in cardiology.
  • Item type:Publication,
    Gender Differences in Authorship in the Journal of Cardiothoracic and Vascular Anesthesia: A 28-Year Analysis of Publications Originating From the United States, 1990-2017 Open PDF 
    (2019)
    Pagel, Paul S.
    ;
    Freed, Julie K.
    ;
    Lien, Cynthia A.
    OBJECTIVE: Gender-based differences in scholarship among cardiothoracic anesthesiologists have not been studied. The authors examined the gender distribution of authorship of original research articles, case reports, review articles, and editorials in the Journal of Cardiothoracic and Vascular Anesthesia (JCVA) originating from the United States during four 3-year intervals to determine temporal changes in productivity of women in cardiothoracic anesthesiology. The authors tested the hypothesis that scholarly output of women has increased progressively in JCVA over time concomitant with greater participation in first, last, and corresponding author roles. DESIGN: Observational study. SETTING: Internet analysis. PARTICIPANTS: Authors of research articles, case reports, review articles, and editorials published in JCVA in 1990-92, 1999-2001, 2008-10, and 2015-17. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: The gender of each author was determined by inspection of the first name. If gender could not be established easily, the author's institutional website was examined or an internet search using the Google search engine was conducted. First, last, and corresponding authors as well as coauthors were noted for each article. A total of 1,195 publications with 4,982 authors (1,032 women; 20.7%) were examined. Gender was identified positively in 98.5% of authors. Women were first, last, and corresponding authors on 22.4%, 10.3%, and 14.6% of publications, respectively. The percentage of women who were authors increased from 12.1% in 1990-92 to 20.9% in 1999-2001 (p < 0.05), but plateaued in 2008 to 2010 (22.3%) and 2015 to 2017 (22.9%). Greater percentages of women were first authors (26.2%), senior authors (11.8%), and corresponding authors (16.6%) in 2015 to 2017 compared with 1990 to 1992 (9.6%, 7.0%, and 8.7%, respectively; p < 0.05 for each). The contributions of women to research articles and case reports were primarily responsible for these observed increases, although women also made a substantial impact with review articles in 2015 to 2017. The percentage of publications that included at least 1 female author in any capacity increased in a time-dependent manner (p < 0.05) from 31.0% (1990-1992) to 74.4% (2015-2017). The proportion of female first or last authors (35.0%) appearing in JCVA during 2015 to 2017 was modestly higher than the current percentage of female cardiothoracic anesthesiologists practicing in departments with accredited fellowship programs (29.1%). CONCLUSION: The results indicate that scholarly output of women rose in JCVA over time, but gains in productivity have plateaued more recently. These findings are encouraging, but women continue to be underrepresented in corresponding and last author roles.
  • Item type:Publication,
    Gender Composition and Trends of Journal of Cardiothoracic and Vascular Anesthesia Editorial Board Membership: A 33-Year Analysis, 1987-2019 Open PDF 
    (2019)
    Pagel, Paul S.
    ;
    Freed, Julie K.
    ;
    Lien, Cynthia A.
    OBJECTIVE: Gender disparities in editorial board composition exist in the vast majority of specialties including anesthesiology. If a similar lack of gender parity exists in cardiothoracic anesthesiology is unknown. The authors examined the gender composition and trends of the Journal of Cardiothoracic and Vascular Anesthesia (JCVA) editorial board from the initial year of its publication (1987) to 2019. The authors tested the hypothesis that the proportion of women serving on the JCVA editorial board has steadily increased over the journal's history, but women are underrepresented compared with the percentage of those currently practicing academic cardiothoracic anesthesia in the United States (US). DESIGN: Observational study. SETTING: Internet analysis. PARTICIPANTS: All members of the JCVA editorial board, 1987-2019. INTERVENTIONS: The JCVA editor-in-chief, the associate editor-in-chief, associate editors, section editors, and general editors on the board were extracted from the masthead of a single issue from each calendar year. The years were divided into quartiles (1987-1995, 1996-2003, 2004-2011, and 2012-2019) to collect representative samples of editorial board composition for analysis. MEASUREMENTS AND MAIN RESULTS: A total of 2,797 members of the JCVA editorial board were positively identified (2,477 [88.6%] men; 310 [11.1%] women); 10 (0.3%) editors could not be identified. Four hundred and fourteen associate and section editors were recorded (men 360 [87.0%], women 54 [13.0%]). There were also 2,353 general editors (2,087 [88.7%] men; 256 [10.9%] women). The total number of JCVA board members, associate and section editors, and general editors progressively increased from 1987 to 1995 to 2012 to 2019. The percentage of women serving on the editorial board increased from 2.5% to 15.8%. Increases in the proportion of female general editors from 2.9% to 16.2% were responsible for this overall increase. A gender gap between the percentage of female first authors (data obtained from a previous publication) and editorial board members was observed in each quartile. Editorial board composition was also different than last author distribution in 1987 to 1995 and 2012 to 2019, but not the other 2 time periods. CONCLUSIONS: The results demonstrate that the proportion of women serving on the JCVA editorial board has steadily increased over the journal's history. Nevertheless, women continue to be underrepresented on the JCVA board compared with the percentage of US female academic cardiothoracic anesthesiologists, and gender gaps between first and last authorship and board composition also persist.
  • Item type:Publication,
    Geographic Mapping of Gender Disparities in Authorship of Cardiovascular Literature Open PDF 
    (2024)
    Goel, Ridhima
    ;
    Sartori, Samantha
    ;
    Vogel, Birgit
    ;
    Okoli, Kimberly
    ;
    Franklin-Bedel, Kayla
    BACKGROUND: Women in cardiology experience considerable gender disparities in publications, which hinders their career advancements to higher faculty and senior leadership positions. However, the extent of these disparities across different types of cardiovascular literature is not well understood. OBJECTIVES: We investigated gender differences in authorship across various cardiovascular publications over a decade and examined geographic variations in the representation of women authors. METHODS: All papers published from January 1, 2010, to December 31, 2019, in 4 major cardiovascular journals (Journal of the American College of Cardiology, European Heart Journal, Journal of the American Medical Association Cardiology, and Nature Reviews Cardiology) were reviewed. RESULTS: Of the 18,535 papers with 111,562 authors, 20.6% of the authors were women, and 47.7% of the papers had no women authors. Over 10 years, the proportion of women authors remained low (20.7% in 2010 to 21.4% in 2019), with the lowest proportion in editorial papers (14.8%) and the highest in research papers (21.8%). More women as first (34.6%) and last (47.6%) authors were affiliated with institutions in the United States compared with other countries. The proportion of women middle-order authors was higher on papers with women as first authors (29.4% vs 20.5%) or last authors (30.6% vs 21.3%), compared with papers with men as first or last authors, respectively. CONCLUSIONS: Over the past decade, the proportion of women authors across all article types in major cardiovascular journals remained low. A call to action is needed to promote women in cardiology and provide them with equitable opportunities.
  • Item type:Publication,
    Gender Differences in Publication Authorship During COVID-19: A Bibliometric Analysis of High-Impact Cardiology Journals Open PDF 
    (2021)
    DeFilippis, Ersilia M.
    ;
    Sinnenberg, Lauren
    ;
    Mahmud, Nadim
    ;
    Wood, Malissa J.
    ;
    Hayes, Sharonne N.
    Background The purpose of this study was to examine gender differences in authorship of manuscripts in select high-impact cardiology journals during the early coronavirus disease 2019 (COVID-19) pandemic. Methods and Results All manuscripts published between March 1, 2019 to June 1, 2019 and March 1, 2020 to June 1, 2020 in 4 high-impact cardiology journals (Journal of the American College of Cardiology, Circulation, JAMA Cardiology, and European Heart Journal) were identified using bibliometric data. Authors' genders were determined by matching first name with predicted gender using a validated multinational database (Genderize.io) and manual adjudication. Proportions of women and men first, co-first, senior, and co-senior authors, manuscript types, and whether the manuscript was COVID-19 related were recorded. In 2019, women were first authors of 176 (22.3%) manuscripts and senior authors of 99 (15.0%) manuscripts. In 2020, women first authored 230 (27.4%) manuscripts and senior authored 138 (19.3%) manuscripts. Proportions of woman first and senior authors were significantly higher in 2020 compared with 2019. Women were more likely to be first authors if the manuscript's senior author was a woman (33.8% for woman first/woman senior versus 23.4% for woman first/man senior; P<0.001). Women were less likely to be first authors of COVID-19-related original research manuscripts (P=0.04). Conclusions Representation of women as key authors of manuscripts published in major cardiovascular journals increased during the early COVID-19 pandemic compared with similar months in 2019. However, women were significantly less likely to be first authors of COVID-19-related original research manuscripts. Future investigation into the gender-disparate impacts of COVID-19 on academic careers is critical.