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  • Item type:Publication,
    The gender gap in academic anesthesiology and critical care medicine: a systematic review Open PDF 
    (Springer Science and Business Media LLC, 2024-12-20)
    De Cassai, Alessandro
    ;
    Rubulotta, Francesca
    ;
    Zdravkovic, Marko
    ;
    Mustaj, Sindi
    ;
    Berger-Estilita, Joana
    Abstract Purpose Gender disparities in academia are a growing concern, impacting various disciplines, including health care. We aimed to investigate gender-based differences in academic performance, leadership roles, and academic distinction within anesthesiology and critical care medicine. Source We conducted electronic searches for relevant articles published in PubMed, CENTRAL, Scopus, Web of Science, Embase, Education Resources Information Center, PsychINFO, and ProQuest from database inception until 23 June 2024. Three researchers conducted blinded assessments using predefined inclusion and exclusion criteria, with discrepancies resolved through discussion. We reported descriptive statistics for quantitative data from the included research articles. Principal findings Our initial screening identified 37,311 studies, 71 of which met the specified inclusion criteria and were therefore evaluated. Analysis of academic publishing trends revealed a gradual increase in the proportion of women as coauthors, first authors (in anesthesiology, the increase ranged from 7% to 17%, and in critical care medicine the increase was 4%), last authors, and corresponding authors. Despite these improvements, women remain underrepresented on the editorial boards of top journals. Although an increase in the representation of women as abstract presenters at conferences was noted, gender disparities persist in senior authorship roles. Conclusion Gender disparities are evident in academic leadership positions within anesthesiology and critical care medicine, with few women holding editor-in-chief positions and underrepresentation of women on editorial boards. We observed similar gaps in departmental and scientific society leadership roles. The distribution of awards, prizes, and grants remains skewed, indicating persistent gender imbalances in academic distinction. While progress has been made in certain areas, substantial gaps persist in scholarly publishing, leadership, and academic distinction.
  • Item type:Publication,
    Gender and Authorship in Pediatric Critical Care Randomized Control Trials∗ Open PDF 
    (2020)
    Xu, G.M.
    ;
    Zavalkoff, S.
    ;
    De Wildt, S.N.
    ;
    Duffett, M.
    Objectives: To examine the gender distribution of authorship of pediatric critical care randomized control trials. Data Sources: The 415 randomized control trials in pediatric critical care published before 2019. Study Selection: We included all randomized control trials enrolling children in a PICU. We used PICUtrials.net, which uses comprehensive search strategies of multiple databases, to identify published randomized control trials. Data Extraction: We manually extracted the name and profession of each listed author from each publication and classified each author as male or female based on their name. Results: We included 2,146 authors and were able to classify 1,888 (88%) as men or women. Overall, 38% of authors were women, this varied with the authorship position: 37% of first, 38% of middle, and 25% of last authors were women (p < 0.001). The three most common professions were physician (63%), nonclinician (11%), and nurse (6%) - of which 30%, 45%, and 97%, respectively, were women. The percentage of female authorship overall has increased from 28% in 1985-1989 to 39% in 2015-2018 (p for trend = 0.004). There were no significant differences in the characteristics of randomized control trials published with a female first or last author versus those with both male first and last authors with respect to the median number of children randomized (60 vs. 50; p = 0.41), multicentred trials (17% vs. 24%; p = 0.12), trials at low risk of bias (50% vs. 66%; p = 0.26), reporting any funding (55% vs. 51%; p = 0.66), or median number of citations per year (1.5 vs. 2.4; p = 0.09). Conclusions: Although increasing over time, the percentage of researchers publishing pediatric critical care randomized control trials who are women still lags behind the percentage clinicians who are women. Trials that female researchers publish are similar in characteristics and impact as male researchers. Further work should identify barriers to gender diversity and potential solutions in pediatric critical care research. © 2020 Lippincott Williams and Wilkins. All rights reserved.
  • Item type:Publication,
    Sex and gender-based analysis and diversity metric reporting in acute care trials published in high-impact journals: a systematic review Open PDF 
    (BMJ Open, 2024)
    D, Granton
    ;
    M, Rodrigues
    ;
    V, Raparelli
    ;
    K, Honarmand
    ;
    A, Agarwal
    Abstract Objective: To characterise sex and gender-based analysis (SGBA) and diversity metric reporting, representation of female/women participants in acute care trials and temporal changes in reporting before and after publication of the 2016 Sex and Gender Equity in Research guideline. Design: Systematic review. Data sources: We searched MEDLINE for trials published in five leading medical journals in 2014, 2018 and 2020. Study selection: Trials that enrolled acutely ill adults, compared two or more interventions and reported at least one clinical outcome. Data abstraction and synthesis: 4 reviewers screened citations and 22 reviewers abstracted data, in duplicate. We compared reporting differences between intensive care unit (ICU) and cardiology trials. Results: We included 88 trials (75 (85.2%) ICU and 13 (14.8%) cardiology) (n=111 428; 38 140 (34.2%) females/women). Of 23 (26.1%) trials that reported an SGBA, most used a forest plot (22 (95.7%)), were prespecified (21 (91.3%)) and reported a sex-by-intervention interaction with a significance test (19 (82.6%)). Discordant sex and gender terminology were found between headings and subheadings within baseline characteristics tables (17/32 (53.1%)) and between baseline characteristics tables and SGBA (4/23 (17.4%)). Only 25 acute care trials (28.4%) reported race or ethnicity. Participants were predominantly white (78.8%) and male/men (65.8%). No trial reported gendered-social factors. SGBA reporting and female/women representation did not improve temporally. Compared with ICU trials, cardiology trials reported significantly more SGBA (15/75 (20%) vs 8/13 (61.5%) p=0.005). Conclusions: Acute care trials in leading medical journals infrequently included SGBA, female/women and non-white trial participants, reported race or ethnicity and never reported gender-related factors. Substantial opportunity exists to improve SGBA and diversity metric reporting and recruitment of female/women participants in acute care trials.
  • Item type:Publication,
    Gender disparity in critical care publications: a novel Female First Author Index Open PDF 
    (2021)
    Chary, S.
    ;
    Amrein, K.
    ;
    Soeteman, D.I.
    ;
    Mehta, S.
    ;
    Christopher, K.B.
    Background: Bibliometric analyses show gender bias against women in scientific publications and citations. We hypothesized that a metric of an individual senior author’s inclusivity of women as first authors in critical care publications would predict gender inequality. Methods: Using PubMed and Web of Science, we conducted a bibliometric analysis of original research publications in critical care from 2008 to 2018 in 11 specialty and general journals. Gender for first and senior authors was assigned by a gender determination application, and manually if needed. For all senior authors we defined the novel Female First Author Index (FFA-index) = #Female first authors in publications by an individual senior author/Total # publications by that senior author. We produced a novel interactive web-based application using the R package Shiny to increase potential utilization of the FFA-index. Results: Of 7370 publications, 30.4% had female first authors and 15.5% had female senior authors. After adjustment for impact factor, journal, year of publication, number of authors, country, and gender determination accuracy, female senior authorship was associated with a 1.9-fold increase in female first authorship [OR = 1.85 (95% CI 1.62, 2.11); p < 0.001] compared with male senior authorship. The mean (SD) FFA-index for all individual senior authors was 30.5 (42.9); with a significant difference in FFA-index between male and female senior authors (27.6 versus 42.5, respectively; p < 0.001). The interactive web-based application (FFA-index App) produces the same FFA-index output as our study results. Conclusions: Female representation at prominent authorship positions in critical care publications is still far from achieving gender parity. By creating an authorship index score, we propose a frame of reference for the advancement of female first authorship. © 2021, The Author(s).