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  • Item type:Publication,
    Sex Disparities in Spine Surgeon Leadership of Clinical Trials for Degenerative Spine Disease Research Open PDF 
    (Ovid Technologies (Wolters Kluwer Health), 2025-08-28)
    Silvestre, Jason
    ;
    Walker, Jasmine J.
    ;
    Kang, James D.
    ;
    Ravinsky, Robert A.
    ;
    Lawrence, James P.
    Introduction: Despite increasing awareness, women remain underrepresented in academic spine surgery. This study assessed whether women were equitably represented among spine surgeon PIs of clinical trials for degenerative spine disease research. Methods: This was a retrospective cohort study of spine surgeon principal investigators (PIs) in the United States (2015 to 2022). ClinicalTrials.gov was queried for the most common diagnoses and surgeries for degenerative spine diseases. Characteristics of spine surgeon PIs were collected from academic profiles. Participation-to-prevalence ratios (PPRs) were calculated for men and women PIs relative to their prevalence among spine surgery faculty at accredited training programs. A PPR of 0.8 to 1.2 indicated equitable sex representation. A PPR <0.8 was defined as underrepresentation and >1.2 as overrepresentation. Results: In total, 129 spine surgeon PIs of 91 clinical trials were included in this study. Overall, there were 125 male (97%) and four female (3%) spine surgeon PIs. Overall, women were underrepresented among spine surgeon PIs (PPR = 0.64), whereas men had equitable representation (PPR = 1.02). From 2015 to 2018, female spine surgeons were underrepresented (PPR = 0.33), but achieved equitable representation from 2019 to 2022 (PPR = 0.95). Male spine surgeons had consistently equitable representation across the study period (PPR range 1.00 to 1.03). Women had equitable representation at assistant (PPR = 1.08) and associate (PPR = 0.31) professor ranks, but were underrepresented at the full professor rank (PPR = 0). PIs were funded by industry (54%), academic institution (44%), and US Federal (2%) sources. No differences were observed in funding sources by sex ( P = 0.36). Discussion: There are a limited number of female spine surgeon PIs for degenerative spine disease clinical trials, which may have negative implications on the vitality of the specialty moving forward. Future investigations are needed to understand the barriers women face in obtaining clinical trial leadership positions.
  • Item type:Publication,
    Gender, Racial, and Academic Authorship Diversity in the Otolaryngology Clinical Trial Literature Open PDF 
    (2024)
    Yang, H.-H.
    ;
    Huynh, J.D.
    ;
    Moffatt, C.
    ;
    Evans, L.K.
    ;
    Bommakanti, K.
    Objective: To investigate the state and trajectory of gender, racial, and academic authorship diversity in the otolaryngology clinical trial literature over the past 2 decades. Study Design: Bibliometric analysis. Setting: Otolaryngology clinical trial literature. Methods: Clinical trials published in the 9 major otolaryngology journals between 2000 and 2020 were included. The gender, race, and academic seniority of the first, senior, and corresponding authors were recorded for each trial. Multivariable regression models assessed the temporal trajectory of authorship diversity over time and the disparity in citations across author characteristics. Models adjusted for relevant confounders pertaining to publication environment and study design. Results: Among 2117 trials, first, senior, and corresponding authors have been predominantly White (60%-64%), male (76%-80%), and attending physicians (63%-69%). Trials led by Black (<1%) and Hispanic (<5%) authors were severely underrepresented. Over time, the representation of female (adj. β 0.8%, 95% CI [0.5%, 1.1%] per year), Asian (1.0% [0.7%, 1.3%] per year), and MD resident (0.4% [0.1%, 0.7%] per year) first authorship increased, but representation of female (0.2% [−0.1%, 0.5%] per year), Black (0% [−0.03%, 0.02%] per year), Hispanic (−0.2% [−0.33%, −0.02%] per year) senior authorship remained persistently low. Asian-led trials were cited significantly less compared to White-led trials even after adjusting for study design and publication year (aIRR 0.82 [0.73, 0.92]). Conclusions: Despite promising signs of improving authorship diversity over time, persistent underrepresentation of female, Black, Hispanic senior authorship underscore the need for additional efforts to diversify the otolaryngology clinical science workforce. © 2024 American Academy of Otolaryngology–Head and Neck Surgery Foundation.