Women under-represented as authors of heart failure trials

Women as authors of randomized controlled trials (RCTs) on heart failure (HF) remain under-represented, with no change seen in temporal trends, reports a study.

“Women had lower odds of lead authorship in RCTs that were multicentre, were coordinated in North America or Europe, tested drug interventions, or had men as senior authors,” the investigators said.

Women have previously reported certain challenges in obtaining leadership opportunities in clinical trials, which required research training, mentorship, sponsorship, and networking. A review was conducted to assess this experience.

The investigators searched Medline, Embase, and Cinahl for HF RCTs published in journals with an impact factor ≥10 between 1 January 2000 and 7 May 2019. They examined temporal trends in the gender distribution of authors and used multivariate logistic regression to determine characteristics associated with women as lead authors.

A total of 10,596 unique articles were identified, of which 403 RCTs met the inclusion criteria. Women represented only 15.6 percent (95 percent confidence interval [CI], 12.2–19.6 percent) of lead authors. In terms of senior and corresponding authorship, they represented only 12.9 percent (95 percent CI, 9.8–16.6) and 11.4 percent (8.5–14.9 percent), respectively.

Furthermore, women were less likely to become lead authors in RCTs that were multicentre (odds ratio [OR], 0.58, 95 percent CI, 0.18–0.96; p=0.037), were coordinated in North America (OR, 0.21, 95 percent CI, 0.08–0.70; p=0.011) or Europe (OR, 0.33, 95 percent CI, 0.09–0.91; p=0.039), tested drug interventions (OR, 0.42, 95 percent CI, 0.16–0.97; p=0.043), or had men as the senior author (OR, 0.50, 95 percent CI, 0.21–0.93; p=0.043).