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Review
. 2023 Apr 2:33:101117.
doi: 10.1016/j.conctc.2023.101117. eCollection 2023 Jun.

Gender-gap in randomized clinical trials reporting mortality in the perioperative setting and critical care: 20 years behind the scenes

Carolina S Romero  1   2 , Nicolò Maimeri  3 , Alessandra Bonaccorso  3 , Martina Baiardo-Redaelli  3 , Gaetano Lombardi  3 , Otito Frances Iwuchukwu  4 , Alessandro Ortalda  3 , Benedikt Schmid  5 , Magdalena Fleming  6 , Giovanni Landoni  7
Affiliations
Review

Gender-gap in randomized clinical trials reporting mortality in the perioperative setting and critical care: 20 years behind the scenes

Carolina S Romero et al. Contemp Clin Trials Commun. .

Abstract

Background: Women researchers might experience obstacles in academic environments and might be underrepresented in the authorship of articles published in peer-reviewed journals.

Material and methods: This is a cross-sectional analysis of female-led RCTs describing all interventions reducing mortality in critically ill and perioperative patients from 1981 to December 31, 2020. We searched PubMed/MEDLINE and EMBASE with the keywords RCTs and mortality. The gender of the first author was extracted and descriptive analysis was performed including the year of publication, impact factor, country of the first author, and methodological aspects.

Results: We analyzed 340 RCTs, of which 42 (12%) were led by female researchers. The presence of women increased from 8% (14/172) until 2010 up to 17% (28/168) in 2010 and beyond. The United States, the United Kingdom, and Brazil were the main countries of origin of female researchers. Women authors conducted mainly single-center and single-nation studies as compared to male authors. The median impact factor of the target journal was 6 (3-27) in women vs. 7 (3-28) in men, with a p-value of 0.67; Critical Care Medicine, JAMA, and The New England Journal of Medicine were the most frequent target journals for both women and men.

Conclusion: In the last 40 years, only one out of eight RCTs had a woman as the first author but the presence of women increased up to 17% by 2010 and beyond. The impact factor of publication target journals was high and not different between genders.

Keywords: Critically ill patient; Diversity; Equity; Gender gap; Inclusion; RCT.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Literature search strategy and gender assessment of the first author.
Fig. 2
Fig. 2
Histogram showing the proportion of women and men as first authors in RCTs reporting mortaility in critical care and in the perioperative setting.
Fig. 3
Fig. 3
Histogram with the number of women as first authors in RCTs reporting mortality in critical care and in the perioperative setting.
Fig. 4
Fig. 4
Dotplot showing the number of women and men as first authors in RCTs reporting mortaility in critical care and in the perioperative setting according to the impact factor of the journal.
See this image and copyright information in PMC

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