BackgroundGiven the readily increasing membership of the pain physician community, efforts toward correcting notable gender disparities are instrumental. The under-representation of women is particularly prevalent within leadership roles in academic medicine, thought to be driven largely by diminished research efforts. Consequently, we aimed to characterize gender differences among the highest impact pain literature.MethodsThe 20 highest cited articles per year from 2014 to 2018 were extracted from each of seven impactful journals affiliated to the largest pain medicine societies. Collected data from each article included genders of the first and last authors, the number of citations accumulated and the journal impact factor at the time of publication.ResultsAcross all considered literature, female authors were surprisingly not under-represented when considering the national prevalence of female pain physicians. However, more in-depth analysis found trends toward significance to suggest that female authorship was relatively diminished within more impactful and higher cited literature. When exploring gender–gender collaboration patterns, we found that male authors were favored over female counterparts with statistical significance; it must be noted that this likelihood analysis and preference toward male authors may be statistically obfuscated by the high prevalence of male authors. Nonetheless, these findings help to quantify overt, demonstrated disparity patterns. Of note, this inequity may also be fully secondary to the lower number of female pain physicians and/or those involved in research endeavors and decreased number of submissions from female physicians. Establishing gender discrimination patterns as causal factors in such disparities can be extremely challenging to determine.ConclusionIn our analysis of authorship between genders within the context of pain medicine literature, we found trends, although non-significant, toward women being lesser represented in the more impactful literature. We suggest that these inequities are possibly resultant of a markedly small and outnumbered female pain physician membership that has yet to achieve a critical mass and possible implicit gender biases that may restrict female authorship. However, further exploration and analysis of this issue are necessary to more clearly illuminate which systemic deficits exist and how they may, in turn, be corrected with cultural and macroscopic organizational-driven change.

Purpose This study was conducted to characterize the gender disparities within academic pain management departments in the United States, specifically focusing on its relation to research and academic leadership. This will allow for targeted improvements in efforts made to reduce gender gaps within academic pain medicine. Methods This is a retrospective, cross-sectional analysis study evaluating pain management faculty of various positions at academic institutions across the United States. We utilized publicly available data on faculty positions and sex to analyze research impact, H-index, number of publications and citations through bibliometric and linear regression analysis. Results Our analysis found that female faculty had significantly less research output to male faculty. The three research measurement indices used in this study including H-index, number of publications, and number of citations were significantly lower in females than in males among associate and full professor faculty ranking. Multivariable analysis did not display any significant disparities of research output at the division director and department chair level. Discussion As in many areas of medicine, there continues to be a significant gender disparity in academic pain management departments, particularly with regard to leadership positions and research impact within the field. Our study found that female pain physicians had a significantly less research output based on the three variables of H indices, number of publications, and number of citations compared to their male counterparts. This has been shown to have the impact on discrepancies in female faculty ranking. Interestingly, these variables were not significantly different between male and female faculty members of the same level of leadership except for program director. There are various contributory reasons for these disparities, including implicit biases, lack of mentorship, and familial obligations. Addressing some of these factors can help narrow the schism and promote greater gender equality within academic pain management.

Biological drugs, termed biologics, are medications that contain or are derived from a living organism (human, animal, or microorganism). With new biological agents being approved by the Food and Drug Administration (FDA) every year, clinicians need to know potential ocular adverse effects that are associated with these drugs. This review provides an overview of ocular adverse effects of biological medications used to treat both ophthalmic and non-ophthalmic diseases. We searched PubMed for relevant case reports, case series, reviews, and clinical trials reporting ocular adverse effects caused by biologics. This review was conducted in June 2021 and investigated the drugs listed in the most updated (April 2021) FDA Purple Book Database of Licensed Biological Products. This review focuses on monoclonal antibodies, interleukins, and receptor fusion proteins. We explore ocular side effects of 33 biological drugs, stating whether they are frequent, common, or rare.