It is well documented that women are underrepresented in leadership within academic medicine. In biomedical sciences, they account for almost half of postdoctoral fellows but only 19% of tenured senior investigators. 1 Cardiology lags behind other internal medicine specialties with regard to women entering the field and achieving leadership positions. 2 However, little is known about women in cardiovascular clinical trial leadership. In this study, we describe their representation within leadership committees of clinical trials, as well as in lead authorship positions of ensuing trial publications.Methods | Because this quality improvement study did not involve patients, it was not subject to approval per the institutional review board specifications at the Cleveland Clinic. For this study, we included cardiovascular medicine publications presenting clinical trial results published in JAMA,

BackgroundDepression is strongly linked to increased morbidity and mortality in patients with chronic stable angina; however, its associated healthcare costs have been less well studied. Our objective was to identify the characteristics of chronic stable patients found to have depression and to determine the impact of an occurrence of depression on healthcare costs within 1 year of a diagnosis of stable angina.Methods and ResultsIn this population‐based study conducted in Ontario, Canada, we identified patients diagnosed with stable angina based on angiogram between October 1, 2008, and September 30, 2013. Depression was ascertained by physician billing codes and hospital admission diagnostic codes contained within administrative databases. The primary outcome was cumulative mean 1‐year healthcare costs following index angiogram. Generalized linear models were developed with a logarithmic link and γ distribution to determine predictors of cost. Our cohort included 22 917 patients with chronic stable angina. Patients with depression had significantly higher mean 1‐year healthcare costs ($32 072±$41 963) than patients without depression ($23 021±$25 741). After adjustment for baseline comorbidities, depression was found to be a significant independent predictor of cost, with a cost ratio of 1.33 (95% confidence interval, 1.29–1.37). Higher costs in depressed patients were seen in all healthcare sectors, including acute and ambulatory care.ConclusionsDepression is an important driver of healthcare costs in patients following a diagnosis of chronic stable angina. Further research is needed to understand whether improvements in the approach to diagnosis and treatment of depression will translate to reduced expenditures in this population.

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