Investigation on Gender Differences in Leadership of Stroke-Related Clinical Trials

Abstract

BACKGROUND: Gender disparities among principal investigators of clinical trials (CT) can have implications regarding the areas of investigation, methods, conduct, trial enrollment, and interpretation of results. An estimation of the gender gap in the leadership of stroke-related CTs from North America has to date not been undertaken. METHODS: We extracted information about stroke-related CTs between 2011 and 2020 from www.Clinicaltrials.gov and PubMed. We examined the gender distribution according to the academic credentials and the trial type. The gender of PIs and authors was determined using gender package in R, which identifies gender using historical data from the United States. Additionally, we obtained information from Association of American Medical Colleges and the Accreditation Council for Graduate Medical Education data resource books on the gender composition of full-time neurology faculty, neurology residents and vascular neurology fellows. RESULTS: In these analyses of 821 CTs registered on Clinicaltrials.gov and 110 trials published on PubMed, we found that gender disparity among the PIs, first and last authors have persisted over the last decade without any significant trend toward parity ( P >0.05). On examining the gender distribution according to academic credentials and trial type, we found that men were over-represented in the sub-group of PIs with an MD degree (78.11% versus 21.87%; P <0.01) and those leading acute stroke trials (86.04% versus 13.89%; P <0.01). We also found that a lower proportion of women neurology residents pursued a vascular neurology fellowship during this period (33.5% versus 42.5%; P <0.05). CONCLUSIONS: Our results show that the favorable trend toward gender parity seen in Neurology faculty over the last decade has not translated to the same in the leadership of CTs. Our findings merit further investigation and a re-examination of efforts toward inclusion of women as leaders of stroke-related CTs.

What Are the Trends in Women’s Representation Among Lead Investigators of Orthopaedic Clinical Trials?

“…Women's leadership in clinical trials has increased from 13% in 2007 to 22% in 2022. This growth is comparable to the representation of women as leaders in clinical trials across various medical specialties [16,18,23,34]. For instance, one study found an increase in women's leadership of oncology clinical trials from 17.5% in 1999 to 30.6% in 2019, suggesting an average annual growth of 0.65% [34].…”

Women and Leadership in Stroke Clinical Trials: Time for a Call to Action

“…The numbers in the study by Rawlley et al 8 deliver a clear message. We have failed in attracting and supporting young female medical doctors, not only in becoming clinical trialists and future academic leads, but first and foremost in specializing in stroke medicine.…”

“…In this issue of Stroke , Rawlley et al 8 have revealed that academic gender inequity is only the tip of the iceberg in stroke medicine. They present the results of their retrospective analysis with estimation of the sex gap in the field of stroke trials in North America.…”