Department of Cardiothoracic Surgery, Weill Cornell Medicine, New York, New York.
Department of Anesthesiology, Weill Cornell Medicine/NewYork-Presbyterian Hospital, New York, New York.
Ann Thorac Surg. 2023 Sep;116(3):643-649. doi: 10.1016/j.athoracsur.2023.01.022. Epub 2023 Jan 25.
Studies have highlighted the paucity of women-led randomized controlled trials (RCTs) in cardiovascular medicine. Whether this finding also applies to cardiac surgery has not been evaluated. In this study, we evaluate women authorship, leadership, and women enrollment in cardiac surgery RCTs.
A systematic literature search was conducted to identify RCTs comparing 2 or more adult cardiac surgical procedures published from 2000 to 2022. Women-led RCTs were defined as those with a woman as either a first or last author. Linear regression and correlation analyses were used.
Of 58 RCTs, 8 (13.8%) were women-led; 17 (29.3%) RCTs had no women authors. Overall, 17.9% of all authors were women, but only 1.2% of all authors were women cardiac surgeons and only 19% of the RCTs had a women cardiac surgeon among the authors. The median proportion of women authors was 14.3% by RCT, which was significantly higher in women-led compared with men-led RCTs (28.6% vs 11.8%; P = .01). No significant change in the proportion of women authors was observed during the study period. North American RCTs had a higher proportion of women authors compared with other geographic regions (28.6% vs 12.5%; P = .01). No correlation was found between the proportion of women authors and the proportion of women participants enrolled in individual RCTs.
During the last 2 decades, only a minority of cardiac surgery RCTs were women-led, and no significant increase in women authorship occurred. There are important geographic differences in women authorship.
研究强调了心血管医学中女性主导的随机对照试验（RCT）的匮乏。这一发现是否也适用于心脏外科手术尚未得到评估。在这项研究中，我们评估了女性在心脏外科 RCT 中的作者身份、领导地位和女性入组情况。
系统地检索了 2000 年至 2022 年期间发表的比较两种或两种以上成人心脏外科手术的 RCT。女性主导的 RCT 定义为女性作者担任第一或最后作者的 RCT。使用线性回归和相关分析。
在 58 项 RCT 中，有 8 项（13.8%）是女性主导的；17 项 RCT 没有女性作者。总的来说，17.9%的作者是女性，但只有 1.2%的作者是女性心脏外科医生，只有 19%的 RCT 的作者中有女性心脏外科医生。女性作者的中位数比例为 RCT 的 14.3%，女性主导的 RCT 明显高于男性主导的 RCT（28.6%比 11.8%；P=0.01）。在研究期间，女性作者的比例没有明显变化。与其他地理区域相比，北美 RCT 的女性作者比例更高（28.6%比 12.5%；P=0.01）。女性作者的比例与单个 RCT 中女性参与者的比例之间没有相关性。
在过去的 20 年里，只有少数心脏外科 RCT 是由女性主导的，女性作者的比例没有显著增加。女性作者的比例存在重要的地域差异。
