Lodhi Sumiya, Kibret Taddele, Mangalgi Shreepriya, Reid Lindsay, Noel Ariana, Syed Sarah, Beauregard Nickolas, Dhaliwal Shan, Hussain Junayd, Vinson Amanda J, Van Spall Harriette G C, Sood Manish M, Shorr Risa, Bugeja Ann
Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ontario, Canada.
Kidney Int Rep. 2024 Jan 28;9(4):898-906. doi: 10.1016/j.ekir.2024.01.031. eCollection 2024 Apr.
Women are underrepresented in the leadership of and participation in randomized controlled trials (RCTs). We conducted a bibliometric review of nephrology RCTs to examine trial leadership by women and participation of women in nephrology RCTs.
A bibliometric review of RCTs published in top medical, surgical, or nephrology journals was conducted using MEDLINE and EMBASE from January 2011 to December 2021. Leadership by women as corresponding authors, women trial participation, and trial characteristics were examined with duplicate independent data extraction. Logistic regression was used to examine associations between trial characteristics and women leadership and trial participation.
A total of 1770 studies were screened and 395 RCTs met eligibility criteria. The number (%) of women in corresponding, first, and last authorship positions were as follows: 89 (22%), 109 (28%), and 74 (19%), respectively, without change over time ( = 0.94). The median percentage (interquartile range [IQR]) of women trial participants was 39.0% (13.5%) with no difference between women or men lead authors ( = 0.15). Men lead authors were statistically less likely to enroll women in RCTs. Women lead authors were less likely to be funded by industry (odds ratio [OR]: 0.30; 95% confidence interval [CI]: 0.14-0.63; = 0.002) or lead international trials (OR: 0.11; 95% CI: 0.01-0.83; = 0.03). Trials with sex-specific eligibility criteria were more likely to have women leaders (OR: 2.56; 95% CI: 1.19-5.49; = 0.02) than those without.
Gender inequalities in RCT leadership and RCT participation exist in nephrology and did not improve over time. Strategies to improve inequalities need to be implemented and evaluated.
在随机对照试验（RCT）的领导层和参与人员中，女性代表人数不足。我们对肾脏病学随机对照试验进行了文献计量学综述，以研究女性在试验中的领导情况以及女性参与肾脏病学随机对照试验的情况。
利用MEDLINE和EMBASE对2011年1月至2021年12月在顶级医学、外科或肾脏病学杂志上发表的随机对照试验进行文献计量学综述。通过重复独立数据提取，研究了女性作为通讯作者的领导情况、女性参与试验情况以及试验特征。采用逻辑回归分析试验特征与女性领导及试验参与之间的关联。
共筛选出1770项研究，395项随机对照试验符合纳入标准。通讯作者、第一作者和最后作者中女性的数量（%）分别为89（22%）、109（28%）和74（19%），且随时间无变化（P = 0.94）。女性试验参与者的中位数百分比（四分位间距[IQR]）为39.0%（13.5%），女性或男性通讯作者之间无差异（P = 0.15）。男性通讯作者在随机对照试验中招募女性的可能性在统计学上较低。女性通讯作者获得行业资助的可能性较小（比值比[OR]：0.30；95%置信区间[CI]：0.14 - 0.63；P = 0.002），领导国际试验的可能性也较小（OR：0.11；95% CI：0.01 - 0.83；P = 0.03）。有性别特定纳入标准的试验比没有此类标准的试验更有可能有女性领导者（OR：2.56；95% CI：1.19 - 5.49；P = 0.02）。
肾脏病学随机对照试验的领导层和参与情况中存在性别不平等，且未随时间改善。需要实施并评估改善不平等的策略。
