Gender Disparities in Pediatric Critical Care Research

Xu G, deWildt S, Zavalkoff S, Duffett M.

Aims & Objectives

Women researchers, in many areas of science, continue to secure less grant funding, author fewer publications, and do fewer podium presentations than male researchers. Gender disparity limits the talent pool of researchers, female role models in research, and the areas of research focus. Women constitute nearly half of the physicians and the majority of nurses in the pediatric critical care workforce but the gender demographics of pediatric critical care clinical researchers are unknown. 

Our objective was to compare the productivity and impact of female and male researchers in pediatric critical care. 

Methods

We included the authors of randomized controlled trials (RCTs) in pediatric critical care published prior to April 2018. We used PICUtrials.net (which uses comprehensive search strategies of multiple databases) to identify RCTs. We used United States Social Security and United Kingdom census data to classify authors’ first names as male or female. We used the Cochrane Risk of Bias Tool to describe the risk of bias for the included trials. We used the degrees and qualifications reported in the publication to determine each researcher’s profession.

Results

We included 1 875 authors of 378 RCTs (published 1986-2018). We were able to classify the names of 1 509 (80%) authors as male or female. The most frequent professions were physicians (60%), academics (8%), and nurses (6%) — of which 28%, 43% and 96%, respectively, were women. Overall, 35% (95% CI 33-37%) of authors were women. First and last authors were 36% (95% CI 31-42%) and 23% (95% CI 19-28%) women, respectively. 

The percentage of female authorship has increased over time (28% in 1985-1989 to 35% in 2015-2018, p = 0.016). The percentage of female last authors has increased over time (0% in 1989-1990 to 32% in 2015-2018, p = 0.011) but first authorship has not changed significantly (16% in 1985-1989 to 33% in 2015-2018, p = 0.22). Twenty-one (11%) female and 59 (13%) male researchers published more than one RCT (p = 0.26). There were no significant differences in the characteristics of RCTs published with either a female first or last author versus those with both male authors with respect to the median number of children randomized (55 vs. 50, p = 0.11), multicentred trials (19% vs. 23%, p = 0.20), and trials at high risk of bias (44% vs. 44%, p = 0.90). RCTs by female authors were cited less often overall (median 17 vs. 31 citations, p <0.001), but not when adjusted for the years since publication (median 2 vs. 3 citations per year, p = 0.21).

Conclusions

Although increasing over time, women still represent a minority of published pediatric critical care researchers. Although fewer in number, the trials that female researchers publish are similar in characteristics and impact as male researchers. Further work should identify barriers to gender diversity in pediatric critical care research and potential solutions. 

Download the poster

This poster was presented at the Critical Care Canada Forum (November 2018; Toronto, Ontario).