Alcohol, Author Interviews, BMJ, Gender Differences / 27.10.2016 Interview with: Tim Slade, PhD Associate Professor National Drug and Alcohol Research Centre University of New South Wales What is the background for this study? What are the main findings? Response: Historically, men have been more likely to drink alcohol than women and to drink in quantities that damage their health. However, evidence points to a significant shift in the drinking landscape with rates of alcohol use converging among men and women born in more recent times. In a bid to quantify this trend over time, we pooled data from 68 published research studies in 36 countries around the world. We looked at how the ratio of men’s to women’s alcohol use differed for people born in different time periods and found that the gap between the sexes consistently narrowed over the past 100 years or so. For example, among cohorts born in the early 1900s men were just over two times more likely than women to drink alcohol. Among cohorts born in the late 1900s this ratio had decreased to almost one meaning that men’s and women’s drinking rates have reached parity. (more…)
Author Interviews, Gender Differences, Pediatrics / 26.10.2016 Interview with: Rachel H. Farr, Ph.D. Assistant Professor Department of Psychology University of Kentucky What is the background for this study? Response: Controversy continues to surround parenting by lesbian and gay (LG) adults and outcomes for their children. As sexual minority parents increasingly adopt children, longitudinal research about child development, parenting, and family relationships is crucial for informing such debates. This longitudinal study compared outcomes for children, parents, couples, and the overall family system among nearly 100 (N = 96) adoptive families with lesbian, gay, and heterosexual parents at two time points: when children were preschool-age, and approximately 5 years later, when children were in middle childhood. Child outcomes were assessed via parent- and teacher-reported behavior problems, while parent outcomes were assessed via self-reports of parenting stress levels. Couple and family outcomes were evaluated by parent reports of couple adjustment and overall family functioning. (more…)
AHA Journals, Author Interviews, Cost of Health Care, Gender Differences, Heart Disease, Social Issues / 19.10.2016 Interview with: Adam L. Beckman Yale College, New Haven, CT (at the time this work was completed) Erica S Spatz MD MHS Assistant Professor, Section of Cardiovascular Medicine Center for Outcomes Research and Evaluation Yale-New Haven Hospital Yale University School of Medicine What is the background for this study? Beckman: Despite the expansion of insurance coverage, young adults face major challenges to obtaining affordable healthcare. We suspected women may experience greater challenges than men — they often have lower income and less complete medical coverage than men, and care for multiple generations of family, and that this may in part explain why young women have worse outcomes following a heart attack as compared with similarly-aged men. (more…)
Author Interviews, CDC, Gender Differences, STD / 06.10.2016 Interview with: Alex de Voux, PhD, Epidemiologist Centers for Disease Control Division of STD Prevention What is the background for this study? What are the main findings? Response: Reported cases of primary and secondary syphilis have been increasing steadily in the United States since 2001, with men-who-have-sex-with-men (MSM) accounting for 83% of male primary and secondary syphilis cases with information on sex of sex partner in 2014. However calculating the true disparity of primary and secondary syphilis cases relative to the MSM population size has been difficult because census data does not routinely collect information on sexual orientation or same-sex behavior. Through a recent collaboration with Emory University and CDC, Grey and colleagues developed refined estimates of the population size of MSM by state allowing us to calculate state-specific rates of primary and secondary syphilis for the first time. Looking at data from 44 states that had information on sex of sex partner for at least 70% of their male primary and secondary syphilis cases, the overall rate of syphilis was 309 per 100,000. The state level data found syphilis rates among gay and bisexual men ranged widely among the 44 states, from 73.1 per 100,000 in Alaska to 748.3 per 100,000 in North Carolina. Some of the highest rates among MSM were in states in the Southeast and the West. Comparing rates of syphilis among MSM to men reporting sex with women only (MSW), the overall rate for MSM was 107 times the rate for MSW. By state, the rate among MSM was at least 40 times the rate among MSW – and at most, 340 times the rate among MSW. (more…)
Author Interviews, Gender Differences, Heart Disease, JAMA, Menopause / 15.09.2016 Interview with: Taulant Muka, MD, MPH, PhD Postdoctoral Researcher Erasmus University, Rotterdam What is the background for this study? What are the main findings? Response: Menopause marks a major life transition for women, resulting in the loss of ovarian follicle development. Although menopause is a universal phenomenon among women, the timing of the final menstrual period differ greatly between women, and is considered a marker of aging. By quantifying data of nearly 310,329 non-overlapping women, we found that women who experienced an early menopause (i.e. younger than 45 years) have an excess risk of CHD, CVD-mortality and all-cause mortality. Furthermore, being 45-49 years at menopause compared to ≥50 years was associated with increased risk of carotid atherosclerosis. (more…)
Author Interviews, Gender Differences, Heart Disease, Surgical Research / 11.09.2016 Interview with: Michael A. Gaglia Jr., MD, MSc, FACC, FSCAI Scientific Lead, Population Research Medstar Cardiovascular Research Network Interventional Cardiology Medstar Heart and Vascular Institute Washington, DC 20010 What is the background for this study? Response: Cardiovascular outcomes vary according to gender in a variety of disease states. For example, short-term mortality is higher among women presenting with an acute coronary syndrome in comparison to men. There is a similar trend for higher short-term mortality of women undergoing coronary artery bypass grafting, although this is in part due to a relatively higher burden of comorbidities. Female gender is also a well-established risk factor for bleeding complications after percutaneous coronary intervention. In regards to women undergoing surgical aortic valve replacement for severe aortic stenosis (AS), however, the data is equivocal; some studies suggest higher mortality for women, whereas others suggest improved survival for women. The emergence of transcatheter aortic valve replacement (TAVR) as the preferred therapeutic option for patients with severe AS at high or extreme risk for surgery offered another opportunity to examine gender disparities in outcomes. The evidence base for the impact of gender upon TAVR, however, is still evolving. A recent meta-analysis suggested improved long-term survival among women after TAVR. And in general, previous studies also suggest more vascular and bleeding complications in women when compared to men. The goal of this study was relatively simple: to compare outcomes between women and men undergoing TAVR at a single center. (more…)
Author Interviews, Emory, Gender Differences, Heart Disease, Stem Cells / 07.09.2016 Interview with: Arshed A. Quyyumi MD; FRCP Professor of Medicine, Division of Cardiology Emory University School of Medicine Co-Director, Emory Clinical Cardiovascular Research Institute Atlanta GA 30322 What is the background for this study? What are the main findings? Response: Circulating progenitor or stem cells were discovered in adults 15 years ago. We now know that they may be stimulated by injury or ischemia, and they go down in number and function with aging, particularly when aging is associated with risk factors. Women with chest pain despite normal coronary arteries are thought to have ischemia because of microvascular dysfunction. We found that these women, with the worst microvascular function (measured as coronary flow reserve), had higher levels of circulating stem or progenitor cells. This implies that the mild ischemia they are having during their normal daily life, leads to stimulation of their stem cells. Also, the vascular abnormality may be a stimulus for repair. (more…)
Accidents & Violence, Author Interviews, Gender Differences, JAMA, Mental Health Research / 17.08.2016 Interview with: Edith Chen, Ph.D. Professor Faculty Fellow, Institute for Policy Research Northwestern University Department of Psychology Evanston, IL 60208-2710 What is the background for this study? What are the main findings? Response: Previous research has documented psychiatric consequences of childhood abuse, but less is known about possible physical health consequences. The main finding is that women who self-reported childhood abuse (in adulthood) were at greater risk for all-cause mortality compared to those who did not report abuse. (more…)
Aging, Author Interviews, Gender Differences, Genetic Research, Menopause, UCLA / 28.07.2016 Interview with: Morgan Elyse Levine, PhD Postdoctoral Fellow Department of Human Genetics University of California, Los Angeles What is the background for this study? What are the main findings? Response: From an evolutionary perspective, aging and reproduction are two processes that are linked. For instance, in order to maximize fitness, an individual has to survive and remain healthy enough to: 1) reproduce and 2) insure offspring survive to reproductive age. Thus, the rate of aging is tied to a species’ timing of reproductive senescence and necessary length of parental involvement. There is also evidence that among humans, women with longer reproductive stages (later age at menopause, ability to conceive at older ages) are more likely to live to age 100, which we hypothesize is because they age slower. Using an epigenetic biomarker believed to capture biological aging (previously developed by the Principle Investigator of this study, Steve Horvath), we tested whether age at menopause, surgical menopause, and use of menopausal hormone therapies were associated with a woman’s aging rate. We found that the blood of women who experienced menopause at earlier ages (especially those who underwent surgical menopause) was “older” than expected, suggesting they were aging faster on a biological level than women who experienced menopause at later ages. We also found that buccal epithelium samples (cells that line the inside of the cheek) were epigenetically younger than expected (signifying slower aging) for post-menopausal women who had taken menopausal hormone therapy, compared to post-menopausal women who had never taken any form of menopausal hormone therapy. Finally, we had a number of results that suggested that the previously mentioned findings were a result of the process of menopause directly speeding up the aging process—rather than the alternative explanation, which would have been that women who aged faster experience menopause earlier. (more…)
AHA Journals, Author Interviews, Exercise - Fitness, Gender Differences, Heart Disease / 27.07.2016 Interview with: Andrea K. Chomistek, MPH, ScD Assistant Professor Department of Epidemiology and Biostatistics School of Public Health Indiana University-Bloomington What is the background for this study?  Response: Previous studies of exercise and  coronary heart disease have been primarily conducted in middle-aged and older adults, so we thought it was important to examine this association in younger women as mortality rates in young women have not declined in recent years like they have in other age groups. (more…)
AHA Journals, Author Interviews, Gender Differences, Stroke, Tobacco Research / 23.07.2016 Interview with: Joni Valdemar Lindbohm, MD Department of Public Health University of Helsinki, Finland What is the background for this study? Response: Approximately 1-6% percent of people carry an unruptured intracranial aneurysm but most of these never rupture during lifetime and cause subarachnoid hemorrhage (SAH). In SAH, the rupture of an aneurysm causes bleeding into the lining between the brain’s surface and underlying tissue. Despite advances in operative techniques, SAH can lead to death in up to 45% of the cases. Because life style risk factors are critical in development of subarachnoid hemorrhage, it is important to characterize the risk factor profile of those with an elevated risk. Widely accepted risk factors for SAH are increasing age, smoking, hypertension and female sex. However, the reasons for an elevated risk in women have remained uncovered and the effect of smoking habits are not well understood. (more…)
Author Interviews, Diabetes, Gender Differences, JCEM, Sleep Disorders / 04.07.2016 Interview with: Dr. Femke Rutters Department of Epidemiology and Biostatistics Vrije Universiteit Medical Centre Amsterdam, The Netherlands; EMGO+ Institute for Care Research What is the background for this study? What are the main findings? Response: In the past 10 years the interest in sleep as a possible cause for obesity/diabetes has risen. But data up until now used mainly self-reported sleep and simple measures of diabetes (related parameters), such as fasting glucose. A study on well-measured insulin sensitivity and beta-cell function was lacking. Such a study could provide more information on the pathophysiology. (more…)
Author Interviews, Gender Differences, JAMA / 27.06.2016 Interview with: Gilbert Gonzales, PhD, MHA Assistant Professor Department of Health Policy Vanderbilt University School of Medicine What is the background for this study? What are the main findings? Response: Using data from one of the largest, most representative health surveys, we found lesbian, gay and bisexual adults were more likely to report substantially higher rates of severe psychological distress, heavy drinking and smoking, and impaired physical health than straight adults. (more…)
Aging, Author Interviews, Gender Differences / 16.06.2016 Interview with: Kathleen Fischer, PhD Department of Biology UAB | University of Alabama Birmingham Birmingham, AL What is the background for this study? What are the main findings? Dr. Fischer: Aging is by far the greatest risk factor for most of the chronic, non-communicable diseases (e.g. cardiovascular disease, cancer, diabetes). By discovering the basic mechanisms responsible for aging we can find ways to extend healthy and productive life and reduce the burdens of chronic disease and disability experienced by individuals and society. Sex differences in longevity can provide novel insights into the basic biology of aging; however this aspect of aging has been largely ignored. Demographic data show that women outlive men in every society during every historical period and in every geographic area. In spite of this robust survival advantage, women suffer far greater morbidity late in life—a phenomenon described as the morbidity-mortality paradox. It is not clear whether this is a general mammalian pattern or something unique to humans. Research on sex differences in aging and age-related diseases in humans and a range of species will be crucial if we are going to identify the basic mechanisms responsible for the patterns we observe. (more…)
Author Interviews, Education, Gender Differences / 07.06.2016 Interview with: Sara E. Brownell PhD School of Life Sciences Arizona State University Tempe, AZ What is the background for this study? What are the main findings? Dr. Brownell: Our group has been broadly interested in gender biases in introductory biology since we published a study that showed that women underperform on course exams and under participate in whole class discussions compared to men ( We were curious why women might be under performing on these course exams so in this new study, we examined characteristics of the exams to see if that had an impact. What we found was that women and men perform equally on questions that test basic memorization. However, when questions tested more higher-level critical thinking skills, women were not scoring as high as men. This happened even when we took into account the academic ability of the students - women and men who had the same ability coming into the class. We also found that students from lower socioeconomic statuses also underperformed on these higher-level critical thinking questions compared to students from higher socioeconomic statuses, again even when we took into account academic ability. (more…)
Author Interviews, Brigham & Women's - Harvard, Gender Differences, Heart Disease, PLoS, Women's Heart Health / 09.05.2016 Interview with: Alexander Turchin, MD, MS Associate Physician, Brigham and Women's Hospital Associate Professor of Medicine, Harvard Medical School Brigham and Women's Hospital Department of Medicine Endocrinology Boston, MA 02115 What is the background for this study? What are the main findings? Dr. Turchin: It is known that fewer women than men at high risk for cardiovascular disease are treated with statins. However, the reasons for this sex disparity are not fully understood. Our study identified 4 factors that accounted for over 90% of the difference in statin therapy between women and men with coronary artery disease:
  • Age (women were older than men),
  • Amoking (men were more likely to smoke),
  • Evaluation by a cardiologist (men were more likely to have been seen by a cardiologist) and
  • History of adverse reactions to statins (women were more likely to have experienced an adverse reaction). This is the first time that a near-complete explanation for the sex disparities in statin therapy was found.
Author Interviews, Education, Gender Differences, Surgical Research / 04.05.2016 Interview with: Alison M. Fecher, MD Assistant Professor of Surgery Indiana University Health What is the background for this study? What are the main findings? Dr. Fecher: It has long been known that female faculty are underrepresented in departments of surgery at U.S. medical schools. Our study wanted to identify obstacles women face in entering certain surgical subspecialties and in career advancement. We found that women are poorly represented in some of the most competitive subspecialties, including cardiothoracic and transplant surgery. We also found that women tend to advance more slowly up the career ladder, with many of them spending more years at the assistant professor level than their male counterparts. One reason for this may be that they tend to publish less peer-reviewed articles than male faculty; however, our results show that the publications of female faculty often has a greater impact on the field, as measured by citations and recentness of articles. (more…)
Author Interviews, Endocrinology, Gender Differences, Kidney Disease / 28.04.2016 Interview with: A.Univ.-Prof. Dr. Judith Lechner Div. Physiology Medical University of Innsbruck Innsbruck Austria What is the background for this study? What are the main findings? Dr. Lechner: Women are not just small men. Sex differences affect most, if not all the organ systems in the body. Over the past decades biomedical researchers have been mainly using male models. Therefore, there is a significant gap in knowledge of female physiology except for organ functions involved in reproduction. While the necessity to fill in these gaps has been advocated, our understanding of sex and gender differences in human physiology and pathophysiology is still limited. This holds especially true for the kidneys, e.g. while international registries show that fewer women than men are in need of renal replacement therapy due to end stage renal disease, the potentially underlying causes are still not known. The aim of our study was to find out, if hormone changes due to the female menstrual cycle would affect normal renal cells. For this purpose, urinary samples of healthy women of reproductive age were collected daily and analyzed for menstrual cycle-associated changes of marker proteins. Specifically, two enzymes (Fructose-1,6-bisphosphatase, Glutathione-S-transferase alpha) were measured, which are intracellular components of proximal tubular cells, a key population of renal cells. Upon cell damage, these enzymes are released into the urine, qualifying them as clinical markers for early detection of tubular injury. Since even in healthy persons low amounts of these enzymes can be detected in the urine, we used these marker proteins to analyze potential effects of the female hormone cycle on normal functioning of this cell population. As a result, we could detect transient increases of Fructose-1,6-bisphosphatase and Glutathione-S-transferase alpha correlating with specific phases of the female hormone cycle, namely ovulation and menses. This finding suggests that cyclical changes of female hormones might affect renal cell homeostasis, potentially providing women with an increased resistance against kidney damages. Thus, recurring changes of sex hormone levels, as during the natural menstrual cycle, might be involved in periodic tissue re-modeling not only in reproductive organs, but to a certain extent in the kidneys as well. (more…)
Author Interviews, Compliance, Gender Differences, Heart Disease / 28.04.2016 Interview with: Sherry L. Grace, PhD Professor, School of Kinesiology and Health Science York University Sr. Scientist, Cardiorespiratory Fitness Team Toronto Rehabilitation Institute, University Health Network Toronto Western Hospital Toronto, ON What is the background for this study? Dr. Grace: Cardiac rehabilitation is an outpatient chronic disease management program. It is a standardized model of care, comprised of risk factor assessment and management, exercise training, patient education, as well and dietary and psychosocial counseling. Patients generally attend two times a week for several months. Participation in cardiac rehab has been shown to reduce death and disability. This is a dose-response association, such that more cardiac rehab participation is associated with even less death, etc. Therefore, it is important that patients adhere to the program, or participate in all the prescribed sessions. No one has ever reviewed patient adherence to cardiac rehab in a systematic way. It has always been assumed that patients only attend about half of prescribed sessions. Also, many studies have shown that women attend fewer sessions than men. However, this has been known for some time, so we would hope that in the current era, this sex difference would not exist. No study has ever aggregated and analyzed sex differences in program adherence, so we set out to do this. (more…)
Author Interviews, Gender Differences, Kidney Disease, Transplantation, University of Pennsylvania / 22.04.2016 Interview with: Matthew Levine, MD, PhD Assistant Professor of Transplant Surgery Perelman School of Medicine University of Pennsylvania What is the background for this study? What are the main findings? Dr. Levine: This work stemmed from a known finding that female mice tolerate kidney injury better than males and this is true of mice that share exactly the same genes.  Therefore, the gender difference was the driving factor.  My basic science laboratory works at the intersection between scientific discovery and clinical application and this led us to question whether the same phenomenon was true in humans and whether we could identify a way in which this could be used to improve injury tolerance above what is seen in untreated subjects.  What we found was that the hormonal environment seems to impact ischemia tolerance, with female environment being protective and the male environment worsening injury tolerance in ischemia models where blood flow is interrupted and then restored.  The kidneys seemed to adapt to take on the injury response of the host after transplantation, indicating that the differences were not forged into the kidney itself and therefore could be altered.  We then found that estrogen therapy improved kidney injury tolerance when given to female mice in advance of injury, but no effect was seen in male mice.  And most importantly, we found that in a large cohort of transplant recipients that female recipients had better injury tolerance after transplant than male recipients, as shown by ability to avoid dialysis in the first week after transplant, otherwise known as delayed graft function (DGF). This is a fairly major finding since it has not been observed in the literature despite several decades of transplant data being carefully studied. (more…)
Author Interviews, Gender Differences, Heart Disease, JACC, Women's Heart Health / 15.04.2016 Interview with: Dr. Neha J. Pagidipati Duke Clinical Research Institute Duke University School of Medicine Durham, North Carolina Medical Research: What is the background for this study? What are the main findings? Dr. Pagidipati: Women and men experience coronary artery disease differently, and a great deal of literature has shown that these differences extend to the diagnostic performance of various noninvasive testing modalities. However, little is known about the sex-specific prognostic value of computed tomographic angiography (CTA) and functional stress testing. We used data from the recent PROMISE trial to address this question. The PROMISE trial enrolled 10,003 patients (53% women) with stable symptoms suggestive of coronary artery disease to a diagnostic strategy of CTA vs stress testing, and found no differences in outcomes overall or by sex. We found that in women, a CTA is less likely to be positive, but when it is positive, it appears to have greater predictive value for a future cardiovascular event (all cause death, myocardial infarction, or unstable angina hospitalization) than stress testing. In men, a stress test is less likely to be positive, and though stress testing trended towards being more predictive of future events, there was no statistically significant difference in the prognostic value of either test type. (more…)
Author Interviews, Breast Cancer, Fertility, Gender Differences, Karolinski Institute, Mammograms, Radiology / 14.04.2016 Interview with: Frida Lundberg | PhD Student Dept. of Medical Epidemiology and Biostatistics Karolinska Institutet Medical Research: What is the background for this study? Response: Fertility treatments involve stimulation with potent hormonal drugs that increase the amount of the sex hormones estrogen and progesterone. These hormones have been linked to breast cancer risk. Further, as these treatments are relatively new, most women who have gone through them are still below the age at which breast cancer is usually diagnosed. Therefore we wanted to investigate if infertility and fertility treatments influences mammographic breast density, a strong marker for breast cancer risk that is also hormone-responsive. Medical Research: What are the main findings? Response: We found that women with a history of infertility had higher absolute dense volume than other women. Among the infertile women, those who had gone through controlled ovarian stimulation (COS) had the highest absolute dense volume. The results from our study indicate that infertile women, especially those who undergo COS, might represent a group with an increased risk of breast cancer. However, the observed difference in dense volume was relatively small and has only been linked to a modest increase in breast cancer risk in previous studies.  As the infertility type could influence what treatment the couples undergo, the association might also be due to the underlying infertility rather than the treatment per se. (more…)
Author Interviews, Gender Differences, Heart Disease, NYU, Women's Heart Health / 06.04.2016 Interview with: Nathaniel Smilowitz, MD Fellow, Cardiovascular Disease NYU Langone Medical Center MeicalResearch: What is the background for this study? What are the main findings? Dr. Smilowitz: Myocardial infarction (MI), commonly known as a heart attack, is a leading cause of death worldwide.  In the majority of patients with MI, examination of the coronary blood vessels by angiography reveals an obstruction that limits blood flow to the heart muscle.  However, some patients develop MI with non-obstructive coronary arteries (MINOCA) at angiography.  This condition is identified more commonly in younger patients and women, and in prior studies, in-hospital death after MINOCA was lower than for MI with obstructive coronary artery disease (MI-CAD).  Despite favorable outcomes associated with MINOCA, young women paradoxically have overall higher in-hospital death after MI in comparison to younger men.  Although sex differences in post-MI mortality are known to vary with age, the interaction between age, sex, and the presence of obstructive coronary artery disease at angiography on death post-MI had not been previously established. In this study, we confirmed that in-hospital mortality is lower after MINOCA than MI-CAD and that women are more likely to have MINOCA than men.  No sex difference in mortality was observed among patients with MINOCA, but women of all ages had significantly higher mortality after MI-CAD than men.  With advancing age, mortality increased to a greater degree in patients with MI-CAD than MINOCA and in men vs. women. (more…)
Addiction, Author Interviews, Brigham & Women's - Harvard, Gender Differences, JAMA, Sexual Health / 27.03.2016 Interview with: Dr. Sari L. Reisner PhD Research Fellow in the Department of Epidemiology Harvard T.H. Chan School of Public Health Associate Scientific Researcher in the Division of General Pediatrics Boston Children’s Hospital/ Harvard Medical School What are the main findings? Dr. Reisner: Transgender youth—including adolescent and young adult transgender women assigned a male sex at birth who identify as girls, women, transgender women, transfemale, male-to-female, or another diverse gender identity on the transfeminine spectrum—represent a vulnerable population at-risk for negative mental health and substance use/abuse outcomes. Although community surveys of transgender people in the United States have found a high prevalence of depression, anxiety, and substance use relative to the general adult U.S. population, studies typically utilize screening instruments or sub-threshold symptom questions and do not use diagnostic interviews. Diagnostic interview data are scarce among young transgender women; such data are important to establish guidelines for diagnosis and treatment for this youth group given their complex life experiences. The aim of this study was to report the prevalence of mental health, substance dependence, and co-morbid psychiatric disorders assessed via a diagnostic interview in an at-risk community-recruited sample of young transgender women. This observational study reported baseline finding from a diverse sample of 298 sexually active, young transgender women ages 16-29 years (mean age 23.4; 49.0% Black, 12.4% Latina, 25.5% White, 13.1% other minority race/ethnicity) enrolled in Project LifeSkills, an ongoing randomized controlled HIV prevention intervention efficacy trial in Chicago and Boston, between 2012-2015 (NIMH-funded, multiple PIs: Rob Garofalo, MD, MPH & Matthew Mimiaga, ScD, MPH). (more…)
Author Interviews, BMJ, Gender Differences / 14.03.2016 Interview with: Giovanni Filardo, PhD, MPH Director of Epidemiology, Office of the CQO, Baylor Scott & White Health Briget da Graca, JD, MSSenior Medical Writer Center for Clinical Effectiveness Office of the CQO Baylor Scott & White Health Dallas, Texas What is the background for this study? What are the main findings? Dr. Filardo: While there are readily available, up-to-date data on the proportion of medical school applicants, graduates, and member of faculty women constitute, no similar information is routinely collected and shared about women’s participation in and leadership of medical research studies. The previous studies looking at this issue were conducted in 2004, and were limited to investigating the proportion of women among the first authors with MD degrees and with institutional affiliations in the United States or United Kingdom. The time was therefore ripe for an updated, rigorous, and comprehensive examination of first authorship in high impact medical journals. We examined female first authorship of original research articles published over the past 20 years in the 6 general medical journals with the highest impact factors: Annals of Internal Medicine (Annals), Archives of Internal Medicine (Archives), The BMJ (formerly the British Medical Journal), Journal of the American Medical Association, The Lancet, and New England Journal of Medicine (NEJM). After adjusting for differences over time and between journals related to different prioritisation of studies according to type, topic/specialty, country in which the research was conducted, or number of listed authors, we found that female first authorship increased overall from 27% in 1994 to 37% in 2014, but had plateaued – and in the cases of The BMJ and NEJM – declined in the last 5 years. Our results also revealed significant differences in female first authorship between journals. (more…)
AHA Journals, Author Interviews, Gender Differences, Heart Disease, Race/Ethnic Diversity, Women's Heart Health / 26.02.2016 Interview with: Karin H Humphries, MBA, DSc | Scientific Director BC Centre for Improved Cardiovascular Health UBC-HSF Professor in Women's Cardiovascular Health Vancouver, BC Medical Research: What is the background for this study? Response: Prior studies have shown that among patients with obstructive coronary artery disease (CAD), women have higher short- and long-term mortality rates as compared to men. Furthermore, a few studies have highlighted the existence of ethnic differences in the incidence of acute myocardial infarction (AMI) and outcomes following an AMI event. However, the joint contribution of sex and ethnicity on outcomes of patients with obstructive  coronary artery disease remains unknown. Our primary objective was to extend these findings by examining the joint impact of sex and ethnicity on long-term adverse outcomes of all patients with angiographic evidence of obstructive CAD presenting with myocardial ischemia. Our study included a population-based cohort of patients ≥ 20 years of age who underwent coronary angiography for acute coronary syndromes (ACS) or stable angina in British Columbia, Canada with angiographic evidence of ≥ 50% stenosis in any epicardial artery. (more…)
AHA Journals, Author Interviews, Gender Differences, Heart Disease, University of Pennsylvania, Women's Heart Health / 26.02.2016 Interview with: Dr. Robert L. Wilensky MD Director, Interventional Cardiology Research Director, Interventional Cardiology Training Program Professor of Medicine Hospital of the University of Pennsylvania Medical Research: What is the background for this study? Dr. Wilensky: We wanted to evaluate whether young women, under the age of 50 years, had an increased risk for recurrent ischemic events after percutaneous coronary intervention (PCI) compared to young men or older women. Medical Research: What are the main findings?  Dr. Wilensky: Despite having less severe coronary artery disease,  had an increased risk of repeated events, generally need for repeat PCI in either the exact location of the original procedure or within the artery that underwent the procedure. This despite the finding that young women were treated with the same medications as young men. (more…)
Author Interviews, Gender Differences, Health Care Systems, Women's Heart Health / 22.02.2016 Interview with: Professor Robyn Norton Principal Director of The George Institute for Global Health Board Member, The George Institute for Global Health Professor of Public Health at the University of Sydney Professor of Global Health at the University of OxfordProfessor Robyn Norton Principal Director of The George Institute for Global Health Board Member, The George Institute for Global Health Professor of Public Health at the University of Sydney Professor of Global Health at the University of Oxford Medical Research: What is the background for this study? What are the main findings? Prof. Norton: The impetus to focus on women’s health, stems from the knowledge that, while noncommunicable diseases (NCDs) are the leading cause of death and disability for women worldwide, this is not sufficiently recognized nor sufficiently resourced. Equally, while there is increasing evidence that we can learn so much more about how to address the burden of disease for women, by collecting and analyzing data on women, separately to that for men, this is not happening. We are calling for a refocus of the women’s health agenda on NCDs – given that globally and in many countries the focus of women’s health almost exclusively is still on women’s sexual and reproductive health. The fact is that in all but the poorest countries, the greatest health burden, for women, is  noncommunicable diseases and so that if we are to make significant gains in improving women’s health then we must focus on addressing NCDs. The current global burden of disease for women reflects both the significant gains that have been made as a result of addressing maternal mortality and changes that have affected both women and men equally – namely, that populations are living longer, as a consequence of reductions in both infant mortality and communicable diseases, as well as the fact that populations are becoming wealthier and, as a result, are engaging in behaviors that increase the risk of noncommunicable diseases. (more…)
Author Interviews, Gender Differences, Race/Ethnic Diversity, Stroke, Wake Forest / 20.02.2016 Interview with: Cheryl Bushnell, MD, MHS Professor of Neurology Director, Wake Forest Baptist Stroke Center Wake Forest Baptist Health Medical Center Boulevard Winston Salem, NC  27157  Medical Research: What is the background for this study? What are the main findings? Dr. Bushnell: The catalyst for the study was to see if comorbidities and the management of them might influence functional status.  But, we pre-specified gender and race because we knew these could be important predictors of outcome.  As it turns out, the results of our analysis did, in fact, show that gender and race were the most significant predictors of poor functional outcome. Medical Research: What should clinicians and patients take away from your report? Dr. Bushnell: The take-home message is that women and minorities have poorer functional outcome after stroke, but the reasons for this outcome need to be further explored.  Our model showed that we only explained 31% of the variance in SIS-16 with gender, race/ethnicity, and stroke severity, so unmeasured factors are extremely important.  We could speculate from this dataset and other published data that women may be more likely to have functional deficits prior to stroke, be unmarried/widowed, live alone, or institutionalized after stroke.  Non-white stroke survivors may have poorer access to care, have multiple strokes, and more comorbidities. (more…)