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Research Letter |

Representation of Women as Authors of Collaborative Cancer Clinical Trials FREE

Gordon H. Sun, MD, MS1; Nicholas M. Moloci, BSE1; Kelsey Schmidt1,2; Mark P. MacEachern, MLIS3; Reshma Jagsi, MD, DPhil1,4
[+] Author Affiliations
1Robert Wood Johnson Foundation Clinical Scholars Program, University of Michigan, Ann Arbor
2student, University of Michigan, Ann Arbor
3A. Alfred Taubman Health Sciences Library, University of Michigan, Ann Arbor
4Department of Radiation Oncology, University of Michigan, Ann Arbor
JAMA Intern Med. 2014;174(5):806-808. doi:10.1001/jamainternmed.2014.250.
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Published online

Team-based research in medicine is common.1 Simultaneously, women’s role in the medical profession has grown, including the representation of women as authors of academic publications.2 We studied the extent to which women lead clinical trial publications from organized collaborative groups in oncology.

We conducted a bibliometric analysis of the PubMed database from 2001 to 2011, screening 5011 citations to identify eligible English-language articles. Collaborative clinical trials had the following characteristics: (1) authorship by a formally named collaborative group (eg, Radiation Therapy Oncology Group); (2) randomized controlled trial or clinical trial designation by PubMed, verified by manual review; and (3) examination of a therapeutic intervention in human patients with cancer. We developed a search protocol combining 43 terms for the corporate author search tag ([cn]) and 24 cancer-related keywords and Medical Subject Heading terms. We collected information on first and corresponding author and gender, as well as study sponsorship (National Institutes of Health, non–National Institutes of Health US government sources, foreign governments, for-profit industry, miscellaneous sources such as philanthropic and nonprofit foundations, and no or unreported sponsorship). Associations between authorship and sponsorship were analyzed using χ2 tests; time-based trends were analyzed using the Cochran-Armitage test.

Between 2001 and 2011, among 2498 eligible articles, first (1913 [76.6%]) and corresponding (2012 [80.5%]) authors were predominantly men. Women were 16.3% to 26.4% of all first authors and 14.7% to 24.0% of all corresponding authors annually. These distributions did not change significantly over time (P for trend, .54 and .69, respectively; Figure 1).

Place holder to copy figure label and caption
Figure 1.
Proportion of Collaborative Oncologic Clinical Trials With Women as First or Corresponding Authors, 2001-2011

Publications for which the gender of the first or corresponding author could not be identified and those whose authors were identified only as groups are not included.

Graphic Jump Location

Either industry or the US government sponsored most of the collaborative clinical trials; one or both groups sponsored 57.3% of studies (Figure 2). Reported industry sponsorship increased from 35.8% of articles in 2001 to 63.0% in 2011 (P for trend, <.001), as did miscellaneous sponsorship (17.0% to 33.6%; P for trend, <.001). In contrast, US government sponsorship peaked between 2005 and 2008 and then declined.

Place holder to copy figure label and caption
Figure 2.
Proportion of Collaborative Oncologic Clinical Trials Sponsored by Funding Entities, 2001-2011

Percentages sum to more than 100% because some trials reported more than 1 funding source. Publications with no reported funding sources are not included.

Graphic Jump Location

Among all US government–sponsored publications, 29.0% had a woman as first author, compared with 18.7% of publications not sponsored by the US government (P < .001). Similarly, among US government–sponsored publications, 29.3% had a woman as corresponding author, compared with 15.1% of those not sponsored by the US government (P < .001). In contrast, among all industry-sponsored publications, 18.9% had a woman as first author, compared with 23.0% of publications not sponsored by industry (P = .02). Among industry-sponsored publications, 15.8% had a woman as corresponding author, compared with 20.6% of those not sponsored by industry (P = .003).

Our results expand on a prior study,3 which found that in 2006 women represented 33% of first authors and 20% of senior authors of original cancer research in 8 major journals.

Although women were 46% of oncology trainees and 45% of biomedical research fellows-in-training in 2013, they represent only 28.4% of oncologists and 20% to 29% of academic researchers in the United States.4 Gender bias and other challenges may explain these differences.5 Addressing barriers to the academic advancement of female oncologists may facilitate equity and improve collaborative research efforts, given the value that diversity brings to team endeavors.6

Corresponding Author: Reshma Jagsi, MD, DPhil, Department of Radiation Oncology, University of Michigan, 1500 E Medical Center Dr, UHB2C490, SPC 5010, Ann Arbor, MI 48109-5010 (rjagsi@med.umich.edu).

Published Online: March 24, 2014. doi:10.1001/jamainternmed.2014.250.

Author Contributions: Drs Sun and Jagsi had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

Study concept and design: Sun, Moloci, MacEachern, Jagsi.

Acquisition of data: Sun, Moloci, Schmidt, MacEachern.

Analysis and interpretation of data: Sun, Moloci, Jagsi.

Drafting of the manuscript: Sun, Moloci, MacEachern, Jagsi.

Critical revision of the manuscript for important intellectual content: All authors.

Statistical analysis: Sun.

Administrative, technical, and material support: Moloci.

Study supervision: Sun, Moloci.

Conflict of Interest Disclosures: Dr Sun previously received a grant from the Blue Cross Blue Shield of Michigan Foundation for head and neck cancer research and an honorarium from the BMJ Publishing Group for sinusitis guideline work. Dr Jagsi is on the medical advisory board for Eviti. Dr Jagsi also is conducting a trial supported by the Breast Cancer Research Foundation, for which the study drug is provided by Abbvie Pharmaceuticals. No other disclosures are reported.

Funding/Support: Dr Sun was a Robert Wood Johnson Foundation Clinical Scholar supported by the US Department of Veterans Affairs at the time of the study and manuscript preparation. Dr Jagsi is supported by grants from the National Institutes of Health, American Cancer Society, the National Comprehensive Cancer Network, and the Burroughs-Wellcome/Alliance for Academic Internal Medicine. This project received no direct funding.

Role of the Sponsor: The funders had no role in the design and conduct of the study; collection, management, analysis, or interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

Disclaimer: Any opinions expressed herein do not necessarily reflect the opinions of the Robert Wood Johnson Foundation or the US Department of Veterans Affairs.

Previous Presentations: This study was presented in part at the Seventh International Congress on Peer Review and Biomedical Publication; September 9-10, 2013; Chicago, Illinois.

Additional Information: Dr Sun is now an employee of Partnership for Health Analytic Research, LLC, in Beverly Hills, CA, and a general otolaryngologist at the UCLA Arthur Ashe Student Health and Wellness Center in Los Angeles.

Weeks  WB, Wallace  AE, Kimberly  BC.  Changes in authorship patterns in prestigious US medical journals. Soc Sci Med. 2004;59(9):1949-1954.
PubMed   |  Link to Article
Jagsi  R, Guancial  EA, Worobey  CC,  et al.  The “gender gap” in authorship of academic medical literature—a 35-year perspective. N Engl J Med. 2006;355(3):281-287.
PubMed   |  Link to Article
Jagsi  R, Sheets  N, Jankovic  A, Motomura  AR, Amarnath  S, Ubel  PA.  Frequency, nature, effects, and correlates of conflicts of interest in published clinical cancer research. Cancer. 2009;115(12):2783-2791.
PubMed   |  Link to Article
Reeder-Hayes  K, Felip  E, Patt  D, Jaffee  E.  Women in oncology: progress, challenges, and keys to success. Am Soc Clin Oncol Educ Book. 2013;33:448-455.
PubMed   |  Link to Article
National Research Council. Beyond Bias and Barriers: Fulfilling the Potential of Women in Academic Science and Engineering. Washington, DC: National Academies Press; 2007.
Page  SE. The Difference: How the Power of Diversity Creates Better Groups, Firms, Schools, and Societies. Princeton, NJ: Princeton University Press; 2007.

Figures

Place holder to copy figure label and caption
Figure 1.
Proportion of Collaborative Oncologic Clinical Trials With Women as First or Corresponding Authors, 2001-2011

Publications for which the gender of the first or corresponding author could not be identified and those whose authors were identified only as groups are not included.

Graphic Jump Location
Place holder to copy figure label and caption
Figure 2.
Proportion of Collaborative Oncologic Clinical Trials Sponsored by Funding Entities, 2001-2011

Percentages sum to more than 100% because some trials reported more than 1 funding source. Publications with no reported funding sources are not included.

Graphic Jump Location

Tables

References

Weeks  WB, Wallace  AE, Kimberly  BC.  Changes in authorship patterns in prestigious US medical journals. Soc Sci Med. 2004;59(9):1949-1954.
PubMed   |  Link to Article
Jagsi  R, Guancial  EA, Worobey  CC,  et al.  The “gender gap” in authorship of academic medical literature—a 35-year perspective. N Engl J Med. 2006;355(3):281-287.
PubMed   |  Link to Article
Jagsi  R, Sheets  N, Jankovic  A, Motomura  AR, Amarnath  S, Ubel  PA.  Frequency, nature, effects, and correlates of conflicts of interest in published clinical cancer research. Cancer. 2009;115(12):2783-2791.
PubMed   |  Link to Article
Reeder-Hayes  K, Felip  E, Patt  D, Jaffee  E.  Women in oncology: progress, challenges, and keys to success. Am Soc Clin Oncol Educ Book. 2013;33:448-455.
PubMed   |  Link to Article
National Research Council. Beyond Bias and Barriers: Fulfilling the Potential of Women in Academic Science and Engineering. Washington, DC: National Academies Press; 2007.
Page  SE. The Difference: How the Power of Diversity Creates Better Groups, Firms, Schools, and Societies. Princeton, NJ: Princeton University Press; 2007.

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