Sticky Floor, Broken Ladder, and Glass Ceiling in Academic Obstetrics and Gynecology in the United States and Canada.

Objective To evaluate the gender proportion in academic obstetrics and gynecology faculty across the United States and Canada and further assess any gender differences in academic ranks, leadership positions, and research productivity. Methods Obstetrics and gynecology programs were searched from the Fellowship and Residency Electronic Interactive Database (FREIDA) (n=145) and the Canadian Resident Matching Service (CaRMS) (n=13) to compile a database of gender and academic profiles of faculty physicians with Medical Doctorate (MD) or Doctors of Osteopathic Medicine (DO) degrees. Elsevier's Scopus was used to gather individual research metrics for analysis, and the data were analyzed using Strata v14.2 (StataCorp. 2015. Stata Statistical Software: Release 14. College Station, TX: StataCorp LP). Results Among 3556 American and 689 Canadian Obstetrics and Gynaecology physicians, women comprised 60.9% and 61.4%, respectively. Among physicians with professorships, women physicians comprised 36.2% and 35.8% in the United States and Canada, respectively. When examining the gender proportion of physicians in leadership roles, women comprised 52.2% and 56.1% in the United States and Canada, respectively. The h-index between men and women physicians showed a significant difference overall in both the United States (p<0.001) and Canada (p<0.001), indicating that men have higher academic output. Conclusion Although the overall proportion of women academic staff physicians in Obstetrics and Gynaecology is higher than the proportion of men, there are more men who had a full professor rank. Men also had higher academic productivity.

Identification and Evaluation of Controlled Trials in Pediatric Cardiology: Crowdsourced Scoping Review and Creation of Accessible Searchable Database.

Cardiac disease in children is associated with significant morbidity and mortality as well as increased health resource utilisation. There is a perception that there is a paucity of high-quality studies, particularly randomized controlled trials (RCTs), in the field of pediatric cardiology. We sought to identify, examine, and map the range of RCTs conducted in children with cardiac conditions, including the development of a searchable open-access database. A literature search was conducted encompassing MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials from inception to 2018. All English-language RCTs enrolling children (age 0-21 years) with cardiac conditions were included. Data extraction and risk of bias assessments were performed in duplicate via crowdsourcing for each eligible study and entered into an online database. A total of 933 RCTs met eligibility criteria. Median trial recruitment was 49 patients (interquartile range 30-86) with 18.9% of studies (n = 176) including > 100 patients. A wide variety of populations and interventions were encompassed with congenital heart disease (79.8% of RCTs) and medications (63.3% of RCTs) often studied. Just over one-half of the trials (53.4%) clearly identified a primary outcome, and fewer than half (46.6%) fully documented a robust randomization process. Trials were summarised in a searchable online database (https://pediatrics.knack.com/cardiology-rct-database#cardiology-rcts/). Contrary to a commonly held perception, there are nearly 1,000 published RCTs in pediatric cardiology. The open-access database created as part of this project provides a resource that facilitates an efficient comprehensive review of the literature for clinicians and researchers caring for children with cardiac issues.

Chronic Disease Onset Among People Living with HIV and AIDS in a Large Private Insurance Claims Dataset.

People living with HIV/AIDS (PLWHA) have a growing life expectancy in the US due to early provision of effective antiretroviral treatment. This has resulted in increasing exposure to age-related chronic illness that may be exacerbated by HIV/AIDS or antiretroviral treatment. Prior work has suggested that PLWHA may be subject to accelerated aging, with earlier onset and higher risk of acquiring many chronic illnesses. However, the magnitude of these effects, controlling for chronic co-morbidities, has not been fully quantified. We evaluate the magnitude of association of HIV infection on developing chronic conditions while controlling for demographics, behavioral risk factors, and chronic comorbidities. We compare chronic disease risks of diabetes, hypertension, stroke, cancers, lung diseases, cardiovascular diseases, and cognitive impairment between PLWHA and HIV- individuals in a large, de-identified private insurance claims dataset (~24,000 PLWHA) using logistic regressions. HIV status is statistically significantly associated with higher levels for all chronic illnesses examined, a result which is robust to multiple model specifications and duration of analysis (2, 5, and 10 years from enrollment). Our results suggest that PLWHA may be at elevated risk for a wide variety of chronic illnesses and may require additional care as the aging PLWHA population grows.

Analysis of H-index in Assessing Gender Differences in Academic Rank and Leadership in Physical Medicine and Rehabilitation in the United States and Canada.

OBJECTIVES: The aims of the study were (1) to establish potential gender differences in academic physical medicine and rehabilitation faculty across the United States and Canada and (2) to evaluate associations between physician gender, leadership position, and research productivity. DESIGN: Physical medicine and rehabilitation programs enlisted in Fellowship and Residency Electronic Interactive Database (n = 72) and Canadian Resident Matching Service (n = 9) were searched for academic faculty with Doctor of Medicine degrees to generate a database of gender and academic profiles. Bibliometric data were collected using Elsevier's Scopus and analyzed by Strata v14.2. RESULTS: Of 1045 faculty meeting the inclusion criteria, 653 were men and 392 were women. Men were found in greater numbers across all academic ranks, with professors as most conspicuous (79.14%), and held most (85.54%) leadership positions. The study's prediction model assessed for gender differences in academic rank and leadership roles and found that odds of men having higher h-index as 0.78 (95% confidence interval = 0.24-0.87), indicating that women were not significantly inferior in academic performance. CONCLUSIONS: A significantly greater number of men make up physical medicine and rehabilitation faculty in all academic ranks and leadership positions. H-index based on gender and adjusted for covariates is comparable between men and women, suggesting that more complex, multifactorial issues are likely influencing the gender differences.