Abstract Details

Title Analysis of Gender Representation Among Physician Authors in American Academy of Neurology Clinical Practice Guidelines

Topic Health Care Disparities

Presentation(s) Health Care Disparities Posters (7:00 AM-5:00 PM)

Poster/Presentation
Number 002

Background

Numerous gender-related disparities are known in neurology. Gender representation in CPGs, which direct clinical care, has not previously been investigated.

Objective

To assess the gender representation among physician authors in American Academy of Neurology (AAN) Clinical Practice Guidelines (CPGs).

Design/Methods We reviewed all AAN CGPs from 1/1/2015 to 9/21/2020. Author degrees and gender were identified by two reviewers using the publication and/or online searches. Gender was delineated as binary (i.e. woman and man), and determined from pronouns or photographs. Gender representation on CPGs was compared to Association of American Medical Colleges (AAMC) data on academic neurologists. Data was analyzed using descriptive statistics.

Results We identified 67 unique CPGs with 641 total physician authors, 205 women (32%) and 436 men (68%). Among physician first authors, there were 13 (20%) women and 51 (80%) men. Among physician last (senior) authors, there were 21 (35%) women and 39 (65%) men. In 2015 there were 4157 academic neurologists, 1455 (35%) women and 2702 (65%) men. Using two proportion z-tests, the representation of women physician authors was compared to the field, and they were significantly underrepresented among physician first authors, p=0.02, 95% CI [-0.25, -0.04]. While the proportion of women among total physician authors was lower than the field, this was not significant, p=0.15, 95% CI [-0.07, 0.01]. The proportion of women for physician last authors was equitable, p=1, 95% CI [-0.12, 0.12]. For subspecialties with 10+ CPGs women physician authorship included: child neurology 58 (52%); neuromuscular 54 (41%); neurology measures 41 (33%); stroke and vascular neurology 18 (16%).

Conclusions Women physicians were underrepresented as guideline authors, though not significantly. Women physicians were significantly underrepresented as first authors, but equitably represented as last authors. For subspecialties women physician authorship ranged from 16% to 52%. As numbers of women neurologists increase, further research is needed for gaps to be addressed.

Authors/Disclosures
Lindsay Ross, MD (Cleveland Clinic Foundation) PRESENTER	The institution of Dr. Ross has received research support from National MS Society.
	No disclosure on file
	No disclosure on file
Peter Brown, DO (Legacy Health Systems)	Dr. Brown has nothing to disclose.
Elizabeth Spurgeon, MD (Cleveland Clinic Foundation)	Dr. Spurgeon has nothing to disclose.
Catherine Hassett, MD	Dr. Hassett has nothing to disclose.
Mary R. Rensel, MD, FAAN	Dr. Rensel has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Biogen. Dr. Rensel has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Cycle Pharma. Dr. Rensel has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for biogen. Dr. Rensel has stock in Brain Fresh LLC . The institution of Dr. Rensel has received research support from NMSS. The institution of Dr. Rensel has received research support from Roche- Genentech .
Julie Silver (Harvard Medical School, Massachusetts General Hospital)	No disclosure on file