Evidence map›Paper›PMID 21713543›Full record

SynthesisJournal of general internal medicine2012

The impact of cardiovascular disease prevalence on women's enrollment in landmark randomized cardiovascular trials: a systematic review.

Wendy Tsang, David A Alter, Harindra C Wijeysundera, Tony Zhang, Dennis T Ko

Open access · bronzeAbstract readComparative StudySystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Journal of general internal medicine, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
21citing papers in PubMed, 2 pooled it
2.8field-weighted citation impact, top 10% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

21 citing papers in PubMed, 2 syntheses or guidelines pooled it, 66 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Review
  4. Review
  5. Article
  6. Underrepresentation of women in cardiovascular disease clinical Trials-What's in a Name?International journal of cardiology. Heart & vasculature · 2024
    Article
  7. Article
  8. Article
  9. Review
  10. Female Recruitment Into Cardiovascular Disease Trials.The American journal of cardiology · 2023
    Article
  11. Review
  12. Article
  13. Underrepresentation of women in cardiovascular trials- it is time to shatter this glass ceiling.American heart journal plus : cardiology research and practice · 2022
    Article
  14. Review
  15. Review
  16. Enrollment and Retention of Men and Women in Health Services Research and Development Trials.Women's health issues : official publication of the Jacobs Institute of Women's Health · 2019
    Article
  17. Article
  18. Review
  19. Article
  20. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 4 institutions in 2 countries.

Wendy TsangUniversity of Chicago Medical Center, Chicago, IL, USA.
David A Alter
Harindra C Wijeysundera
Tony Zhang
Dennis T Ko
Sunnybrook Health Science Centre · CAInstitute for Clinical Evaluative Sciences · CASt. Michael's Hospital · CAUniversity of Chicago Medical Center · US

Funding

Canadian Institutes of Health Research MOP 102487
6 · The paper itself

Abstract

Many studies have demonstrated that women are substantially underrepresented in cardiovascular trials, but few have considered that women develop cardiovascular disease at older ages than men. The extent to which observed gender enrollment inequalities persist after accounting for age-gender differences in disease prevalence is unknown. The purpose of the study was to compare observed rates of women participating in cardiovascular clinical trials with expected rates of female participation based on age- and gender-specific population disease prevalence. Publications between 1997 and 2009 in the three leading medical journals were included to calculate observed women's enrollment rates. Population-based data in Canada were used to determine the expected enrollment rates of women. Multicenter, randomized cardiovascular clinical trials that enrolled both men and women were analyzed. Two reviewers independently extracted data on women's enrollment and important clinical trial characteristics. The female enrollment rate was 30% in the included 325 trials, which ranged from 27% in trials of coronary artery disease, 27% in heart failure, 31% in arrhythmia, to 45% in primary prevention. Increased female enrollment correlated strongly with increasing age at recruitment in cardiovascular clinical trials (P < 0.001). After accounting for age- and gender-specific differences in disease prevalence, gaps in female enrollment were much lower than the expected enrollment rates estimated by 5% in coronary artery disease, 13% in heart failure, 9% in arrhythmia, and 3% in primary prevention. Only cardiovascular trials were evaluated in our study. Female underrepresentation in cardiovascular clinical trials is smaller than conventionally believed after accounting for age- and gender-specific population disease prevalence. Our findings suggest that greater representation of women in cardiovascular clinical trials can be achieved through the recruitment of older populations.

Indexed as

Patient SelectionWomen's HealthAge FactorsCardiovascular DiseasesFemaleHumansPrevalenceRandomized Controlled Trials as TopicSex Factors

Identifiers

PMID21713543
PMCPMC3250532
OpenAlexW2077158895

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.