Women Experts Were Underrepresented in the Development of Clinical Practice Guidelines Used by a Consensus Task Force in Mild Traumatic Brain Injury

Nicole B. Katz, MD (Mount Auburn Hospital, Boston, Massachusetts); Allison C. Bean, MD, PhD; Charles A. Odonkor, MD, MA; Don D. McGeary; Monica Verduzco-Gutierrez, MD, FAAPMR; Julie K. Silver, MD

Meeting: AAPM&R Annual Assembly 2021

Categories: Practice Management, Leadership, and Quality Improvement (2021)

Session Information

Session Title: AA 2021 Virtual Posters - Practice Management, Leadership, and Quality Improvement

Session Time: None. Available on demand.

Disclosures: Nicole B. Katz, MD: No financial relationships or conflicts of interest

Objective: We hypothesized that women experts would be underrepresented in clinical practice guidelines (CPGs) that a mild traumatic brain injury (TBI) consensus group used to create a highly cited authoritative report. Our aim is to demonstrate the cumulative underrepresentation of women experts in CPGs.

Design: Observational study.Setting : Online.Participants : All CPGs meeting inclusion criteria (n=8) cited in “Management of Concussion and Mild Traumatic Brain Injury: A Synthesis of Practice Guidelines” produced by an expert consensus group published in Archives of Physical Medicine and Rehabilitation (2020).

Interventions: Not applicable.

Main Outcome Measures: Gender-based proportional differences (women; men) in CPG committee roles (authors; contributors), physician authors, CPG committee leadership positions (chairs; project leaders), and affiliations.

Results: In the 8 CPGs there were 310 authors and contributors (44.5% women; 55.5% men). The majority of contributors (n=67; 55.8%) and authors (n=105; 55.3%) were men. Of 102 (53.7%) physician authors, 75 (73.5%) were men and 27 (26.5%) were women. Differences were also found in leadership positions. Of 7 chairs, 5 (71.4%) were men and 2 (28.6%) were women (X^2 =1.35, p=0.25) and of the 11 project leaders, 9 (81.8%) were men and 2 (18.2%) were women (X^2=5.46, p=0.02). Gender-based differences were also identified in affiliations with a higher proportion of women affiliated with industry (n=13; 9.4%) and non-profit organizations (n=10; 7.2%) compared to men (n=6; 3.5% and n=2; 1.2%, respectively), and more men affiliated with academia (n=163; 94.8%) compared to women (n=114; 82.6%, X^2=13.01, p=0.005). This authoritative report has been cited 19 times.Conclusions: We found underrepresentation of women as CPG committee leaders and women physicians as authors in CPGs used in an authoritative consensus report intended to guide the clinical care of patients with mild TBI. Consensus groups should be aware of workforce gender disparities and bias as these may affect patient care. Systemic level interventions are needed to address these disparities.

Level of Evidence: Level IV

To cite this abstract in AMA style:

Katz NB, Bean AC, Odonkor CA, McGeary DD, Verduzco-Gutierrez M, Silver JK. Women Experts Were Underrepresented in the Development of Clinical Practice Guidelines Used by a Consensus Task Force in Mild Traumatic Brain Injury [abstract]. PM R. 2021; 13(S1)(suppl 1). https://pmrjabstracts.org/abstract/women-experts-were-underrepresented-in-the-development-of-clinical-practice-guidelines-used-by-a-consensus-task-force-in-mild-traumatic-brain-injury/. Accessed May 31, 2025.

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