Association of Women Authors with Women Enrollment in Clinical Trials of Atrial Fibrillation

This meta-analysis of atrial fibrillation randomized trials examined whether the sex of study authors predicted enrollment of women participants — a structural question about whether academic leadership composition shapes who gets studied.

Women comprised 35 percent of trial participants and 14 percent of authors. Only 7 percent of trials had a female first author. Trials with a higher proportion of women authors enrolled significantly more women participants (β=0.19, p=0.02), even in multivariate analysis. The signal was modest but statistically robust.

AF is a condition with known sex-specific presentations and outcomes, yet women remain underrepresented on both sides of the research enterprise — as participants and as investigators. The observed association suggests that research leadership shapes research questions and recruitment practices.

The limitation is causality. Women authors may be more likely to choose research questions relevant to women, or may participate in networks that enroll more diverse populations — the mechanism is unknown and reverse causation is plausible.

We rate the evidence limited. An interesting association between academic representation and research diversity in AF trials, but one that cannot establish a causal pathway or prescribe a direct intervention.