Abstract
BACKGROUND AND AIMS: Female physicians, particularly those from minority populations, are significantly underrepresented in research authorship in gastroenterology. This underrepresentation negatively impacts their career progression. This study analyses gender and race representation trends in published clinical trials in inflammatory bowel disease (IBD) and associated factors. METHODS: Inflammatory bowel disease clinical trials were identified from ClinicalTrials.gov and www.ibd-eii.com, spanning the years 1955 to 2023. The variable gender was extracted for all authors and race was extracted for first, second, senior, corresponding authors, and principal investigator (PI) using predictive tools and manual verification. Data on authorship, trial characteristics, and sponsorship were collected. RESULTS: A total of 438 clinical trials involving 5517 authors were analyzed. Females constituted 26.3% of authors, 17.1% of first authors, 6.1% of senior authors, and 24.2% of PIs, with nonwhite individuals representing 12.3% of first authors, 5.9% of senior authors, and 18.8% of PIs. Female representation increased from 1971 to 2023 but remained substantially lower relative to male representation. Industry-sponsored trials had the lowest female author and PI representation while nonindustry, single-center, pediatric, and advanced therapy trials had higher female representation. CONCLUSIONS: This study highlights persistent gender and racial disparities in IBD trial authorship and leadership despite some progress over the decades. Female and nonwhite individuals remain underrepresented, especially in industry-sponsored trials and in senior authorship roles. Systemic interventions are warranted to foster an inclusive and equitable research environment, including mentorship and support for underrepresented groups.