Women Underrepresented in Device Trials: Research

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Writing in a JAMA Internal Medicine research letter, Israeli researchers say that despite a 2014 FDA guidance, women have been underrepresented in medical device clinical trials. The researchers say that CDRH recently issued a strategic plan for improving women’s representation in medical device trials.

“We found that device trials randomized a median of 33% of women,” the letter says. “The participation-to-prevalence ratio for most common devices was less than 0.8, implying underrepresentation of women, as has been demonstrated in older device trials showing lower representation than drug or lifestyle interventions.”

The article identifies obstacles to women’s inclusion as concerns about fetal consequences, underdiagnosis or under-referral of women, perceived recruitment challenges, and inclusion and exclusion criteria favoring men.

It says that solutions proposed include equal enrollment of women to their share in the population with disease or planning a sample size that could detect gender differences.

“Improved awareness and initiatives are essential to ensure adequate enrollment, considering potential gender-specific differences in medical device performance,” the researchers conclude.

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