The estimated survival times from start of renal replacement therapy were 23.1 years (95% confidence interval (CI): 21.2−25.0) and 9.3 years (95% CI: 7.8−10.8) for kidney transplantation and dialysis, respectively. The potential outcome mean and the average treatment effect were estimated using an inverse-probability-weighted regression adjustment approach. Weibull and logistic regression models were used for the outcome and treatment models, respectively. We included 2676 adult waitlisted patients who started renal replacement therapy in Sweden between 1 January 1995, and 31 December 2012. This study applied the propensity score weighting approach in order to address the treatment selection bias of kidney transplantation on survival time compared with dialysis for patients on the waitlist. Using observational data to assess the treatment effects on outcomes of kidney transplantation relative to dialysis for patients on renal replacement therapy is challenging due to the non-random selection into treatment. There is considerable room for improvement to enhance the involvement of UIM racial/ethnic minority individuals in leadership of prominent general and specialty medical journals. Among "control" journals, there were Black Editors-in-Chief, but no Hispanic Editors-in-chief 7 (8%) Black and 1(1%) Hispanic Deputy and Associate editors (n=86) 43 (47%) Black and 3 (3%) Hispanic Editorial Board Members (n=92). Among specialty journals, there were no UIM Editors-in-Chief 3 (7%) Black and 0 (0%) Hispanic Deputy or Associate Editors (n=43) 6 (6%) Black and 5 (5%) Hispanic Editorial Board Members (n=105). Among general medicine journals, there were no UIM Editors-in-Chief or Deputy Editors 1 (2%) Black and 3 (5%) Hispanic among Associate Editors (n=65) and 8 (6%) Black, and 2 (2%) Hispanic among Editorial Board Members (n=136).
We searched the journal databases for all articles published on racial/ethnic disparities or health equity by each journal between January 2015 to October 2020. We pre-selected 6 prominent general medicine journals, 9 prominent specialty journals, and 5 "control" journals (covering public health, health equity, and bench research), assembled names of all editors/ editorial board members listed on the website-based journal mastheads and used major public internet search engines to obtain information about sex, race, and ethnicity. The objective of this study was to assess the proportions of the underrepresented in medicine (UIM) racial/ ethnic minorities in medical journal leadership. Medical journals play an important role in achieving health equity by diversifying their leadership, but there is a dearth of published data on how they are faring. This survey reveals alarmingly high rate of experience with racial and gender disparity, lack of mentorship, and very low rates of female leadership in the LT field and calls to action to equity and inclusion. An association between female responses and discrimination, differences in compensation, and job promotion was observed. Less than half (43.7%) received mentorship when discrimination occurred.
Sixty-eight of respondents (34.7%) reported some form of discrimination during training or at their current position, presumably related to gender/sexual orientation (20.6%), race/country of origin (25.2%) and others (7.1%). Among 856 LT programs worldwide, 8.2% of leadership positions were held by females, and 22% of division chiefs were female across all specialties. Almost half were surgeons (45.7%), 27.6% hepatologists and 26.6% anesthetists. The survey was e-mailed to 1312 ILTS members, 199 responses (40.7% female) were collected from 38 countries (15.2% response rate). Worldwide female leadership was also queried via publicly available data. Answers were collected and analyzed anonymously. International Liver Transplant Society (ILTS) EDI Committee survey around topics related to discrimination, mentorship, and gender. Little is known about the pattern of practice and perceptions of EDI among liver transplant (LT) providers. Equality, diversity, and inclusion (EDI) are fundamental principles.
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