Important Questions Deserve Rigorous Analysis: A Cautionary Note About Selection Bias

In this issue of the Journal of the American Heart Association (JAHA), the article by Millenaar et al. ti-tled “Sex Differences in Cardiovascular Research: A Scientometric Analysis,” tackles a pervasive issue in cardiovascular research: the sex gap in publish-ing.¹ We commend the authors (henceforth referred to as “researchers” to avoid confusion with the authors they study) for tackling this difficult topic, adding to a growing body of literature documenting both historical underrepresentation of women in and recent upwards trends in number of publications by female authors in published cardiovascular research.^{2– 4} As female researchers ourselves, we agree with the researchers’ conclusions that structural changes—such as parity in pay and mentorship programs—are important steps toward reducing disparities between men and women in research opportunities. However, this important issue deserves to be held to rigorous standards, both for study design and statistical approach.