Schadenfreude Corner
He must not be replaced with an Otter
My very dear GFPs, hello, and let’s start the day with a HUGE thank you from me for your generosity! After my last newsletter, the ENDO1000 project got another flurry of donations — and one EXTREMELY generous GFP got in touch with the project directly and donated £3000! So GFPs have now officially funded nearly five whole participants for this study! I am so proud of us! And it goes without saying that I am hugely grateful to you all, as of course are the good people at ENDO1000.
And in fact, that is not all that GFPs have been up to. Check this out from GFP Robin!
Because I am (clearly very unlike GFP Robin) rubbish, I did not in fact put a shout-out in the next newsletter, oops. I’m so sorry! As usual I blame my book — not the old book, the new one that I have been whining about for what feels like forever now. The good news for everyone who is not a fan of my whining is that I have only about a month left of being able to blame it for everything; the bad news is that I feel confident I will quickly be able to find something else to whine about and on which to blame my failure to reply to emails in a timely fashion. Which is, ironically, good news for me. In any case, useless as I am, I am very excited to find out how Robin got on with this! It’s absolutely thrilling to keep seeing Invisible Women reap tangible dividends seven years on from publication — please do keep sharing this stuff with me!
Sticking with fabulous GFPs getting on and making a difference, here is GFP Ruth, who got in touch to share the special women-focused edition of the Sports Engineering Journal she works with. “I’m a minor part of the entire publication process,” Ruth explains, “but since reading your book I have encouraged our authors to include details whether their test subjects are male or female for the sake of future research and overall information gathering.”
This, GFPs, is how change happens ✊
In less jolly news GFP Alex got in touch to share this new paper (and accompanying editorial) on yet another way default medicine is harming women.
So, as I believe I’ve mentioned once or twice, although women are on average smaller than men, it does not therefore follow that women are simply scaled-down men, which is something you might imagine that most medical specialties would have figured out by now and yet it feels like every day we discover a new area of medicine that has yet to uncover this little known fact. And so, to anaesthesiology, where it transpires that the formula used to determine how much air to deliver to a patient who needs a machine to breathe for them has been determined using, yes you guessed it, predominantly male data. This is a problem because while the formula assumes that height and body weight can be used as “a uniform surrogate for lung size, with only a crude sex correction,” in fact women and men “of identical height do not have identical lung volumes.” Rather, thanks to a range of sex differences, including “[c]hest wall mechanics, thoracic geometry, and body composition,” women have “smaller lungs relative to bodyweight.” And what this means is that the formula used to determine the safe level of mechanical ventilation to deliver to a patients lungs systemically overestimates lung capacity in women, and the end result is that female patients are being injured and, disproportionately, are dying.
None of this is helped by the fact the state of critical care research which overall has a major female data gap and not because there are no women available to take part in research (which long-time GFPs and readers of Invisible Women will remember is one of the classic excuses trotted out by researchers who fail to include women in their clinical trials). Indeed, as the authors of this paper point out, “anaesthesia research, women approached for trial participation do not systematically decline at higher rates than men.” The trouble instead lies in what researchers have decided is worth their time studying which, curiously enough overlaps quite nicely with conditions that are more likely to affect men. I know, this is a shock. Meanwhile, when women actually are included in a study, critical care researchers are no better than researchers in general when it comes to doing any sex-disaggregated analysis.
Recent systematic reviews confirm this pattern: among 60 large critical care trials, statistical considerations for sex were made in only 15%, and no trial explicitly stated efforts to improve equitable recruitment. Investigators report overall treatment effects, occasionally noting sex as a covariate but seldom examining whether treatment efficacy or safety differs between men and women.
I will never understand this. If you include both sexes why would you not do sex analysis MAKE IT MAKE SENSE.
And now for something completely schadenfreude
I have waited a decade to make this joke.
For those of you who don’t understand how hilarious I am being here, the backstory here is that when I was campaigning for a grand total of one (1) female historical figure on the back of our banknotes, I found myself being informed by many, many, many men, including, memorably, the then Governor of the Bank of England himself, that there was a woman on all the banknotes. As if I was too thick to have noticed that the Queen is female, when in fact they were too thick to realise that there’s a difference between being represented as a monarch, and honoured as a historical figure. Or maybe they did realise and simply delighted in wasting my time with dumb arguments. Either way, I challenge you to begrudge me my lap of schadenfreude.
More schadenfreude!
Just a brief moment to laugh at Anthropic (who famously used pirated books to train their large language model) suddenly discovering that oh pirating is bad and copyright is important now that it is their own code as opposed to the work of millions of authors (including this author) that has been leaked and stolen and used to profit someone else.
Very bad very sad very very very funny.
And finally..
Thanks to GFP Sophie for getting in touch to point us towards this House of Lords call for evidence on “Innovation in the NHS: personalised medicine and AI.” I’m afraid today is the final day to submit your comments, not because of Sophie but because of me (book!), but hopefully some GFPs will be able to sneak in under the deadline.
Poppy pic of the week
TONGUE!
That’s it! Until next time, my dear GFPs…xoxoxo