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Background: The effect of physician–patient sex concordance in medicine has been reported in many studies. Whether physicians believe that the sex concordance between physician and athlete influences treatment has not been investigated. Objective: To determine whether physicians believe that the sex concordance between physician and athlete influences treatment. Design: Cross‐sectional study. Setting: Online survey. Participants: One thousand one hundred ninety‐three sports medicine physicians in 51 countries. Participants were sports medicine physicians trained in orthopedics (n = 443 [37.1%]) and nonorthopedics (n = 750 [62.9%]). Interventions: Not applicable. Main Outcome Measures: Participants were asked to decide whether sex of the physician made them better suited to care for athletes of concordant or different sexes along with their personal background. Results: Orthopedic sports medicine physicians agreed less than nonorthopedic sports medicine physicians regarding the statement "MALE sports medicine physicians are better suited than their female counterparts to care for MALE athletes" (odds ratio [OR] 0.56, 95% confidence interval [CI] 0.35–0.91, p =.02), and compared to sports medicine physicians based in Europe, those based in Asia agreed more to this statement (OR 7.91, 95% CI 4.60–13.60, p <.01). In addition, regarding the statement "FEMALE sports medicine physicians are better suited than their male counterparts to care for FEMALE athletes," compared to sports medicine physicians based in Europe, those based in Asia (OR 9.12, 95% CI 5.63–14.79, p <.01) and North America (OR 2.18, 95% CI 1.46–3.25, p <.01) agreed more and orthopedic sports medicine physicians agreed less than nonorthopedic sports medicine physicians (OR 0.61, 95% CI 0.39–0.93, p =.02) to this statement. Conclusions: Sports medicine physicians trained in orthopedics felt sex concordance was less important than physicians trained in other specialties. Asian sports medicine physicians believed sex concordance was more important compared to physicians in other regions. [ABSTRACT FROM AUTHOR]

Supporting female sports medicine physicians to simultaneously be mothers and pursue professional careers is crucial to maintain gender diversity in sports medicine physicians. The purpose of this study is to understand the attitudes toward female sports medicine physicians during pregnancy and postpartum. An anonymous online survey was distributed to sports medicine physicians practicing in 51 different countries. They were asked how comfortable they felt with female sports medicine physicians working on the sidelines of sporting events during pregnancy, if the female sports medicine physicians were as productive as their male counterparts after giving birth, and how satisfied they were with the percentage of female sports medicine physicians in their country. Data were analyzed using the chi-square test, and multivariate logistic regression analysis was performed to identify independent variables. In total, 1193 physicians (380 [31.9%] female) were included for analysis. Physicians in Asia were the least comfortable with pregnant sports medicine physicians working on the sidelines and those in North America were the most comfortable (odds ratio = 0.28 and 2.51, 95% confidence interval 0.18–0.44 and 1.55–4.06, respectively). More experienced sports medicine physicians (odds ratio = 1.01, 95% confidence interval 1.00–1.03; p < 0.05) and divorced physicians (odds ratio = 0.33, 95% confidence interval 0.12–0.91; p < 0.05) were less comfortable with pregnant female sports medicine physicians working on sidelines, and those trained in orthopedics were less likely to agree that female sports medicine physicians were equally as productive as male counterparts postpartum (odds ratio = 0.29, 95% confidence interval 0.10–0.88; p < 0.05). Female physicians were less satisfied with the percentage of female sports medicine physicians in their country (odds ratio = 0.41, 95% confidence interval 0.27–0.60; p < 0.01) than their male counterparts. Female sports medicine physicians may experience bias in their practice during pregnancy and postpartum. [ABSTRACT FROM AUTHOR]

Objectives: Multiple system atrophy (MSA) is a refractory neurodegenerative disease, but novel treatments are anticipated. An accurate natural history of MSA is important for clinical trials, but is insufficient. This regional registry was launched to complement clinical information on MSA., Setting: Patient recruitment started in November 2014 and is ongoing at the time of submission. The number of participating facilities was 66. Postal surveys were sent to medical facilities and patients with MSA in Hokkaido, Japan., Participants: After obtaining written consent from 196 participants, 184 overview surveys and 115 detailed surveys were conducted., Primary and Secondary Outcome Measures: An overview survey evaluated conformity to diagnostic criteria and a detailed survey implemented an annual assessment based on the Unified Multiple System Atrophy Rating Scale (UMSARS)., Results: At the time of registration, 58.2% of patients were diagnosed with cerebellar symptoms predominant type MSA (MSA-C) and 29.9% were diagnosed with parkinsonism predominant type MSA (MSA-P). UMSARS Part Ⅳ score of 4 or 5 accounted for 53.8% of participants. The higher the UMSARS Part Ⅳ score, the higher the proportion of MSA-P. At baseline, levodopa was used by 69 patients (37.5%) and the average levodopa dose was 406.7 mg/day. The frequency of levodopa use increased over time. Eleven cases changed from MSA-C to MSA-P during the study, but the opposite was not observed. Information about survival and causes of death was collected on 54 cases. Half of deaths were respiratory-related. Sudden death was recorded even in the group with UMSARS Part Ⅳ score of 1., Conclusions: This study is the first large-scale prospective MSA cohort study in Asia. MSA-C was dominant, but the use of antiparkinsonian drugs increased over the study period. Changes from MSA-C to MSA-P occurred, but not vice versa., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)