Segelov Research Group

Studies show that gender disparities are common within academic career paths. In Switzerland, women are well represented at all levels from Master’s programs and PhD programs until habilitation but are underrepresented at the associated and full professor level. This tendency is also referred to as the scissor-shaped gender inequality curve.

Several measures have been implemented in Switzerland to improve gender equity in reaching an academic career, but inequalities remain. It is essential to better understand the different career paths and experiences after habilitation and identify factors associated with pursuing and accomplishing an academic career to improve opportunities in the future for women in particular.

The aim of this project is to study career paths after habilitation among people who have habilitated or umhabilitated at the Faculty of Medicine, University of Bern since 2014 and examine which factors are associated with reaching the level of associate and full professor, with a special focus on gender differences.

To answer these aims, the following projects are planned;

• A systematic review to evaluate the literature on the gender distribution at different academic career stages in Europe and identify factors associated with the underrepresentation of women at the professorship levels.
• A cross-sectional survey will be distributed to all individuals who have either habilitated or failed to habilitate at the Faculty of Medicine, University of Bern, since 2014. The aim is to explore various career paths and their predictors. The questionnaire will include detailed inquiries about sociodemographic factors (e.g., age, gender), current job position, career trajectory (including reasons for pursuing or not pursuing an academic career), and other factors that may influence career development, such as the number of children, language barriers, and other relevant circumstances.
• A qualitative study to explore experiences of people who have habilitated or umhabilitated at the Faculty of Medicine, University of Bern since 2014. Focus group interviews will be conducted.

Status: Protocols and questionnaire in development.

Survival of melanoma patients after immune checkpoint inhibitor discontinuation for response or toxicity – a single center analysis

Immune checkpoint inhibitors (ICI) have improved survival for patients with advanced melanoma, however outcomes after treatment discontinuation are yet unclear. The aim of this project is to study the prognosis after ICI discontinuation among patients with metastatic melanoma using electronic health records data from patients treated at the Cancer Centre of the University Hospital Bern between 2016 and 2022.

Status: Data is being analyzed.

Characteristics of adolescents and young adults with cancer treated at the University Hospital Bern between 2015 and 2021.

Adolescents and young adults (cancer) with cancer are recognized as a distinct population compared to children or older adults with cancer due to differences in cancer epidemiology and due to being in the challenging phase between childhood and adulthood. Knowledge gaps remain for understanding the incidence and prognosis of specific cancers, as well as access to care tailored to the AYA age group. Using electronic health records data, this project aims to describe cancer and treatment characteristics as well as prognosis by sex and age groups among all AYA treated at the University Hospital Bern between 2015 and 2021.

Status: Data is being analyzed.

An overview of clinical trials in anal cancer 1999-2024

Anal cancer (AC) is an uncommon malignancy. Clinical trials are crucial for improving prevention and treatment, but due to the rarity of anal cancer, conducting clinical trials is challenging. The aim of this project is to provide a comprehensive overview of the past 25 years of clinical trials in anal cancer to inform research gaps and understand the global research efforts across the prevention-treatment spectrum. A systematic review of data from the two main global trial databases will be analyzed including the International Clinical Trials Registry Platform and clinicaltrials.gov.

Status: Publication submitted.

Incidence and burden of anal cancer – time to fight the growing disparities

Anal cancer (AC) is rare, but incidence is increasing, although at different rates across countries and population groups. The increase in AC incidence is primarily due to the increased prevalence of human papillomavirus (HPV), which causes 90% of squamous cell carcinoma (SCC), the most common anal cancer histology subtype. Understanding estimates of incidence across countries and risk groups is essential for estimating future disease burden and predicting cancer care resource allocation. The aim of this project is to summarize the literature to describe the epidemiology of anal cancer, with an emphasis on global disparities and challenges for anal cancer prevention.

Status: Publication submitted.

Through a competitive call, Gesundheitsförderung Schweiz has granted DCR the mandate to evaluate the “Concurrent Care (CoCa)” project, which aims to implement advanced health planning as part of advanced cancer care. CoCa is led by Monica Fliedner, University Center for Palliative Care, Inselspital Bern.

The DCR evaluation runs in parallel with the CoCa project implementation, including process and outcome evaluations from the perspectives of the patients, their relatives, care providers, and health promotion institutions. The DCR and CoCa project team will collaborate closely during the project duration between 2024 and 2028.

Status: Evaluation plan is being developed in collaboration with the CoCa project team.

Traditional models of single large cohorts may no longer be fit for purpose due to high costs, low recruitment and inefficiencies including duplication of basic information. There is a need for large collaborative initiatives that leverage of existing structures to improve efficiency and lower costs. Further, controls are often needed in clinical studies, but these are usually difficult and costly to recruit. Alone in Bern, many separate projects are currently recruiting controls. With a cohort study in Bern available as a patient- and control pool, time and resources for recruitment could be saved to increase feasibility and avoid project delays.

In response to a request, a proposal has been sent to the Strategic Funding board of the Faculty of Medicine for setting up a unique, modular clinical and control cohort, the Families Bern, which would include extended families to directly facilitate clinical research from multiple clinical disciplines in Bern, Switzerland, and internationally.

Status: Currently awaiting response.

The EVALUATE is an observational study looking at the prevalence and predictors of metabolic-dysfunction-associated fatty liver disease (MAFLD) among survivors of breast and colorectal cancer.

Status: A grant proposal has been submitted, and currently awaiting response.

The DCR was part of the AGNODICE grant submitted for consideration  in the 2024 funding round. AGNODICE aims to establish the next-generation evidence-synthesis ecosystem, tailored to meet the evolving needs of integrated healthcare in Switzerland. With a focus on patient-centric and societal considerations, as well as the imperative of real-time decision-making, AGNODICE will address diagnostic, prognostic, and therapeutic domains where intricate, cost-effective, and personalized combinations of health technologies are crucial. DCR is the lead for the work package describing PPI and co-production.

IMCI-PLUS is an interdisciplinary research initiative, funded by Global Health EDCTP3, focused on improving the management of childhood pneumonia through the integration of Point of Care Lung Ultrasound (PLUS) into clinical practice and healthcare policy. Lung ultrasound, performed at the bedside by clinicians, offers a non-invasive method for diagnosing pneumonia, but further evidence is needed to support its widespread use. IMCI-PLUS will evaluate the clinical and economic impacts of PLUS through a prospective randomized controlled trial and implementation research across four sites in Senegal, South Africa, and Tanzania, involving more than 8,500 children.

Prof. Segelov is one of 5 co-applicants across Switzerland for this grant which is currently under review by the Helmut Horton Foundation.