Author Index

Background Studies in several fields of medicine have found that women published less during the COVID-19 pandemic, potentially due to an increase in domestic responsibilities. This study examines whether a similar pattern exists for female authorship in ophthalmology. Purpose To compare the proportions of female authorship published in high-impact ophthalmology journals before and during the COVID-19 pandemic. Methods A cross-sectional study analyzing authorship gender of articles published during the COVID-19 pandemic (between July and September 2020) compared with matched articles published in the same journals before the COVID-19 pandemic (between July and September 2019). Gender of the first and last authors was analyzed using an online gender determination tool. Results A total of 577 articles and 1,113 authors were analyzed. There was no significant difference in the average number of publications by male and female authors before and during the COVID-19 pandemic. There was a significant increase in the percentage of female first authorship from the prepandemic period (32%) to during the COVID-19 pandemic (40%; p = 0.01), but no significant increase in the last authorship ( p > 0.05). When analyzing only research articles, a similar increase in female first authorship was noted when comparing the publications before (31%) and during the COVID-19 pandemic (43%; p = 0.02). No significant differences were noted when analyzing the editorials ( p > 0.05). Conclusion While disparities continue to exist between male and female authorship, an increase in female first authorship was noted during the COVID-19 pandemic for overall articles as well as research articles. Precis During the COVID-19 pandemic, female authorship as first and last authors of peer-reviewed articles in high-impact ophthalmology journals was below 50%. However, while the overall rates of female authorship were unchanged, female first authorship significantly increased during the pandemic. These results differ from studies published in other medical fields that demonstrated a decrease in female authorship during the COVID-19 pandemic.

Background: Orthopedic surgery is male-dominated, both in residency and leadership. This gender disparity also extends to research authorship. This study analyzes female authorship in top orthopedic journals over five years from 2018 to 2022. We compare female first author rates, senior female author rates, and overall female author counts in the Journal of Arthroplasty, American Journal of Sports Medicine, and Journal of Bone and Joint Surgery. Methods: A retrospective bibliometric review analyzed articles published from 2018 to 2022 in leading American orthopedic journals: Journal of Arthroplasty, American Journal of Sports Medicine, and Journal of Bone and Joint Surgery. Using the web-based application Genderize, we determined the gender of each author in each article. ANOVA and chi-squared tests were used to analyze continuous and categorical variables. Multivariate regression identified factors influencing first female authorship. Results: In the American Journal of Sports Medicine, Journal of Arthroplasty, and Journal of Bone and Joint Surgery, women comprise between 14.2% and 17.1% of first authors (P=0.011) . Female first authorship proportion has not significantly changed from 2018 to 2022 (P=0.074). However, senior female authorship had a noticeable impact on female authorship trends. Average female authors per publication significantly increased from 0.78 to 2.47 (P<0.001) and the percentage of female authors rose from 12.54% to 47.50% (P<0.001) under female senior authors. Female senior authors markedly enhance the odds of a female first author (OR: 3.33; 95% CI [2.80, 3.95]; P<0.001). Conclusions: In the past five years, women as first authors in top orthopedic surgery journals have not significantly increased. Senior female authorship and average female authorship notably rose. Female first authors often collaborate more with female senior authors. This highlights female-led mentorship’s role in achieving balanced gender representation in publications. Women supporting women is crucial in achieving equity in authorship and nurturing future female faculty, residents, and medical students in orthopedic surgery. Level of Evidence: Level III Retrospective Comparative Study

No. 486 Scholarly trends in interventional radiology: an analysis of U.S. female authorship in the Journal of Vascular and Interventional Radiology

PURPOSEAuthorship gender disparities persist across academic disciplines, including oncology. However, little is known about global variation in authorship gender distribution.METHODSThis retrospective cross-sectional study describes the distribution of author gender as determined from the first name across variables such as authorship position (first, middle, and last), country region, and country income level. The 608 articles with 5,302 authors included in this analysis were published in the Journal of Clinical Oncology Global Oncology, from its inception in October 2015 through March 2020. Primary outcome measure was author gender on the basis of first name probabilities assessed by genderize.io. World Bank classification was used to categorize the country region and income level. Odds ratios were used to describe associations between female last authorship and representation in other authorship positions.RESULTSAlthough female authors were in the minority across all authorship positions, they were more under-represented in the last author position with 190 (32.1%) female, compared with 252 (41.4%) female first authors and 1,564 (38.1%) female middle authors. Female authors were most under-represented among authors from low-income countries, where they made up 21.6% of first authors and 9.1% of last authors. Of all the regions, sub-Saharan Africa and South Asia had the lowest percentage of female authors. Compared with articles with male last authors, those with female last authors had odds ratios (95% CI) of 2.2 (1.6 to 3.2) of having female first authors and 1.4 (0.9 to 2.1) of having 50% or more female middle authors.CONCLUSIONThere are wide regional variations in author gender distribution in global oncology. Female authors remain markedly under-represented, especially in lower-income countries, sub-Saharan Africa, and South Asia. Future interventions should be tailored to mitigate these disparities.

INTRODUCTION: Despite recent advances, we hypothesized that women remain underrepresented as authors in neurosurgical literature–a key indicator of success in academic medicine. METHODS: We queried Web of Science for all contents published in the top 15 neurosurgical journals by h5-index. Articles and metadata were exported. Analyses were performed using Python packages (Gender-Guesser and Wiki-Gendersort for gender identification). RESULTS: 143,713 articles from 112,932 unique authors with full names were identified (62.0% (69,985/112,932) male, 24.0% (27,148/112,932) female, 14.0% (15,799/112,932) unknown). Female co-authorship was limited before 1980, with an increase in the 2000’s (7.0% in 2000 to 60.7% in 2023). However, female first and last authorship have yet to exceed 17.6% (2023) and 11.2% (2022), respectively. This is consistent across the top 3 neurosurgical journals. Compared to male last authors, female last authors are 3.45 times more likely to publish with female first authors (95% CI 3.27-3.64). Female first authors are also 3.73 times more likely than male first authors to publish with female last authors (95% CI 3.53-3.93). Of the 10,000 most productive authors, male authors have a higher h-index than female authors (p<0.001). However, female authors have a higher m-index (p<0.03), which is normalized to impact over time in the field, suggesting an emerging contingent of female authors who are academically productive and authoring impactful works. CONCLUSIONS: While progress has been made in female co-authorship, female first and last authorship remain below 20%. Female last authors are more likely to be associated with female first authors and vice versa. This finding suggests that women are paving the way towards a more equitable future of neurosurgery by mentoring other women, and that efforts to support female senior authors can also benefit female trainees.

In a previous report on the gender distribution of authors of articles published in leading pediatric journals, researchers found disparities in the proportion of articles written by women relative to men, with some closing of the gender gap from 2001 to 2016.1 In 2016, 63% of pediatricians were women; 58% of the publications had a female first author, but only 38% had a female senior author.1,2 Additionally, reports have found that female first authors are associated with female authors in the senior author position and female gender of the first or senior author is associated with a higher number of collaborating departments and institutions.1,3–6 However, to our knowledge, this report is the only study on this topic in the field of pediatrics, assessing authorship gender distribution in 5-year intervals through 2016.1The Pediatrics editorial board is committed to addressing underrepresentation of all types, including gender differences in authorship. To begin to understand this issue, we evaluated regular articles published in Pediatrics within the past 4.5 years for female representation in authorship, the degree to which the gender of first and senior author is correlated, and other measures of collaboration (eg, the number of participating institutions and total number of authors). Regular articles are defined as "original research contributions that aim to inform clinical practice or the understanding of a disease process…includ[ing] but are not limited to clinical trials, interventional studies, cohort studies, case-control studies, epidemiological assessments, and surveys."7 These more recent findings will be used to inform future journal policies to address implicit bias in the review process and inform academic departments about the need to support women in academics.We reviewed research articles published in Pediatrics from January 2015 to July 2019, extracting the number of authors and institutions. The gender of the first and senior author was determined from the following sources, in sequence: the author's institutional Web site, ResearchGate, LinkedIn, or Doximity. Only 1 affiliation was counted per author. Differences in categorical variables were evaluated with χ2 tests, and median values of nonparametrically distributed continuous variables were compared by using Mann–Whitney U tests. P < .05 was considered statistically significant.From January 2015 to July 2019, there were 1231 published research articles, involving 9444 authors. Overall, 61% (756) had a female first author, and 44% (547) had a female senior author. Gender could not be identified in 2% (22) of the first authors and 1% (13) of the senior authors. The gender distribution of first and senior authors over the study period is shown in Fig 1. There was no change in the proportion of female first or senior authors over the study period (P = .25 and P = .63, respectively). The number of coauthors (median: 7 [interquartile range (IQR) 5–9]) and number of collaborating institutions (median: 3 [IQR 2–4]) per article did not change over the study period (P = .90 and P = .70, respectively).First authors were more likely to be female in articles with female senior authors than in those with male senior authors (69% [377 of 547] vs 56% [375 of 671]; P < .001). Senior authors were more likely to be female in articles by female first authors than in articles by male first authors (50% [377 of 756] vs 36% [164 of 453]; P < .001).Female first authors wrote articles involving a lower number of collaborating institutions compared with male first authors (median: 2 [IQR 1–4] vs 3 [IQR 2–4]; P = .03). Female senior authors also wrote articles with a lower number of collaborating institutions compared with male senior authors (median: 2 [IQR 1–4] vs 3 [IQR 2–4]; P = .02). There was no difference in the median number of collaborating authors on the basis of the gender of first or senior authors (P = .62 and P = .98, respectively)We noted 2 important findings regarding articles published in Pediatrics: articles with female first authors were more likely to have female senior authors, and articles with female first or senior authors had fewer collaborating institutions.The proportion of female first authors publishing in Pediatrics over the past several years appears representative of the proportion of female physicians in the field of pediatrics overall.1,8,9 In contrast, the proportion of female senior authors is lower than the proportion of female physicians in the field. This may be related to factors discussed in past reports including, but not limited to, fewer women in senior positions, such as division chiefs or leaders of academic collaboratives, implicit gender bias in grant awarding, and midcareer burnout.10–12 Nonetheless, the pipeline of future female senior academic pediatricians is promising on the basis of our first author findings, if we can preserve the successful transition of these first authors to the senior authorship role. Our finding that articles with a female first author were more likely to have a female senior author is consistent with previous publications.1,3–5 This may highlight the importance of female research guidance for female young investigators, promoting what may be an important strategy for supporting more junior female faculty. Our finding that articles with a female first or senior author involve fewer centers is in contrast with a previous report regarding radiologists.6 Future work is needed to better understand if female pediatricians have less opportunity for multisite collaboration.This study is limited by the restriction to a 4.5-year study period in a single journal, and only published original investigations. We assumed first authors are junior and senior authors serve as mentors. We did not consider authors' subspecialty of practice. The submission platform during the study period did not elicit information about sex, gender, or race and/or ethnicity. We categorized author gender on the basis of the pronouns used in their profiles on institutional or professional Web sites but were not able to assess whether specific gender preferences were accurately represented. We were also not able to ascertain the gender for 1.4% of the authors. The intersectionality of race and ethnicity and gender identification likely adds additional complex layers into the role bias may be playing in these findings.With this study, we suggest that the current pool of junior faculty publishing as first authors in Pediatrics is representative of the current percentage of women pediatricians in the United States. With the findings, we underscore the importance of ensuring that female junior faculty progress in their career pathway to increase the pool of female physicians in academic leadership roles and expand the number of female senior authors engaged in research and subsequent publications.

ObjectiveFemale neurointerventionalists make up a minority of the neurointerventional work force. We sought to evaluate the contributions of this group to the Journal of Neurointerventional Surgery (JNIS) by identifying all...

From the Brontës to J.K. Rowling and Beyond – Have We Hit a Wall? The Status of Women Authors

Assessing the Gap in Female Authorship in Radiology: Trends Over the Past Two Decades

Historically, orthopaedic surgery has had low female representation, with <6% of practicing surgeons identifying as female. Although prior literature has illustrated gender disparities in first and last authorship as well as changes in gender representation over time, less attention has been paid to middle authorship. We hypothesized that trends in female authorship would reflect increasing female participation in orthopaedic surgery and orthopaedic subspecialties coinciding with an overall increase in female authorship. Bibliometric information from articles published between 2011 and 2021 in 6 orthopaedic journals was extracted with use of the Web of Science. Collected data included author order, author names, affiliation, and corresponding author address. A gender was assigned with the use of Genderize.io, which is validated software, on the basis of author first name. Statistical analysis was performed with use of an analysis of variance for each journal, and linear regression was performed to determine trends, controlling for year. Among all included orthopaedic journals, female middle authorship increased by 5 percentage points, female first authorship increased by 4 percentage points, and female last authorship increased by 1 percentage point. Over the study period, the highest rate of female middle authorship (28%) was seen in the Journal of Pediatric Orthopaedics, whereas the lowest rate (16%) was seen in The Journal of Arthroplasty . We found that the 5 highest-producing female last authors were, on average, cited significantly less per publication than their male counterparts in all but 2 journals. Gender gaps exist within orthopaedic surgery as well as within its body of literature. Although this study highlights areas of growth, it also promotes further inquiry into research productivity and the availability of opportunity within orthopaedic surgery as a whole. The increase in female middle authorship overall and in each journal demonstrates momentum for future growth for women in the field of orthopaedic surgery.

To provide information for targeted support of female scientists, the objective of this study was to evaluate how female authors are represented in journals of five medical disciplines with varying rates of female physicians from the United States of America (USA), Europe, and Asia. For this retrospective bibliometric study 15 representative gynecologic, pediatric, radiologic, urologic, and surgical journals from the USA, Europe, and Asia were selected from the Web of Science database. From these, all n = 24182 publications of the years 2007/2008 and 2017/2018 were included. Gender and affiliations were assigned to first and senior authors using a software (Gender API, Passau, Germany), native speakers, and a web-based search. For statistics mixed logistic and multinomial logistic regression were applied. In pediatrics, radiology, and urology, highest female first and senior author shares were consistently found in journals from the USA. In European journals proportions across all disciplines tripled (odds ratio 2.96 [95% CI 2.60–3.37], P < .0001). Asian journals showed three-times fewer female authorships than journals from the USA or Europe and the smallest increase (1.36 [1.11–1.66], P = .0026). Compared to the proportion of female physicians within each specialty, female first authors remained underrepresented in Asian journals and female senior authors in journals of all regions. In journals from the USA most female authors originated from institutes within the USA (36.2%), in European journals from the USA (21.1%) or Europe (21.7%). Women from Asian institutes were worst represented in journals of all regions with lowest rates in Asian journals (9.4%). In conclusion female first authors remained underrepresented in Asian journals, female senior authors and women from Asian institutes in journals from all regions. Programs for gender equality in science are thus particularly necessary to support female senior authors, for Asian journals, and women from Asian institutes.

Orthopaedic surgery remains a male-dominated specialty. To date there has not been a focused analysis of gender in authorship within the pediatric orthopaedic literature. The electronic table of contents from 2011 to 2020 of 3 major pediatric orthopaedic journals [Journal of Children's Orthopaedics (JCO), Journal of Pediatric Orthopaedics (JPO), and Journal of Pediatric Orthopaedics Part B (JPO-B)] were reviewed. Publications were reviewed for the number of articles with at least 1 female author and the number of articles with women listed as first authors. These were compared over the 10-year study period, and by individual year of publication. Statistical analysis included a general linear model with factorial one-way anslysis of variance and Bonferroni post hoc testing. A total of 4097 articles were reviewed. In 2020, there was a significantly higher percentage of articles with a female author when compared with 2011 (64% to 42%, P=0.010). A female was listed as first author in significantly more publications in 2020 as compared with 2011 (23% to 10%, P=0.031). During the 10-year study period, the highest mean proportion of articles with at least 1 female author was seen in JPO (60%), with similar findings in JCO (55%). Significantly fewer articles in JPO-B contained a female author (37%, P=0.001). The highest percentage of publications with a female first author across 10 years was in JCO (22%), followed by JPO (20%). Significantly fewer articles with a female first author were found in JPO-B (9%, P=0.001). There is an increasing proportion of publications in the pediatric orthopaedic literature with female authors and female first authors from 2011 to 2020. In addition, there was a statistical difference in female authorship when comparing specific publications, which should be investigated further. Level IV.

To examine trends in female authorship in the journal Emergency Radiology from January 1994 to December 2014. We obtained institutional review board approval for our study. We retrospectively reviewed a total of 1617 articles published in the journal Emergency Radiology over a 20-year period. Original articles, case reports, review articles, and pictorial essays were included. The first and last position author's gender was categorized as female or male. We analyzed trends by comparing the first and last position authors of original articles from the first and last year reviewed. We utilized Chi-square test for statistical analysis, with a p value <0.05 noted as significant. One thousand four hundred twenty articles met our inclusion criteria. There were 1420 first position authors and 1295 last position authors. There were 125 articles that had a sole author-these authors were considered as first position authors only. We determined, as best as possible, the gender of 96% of the authors. Overall, female authors were 21% of first position authors (290 of 1368) and 15% of last position authors (183 of 1246). Thirty-two percent of articles with female last position authors also had female first position authors (58 of 183). There was a statistically significant increase in female last position authors, from 12.9% in 1994 to 21.3% in 2014 (p=0.026), a non-significant increase in female first position authors, from 17.5% in 1994 to 20.9% in 2014 (p=0.514), and a non-significant increase in articles with both a first and last female author, from 25% in 1994 to 35% in 2014 (p=0.593). Over the last 20years, there has been a statistically significant upward trend in female last position authors publishing in the journal Emergency Radiology.

Medicine is a discipline where there are still pronounced gender imbalances. Whereas worldwide about 50% of beginners in medical schools are female, only few of them reach leading positions. Our aim was to analyze how this situation is reflected in a peer-reviewed general medical-scientific journal. We screened all papers submitted to the Wiener klinische Wochenschrift - The Middle European Journal of Medicine between January 2001 and September 2009, analyzing the percentage of female first authors of submitted papers and accepted papers, the contribution of female authors depending on the type of article and medical specialty, and the percentage of invited female peer reviewers as well as the quality of their reviews. During the period studied, a total of 2507 manuscripts were submitted to Wiener klinische Wochenschrift. 26% of these papers had female first authors, and this proportion increased continuously from 16% in 2001 to 32% in 2007, whereafter it remained constant. The proportion of papers submitted by female first authors was dependent on the medical subspecialty (e.g. 48% female first authors of pediatric papers, 12% female first authors of cardiology papers). There was no difference in the acceptance rate of papers by male and female first authors; however, a somewhat higher rate of papers with female first authors was subject to rapid rejection (21% vs. 16%). Papers with female first authors more often named a different corresponding author than papers with male first authors, and in most of these cases the corresponding author was a man. More than 40% of all submitted original papers, 24% of the review articles, but only 10% of the editorials had female first authors. During the years studied only 5-11% of reviewers were women, despite that the quality of their reviews was generally better than those by men. Among the 21 members of the editorial board only one is a woman. Between 2001 and 2007 the percentage of manuscripts submitted to Wiener klinische Wochenschrift by female authors constantly increased and is now around 30%, reaching almost 50% in some specialties such as pediatrics. Nevertheless, there remains a massive gender imbalance in Wiener klinische Wochenschrift: review papers or invited editorials are only rarely authored by female researchers, a very low percentage of peer reviewers is female - although the quality of their reviews is generally better - and only one member of the editorial board is female. Even though this is mostly a reflection of the general situation in academic medicine, medical journals can and must take action and contribute to the elimination of these gender inequalities.

Authorship of peer-reviewed publications is important for academic rank, promotion, and national reputation. In pain medicine, limited information is available for authorship trends for women as compared with men. The objective of this study was to describe trends of female authorship data in the 5 pain journals with the highest impact factors over a 10-year period. We analyzed data for January, April, and October in 2009, 2014, and 2019. For each article, the following information was recorded: journal name, journal month, journal year, article title or article PMCID, total authors, total female authors, total male authors, total authors of unknown gender, presence or absence of a female first author, and presence or absence of a female last/senior author. Authorship for 924 articles was reviewed. When a man was senior author, women were first author on only 27.9% of articles (P<.001). A woman was 2 times as likely (57.2%) to be first author when a woman was the senior author (P<.001), pointing to the potential impact of female senior authors. An article with 50% or more female authors was 76.4% more likely to have a female senior author (P<.001). The results demonstrate the influence of a senior female author on the likelihood of an article's having a female first author. When men were the senior authors, women were half as likely to be first authors. The total number of female authors changed very little between 2009 and 2019.