Sex Disparities in Ophthalmic Research

Abstract

Previous studies examined sex distributions in different medical faculties, especially because increasingly more women entered the medical field in recent decades. Little is known at present about the female representation in ophthalmic research. To clarify sex equalities in ophthalmic research by evaluating the representation of female authorships. This bibliometric analysis included original English-language articles published in ophthalmologic journals indexed in the Web of Science from January 2008 to August 2018. Authorships were assigned by sex according to first name. Outcomes included the proportion of female authorships, odds ratios of women holding prestigious first and last authorships compared with men (measured by the prestige index), citation rates, a productivity analysis, and cross-journal and transnational female representation within ophthalmic research. The hypothesis was formulated during data collection. Bibliometric data were abstracted from 87 640 original articles published in 248 ophthalmologic journals. Of 344 433 total authorships, female scholars held 34.9% (120 305 of 344 433) of all authorships, 37.1% (24 924 of 67 226) of first authorships, 36.7% (77 295 of 210 372) of coauthorships, and 27.1% (18 086 of 66 835) of last authorships. The female-to-male odds ratio was 1.12 (95% CI, 1.10-1.14) for first authorships, 1.20 (95% CI, 1.18-1.22) for coauthorships, and 0.63 (95% CI, 0.62-0.64) for last authorships, with annual growth rates of 1.6% overall, 1.6% for first authorships, 1.3% for coauthorships, and 2.5% for last authorships. Women were underrepresented in prestigious authorships (prestige index = -0.22). The underrepresentation remains almost stable for articles with many authors (prestige index = -0.17 for articles with >9 authors per article). Articles with female key authors were cited slightly less frequently (95% CI for female vs male authors, 10.8-11.0 vs 11.5-11.7 citations/articles). Women published fewer papers than men (42.5% [n = 41 383]; women held 34.9% [n = 120 207] of the authorships), show cross-journal uniformity and differences among single countries (change in prestige index = 0.66 vs 1.96). Overall, 44.1% of female authorships and a sex-neutral distribution of prestigious authorships are prognosticated for 2028. This algorithm analysis suggests the integration of women into ophthalmic research is average compared with other disciplines. A sex-specific gap exists for last authorship, suggesting career inequalities. With a growing number of female researchers in ophthalmology, the number of women in senior ranks may increase in the future.