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  • Item type:Publication,
    Priority of Gender and Racial Disparity in Neurology Journals: A Bibliometric Analysis, 2016-2021 Open PDF 
    (2022)
    Mohammed, S.
    ;
    Siddiqi, J.
    Introduction: Medicine and the field of neurology are not immune to gender and racial disparities present more broadly in society. Even within academia there remains a persistent lack of representation of women and racial minorities, but with the recent spotlight on discrimination it is more necessary than ever that prevailing disparities are acknowledged by medical journals and reflected in their publication priorities. This bibliometric study assesses whether social justice trends have influenced the number of articles published that discuss gender and racial disparity in the past 5 years within the top three leading neurological journals. Our assumption is that any trend towards more publications related to gender and racial disparities are reflective of the publication priorities of, and thus the perceived relevance to, the editorial boards of the chosen journals. Methods: Using key word search of "gender,""race,"and "disparity"in the title or context of published papers, the archives of Lancet Neurology, Nature Reviews Neurology, and Alzheimer's & Dementia were reviewed. Results: The results indicated that although there was a slight overall increase in coverage of the aforementioned topics, it was negligible compared to the broad impact of current social justice movements. Conclusion: Our data suggest an inadequate publication priority for scholarly work on gender and racial disparity in the chosen journals, over the latest 5 years reviewed. © 2022
  • Item type:Publication,
    Prevalence of female authors in case reports published in the medical literature Open PDF 
    (2019)
    Hsiehchen, D.
    ;
    Hsieh, A.
    ;
    Espinoza, M.
    IMPORTANCE Underrepresentation of female authors in research publications is prevalent, but it is unclear whether this is attributable to sex disparities in research conduct or authorship practices. Case reports are a poorly understood component of the biomedical corpus, and the production of anecdotal observations is not confounded by factors associated with disparities in female representation in research publications. Whether female authorship disparities exist in nonresearch publications of clinical information is unknown. OBJECTIVES To examine the authorship of case reports and elucidate factors associated with sex disparity. DESIGN AND SETTING Cross-sectional study of all case reports published by US authors in 2014 and 2015 indexed in PubMed performed from July 2015 to July 2018. MAIN OUTCOMES AND MEASURES The primary outcome measure was the proportion of female first authors. The secondary outcome measures were the proportion of female last authors and female authorship representation among different clinical specialties. RESULTS Bibliometric data was abstracted from 20 427 case reports published across 2538 journals. A total of 7252 (36%) and 4825 (25%) case reports had a female first and last author, respectively. In comparison, 44%and 34%of US trainees and physicians, respectively, were female in 2015. Among adult case reports, female authorship was more prevalent in academic environments compared with community settings (34.0%vs 28.2%for female first authors and 23.4%vs 19.7% for female last authors). Across states, the proportions of female first authors and last authors were universally less than the proportions of female trainees and active female physicians, respectively. Female first authorship was associated with larger author teams (odds ratio [OR], 1.02; 95%CI, 1.01-1.03), an academic affiliation (OR, 1.16; 95%CI, 1.06-1.27), and a female last author (OR, 1.58; 95%CI, 1.47-1.70). Relative to general internal medicine, specialties dominated by male clinicians were less frequently associated with female first authors. Several exceptions displaying a relatively equivalent tendency for male and female first authorship included oncology (OR, 0.97; 95%CI, 0.81-1.16), ophthalmology (OR, 0.87; 95%CI, 0.72-1.05), and radiation oncology (OR, 0.94 95%CI, 0.56-1.56). CONCLUSIONS AND RELEVANCE The underrepresentation of women among first and last authors in publications of case reports underscores the pervasiveness of sex disparities in medicine. Collaboration and female mentors may be critical instruments in upsetting longstanding practices associated with sex bias. Not all clinical specialties were associated with lower-than-expected female authorship, and further exploration of specialty-specific norms in publication and mentorship may elucidate specific barriers to female authorship. © 2019 JAMA Network Open.All right reserved.
  • Item type:Publication,
    Sex Differences in Academic Productivity Across Academic Ranks and Specialties in Academic Medicine: A Systematic Review and Meta-analysis Open PDF 
    (2021)
    Ha, Giang L.
    ;
    Lehrer, Eric J.
    ;
    Wang, Ming
    ;
    Holliday, Emma
    ;
    Jagsi, Reshma
    Importance: Despite equal numbers of men and women entering medical school, women are underrepresented in the upper echelons of academic medicine and receive less compensation and research funding. Citation-related publication productivity metrics, such as the h-index, are increasingly used for hiring, salary, grants, retention, promotion, and tenure decisions. Exploring sex differences in these metrics across academic medicine provides deeper insight into why differences are observed in career outcomes. Objective: To systematically examine the available literature on sex differences in h-index of academic faculty physicians across all medical specialties and all levels of academic rank. Data Sources: Medical literature with the term h-index found in PubMed and published between January 1, 2009, and December 31, 2018, was used. Study Selection: A PICOS (Population, Intervention, Comparison, and Outcomes), PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses), and MOOSE (Meta-analysis of Observational Studies in Epidemiology) selection protocol was used to find observational studies that published h-indexes for faculty physicians that were stratified by sex. Studies were excluded if they were review articles, retracted, or unavailable online. Ultimately, 14 of 786 studies (1.78%) met the inclusion criteria. Data Extraction and Synthesis: Data from 9 studies across 16 specialties were examined using weighted random-effects meta-analyses. Five studies were excluded because of overlapping specialties with another study or because they were missing appropriate statistics for the meta-analysis. Four of these studies were included in qualitative synthesis to bring the total to 13 studies. Main Outcomes and Measures: The primary study outcome was the h-index. Results: The meta-analysis included 10 665 North American unique academic physicians across 9 different studies from the years 2009 to 2018. Of the 10 665 physicians, 2655 (24.89%) were women. Summary effect sizes for mean h-indexes of men and women and mean h-index difference between men and women were determined for all faculty physicians and at each academic rank. Overall, female faculty had lower h-indexes than male faculty (mean difference, -4.09; 95% CI, -5.44 to -2.73; P < .001). When adjusting for academic rank, female faculty still had lower h-indexes than male faculty at the ranks of assistant professor (mean difference, -1.3; 95% CI, -1.90 to -0.72; P < .001), associate professor (mean difference, -2.09; 95% CI, -3.40 to -0.78; P = .002), and professor (mean difference, -3.41; 95% CI, -6.24 to -0.58; P = .02). Conclusions and Relevance: In this systematic review and meta-analysis, women had lower h-indexes than men across most specialties and at all academic ranks, but it is unclear why these differences exist. These findings suggest that future investigation should be conducted regarding the causes of lower h-indexes in women and that interventions should be developed to provide a more equitable environment for all physicians regardless of sex.
  • Item type:Publication,
    Visibility and representation of women in multiple sclerosis research. Open PDF 
    (2019)
    Thomson, Alison
    ;
    Horne, Rachel
    ;
    Chung, Christine
    ;
    Marta, Monica
    ;
    Giovannoni, Gavin
    OBJECTIVE: To establish the gender distribution of multiple sclerosis (MS) researchers across high-impact neurologic publications, MS-specific journals, and the European Committee for Treatment and Research in MS (ECTRIMS). METHODS: Journal editorial boards and contents were retrieved online to assess first-named and senior authors. Published tables of contents for each journal from 2017 were reviewed. Congrex, the ECTRIMS organizers, were contacted and speaker names were obtained from online abstracts to assess visible opinion leaders. RESULTS: A total of 2,080 articles were analyzed across 4 general neurology journals, and 452 across 2 MS journals. Overall, 36% of general neurology articles had a female first name author and 25% had a female senior author. In MS-specific journals, 44% of first authors and 35% of senior authors were female, with similar proportions of unique authors. There is limited female representation on the ECTRIMS executive board, but reasonable balance on Council. Almost 50% of attendees in 2017 were female, but only 35% of invited speakers. CONCLUSIONS: There is substantial female drop-off between junior and senior research level across multiple areas. Strategies to support gender balance are urgently required, including developing mentorship schemes, ensuring gender balance in conferences, and thorough examination of the barriers facing female academics with direct challenges to address unconscious bias.
  • Item type:Publication,
    Assessing the Gap in Female Authorship in Neurosurgery Literature: A 20-Year Analysis of Sex Trends in Authorship Open PDF 
    (2020)
    Farhan, S.A.
    ;
    Shahid, I.
    ;
    Siddiqi, J.
    ;
    Khosa, F.
    Background: Publications are considered a major factor for advancement in academia. An effort has been made to study authorship trends in neurosurgery publications. The objective of this study was to investigate authorship trends in the neurosurgery literature for the last 20 years (1998–2018). Methods: Articles for the years 1998, 2008, and 2018 were extracted from Neurosurgery, Journal of Neurosurgery, and World Neurosurgery for this retrospective study. Only original articles, case reports, and review articles were included. The gender of the first, senior, and corresponding author was determined. Subspecialty topic, type of paper, geographic origin of articles, and the number of citations for each article were also collected. Results: A total of 3912 articles were included. The number of articles, the total number of authors, and nonexperimental studies increased in the successive decades. A total of 744 women (19.0%) were first authors and 520 (13.3%) were senior authors of their respective publications. A decreasing trend (P < 0.05) was noted between female first authors and male senior authors over time. All 3 journals showed an increasing pattern of female authorships across the 2 decades. Conclusions: A rapid rise in female authorship positions in particular and authorship positions in general demonstrates the diversity that is slowly burgeoning to cater to perspectives and issues that require a multidimensional approach in neurosurgery. Increasing linkages among researchers in neurosurgery on a global scale are evident by the increase in multinational collaborations. Expansive efforts are needed at institutional and individual levels to eradicate sex-based pitfalls that hinder excellence in neurosurgery research. © 2020 Elsevier Inc.
  • Item type:Publication,
  • Item type:Publication,
    The role of gender in academic productivity, impact, and leadership among academic spine surgeons Open PDF 
    (2022)
    Agaronnik, Nicole
    ;
    Xiong, Grace X.
    ;
    Uzosike, Akachimere
    ;
    Crawford, Alexander M.
    ;
    Lightsey, Harry M.
    BACKGROUND/CONTEXT: Women represent a small minority of practicing orthopedic surgeons and neurosurgeons, with spine surgery having a disproportionately low representation relative to other subspecialties. Previous efforts have attempted to characterize gender patterns in authorship amongst select spine journals. However, no study to our knowledge has done a comprehensive assessment of the influence of gender on academic productivity, impact, and leadership amongst academic spine faculty. PURPOSE: To evaluate the impact of gender on academic productivity, promotion to leadership positions, and career advancement among academic spine faculty in the United States. STUDY DESIGN: Cross-sectional study. PATIENT SAMPLE: Academic spine faculty associated with orthopedic residency, North American Spine Society spine fellowship programs, and American Association of Neurological Surgeons spine fellowship programs. OUTCOME MEASURES: Academic productivity as measured by publications counts, h-index, authorship ranking as well as academic rank and leadership roles METHODS: We identified all spine faculty across orthopedic residency, orthopedic spine fellowship, and neurosurgical spine fellowship programs in the United States, and abstracted academic performance characteristics, cumulative h-index, and complete publication records for each individual faculty member. Proportions of men and women by specialty, academic rank, and leadership were compared with Fisher's exact testing, and comparison of mean h-index and publication counts compared with Wilcoxon rank-sum testing. Adjusted analyses on publication count and h-index were achieved with poisson regression analysis with gender as the primary predictor adjusting for specialty, degrees, academic rank, and seniority based on time since fellowship completion. RESULTS: The representation of women among spine faculty associated with orthopedic residency and North American Spine Society spine fellowship programs was 5.6%. On average, women had 40% fewer total publications (p=.025), h-indices approximately 5 units lower than men (p=.006), 40% fewer total high-impact publications (p=.030), half the senior author publications (p=.005), and half the high-impact senior author publications (p=.007) compared to men. After adjusting for seniority and academic rank, the number of publications in high impact journals no longer differed between men and women, although differences persisted for total publication count and the h-index. Men were significantly more likely to occupy higher academic ranks, with 25.6% of men and 9.5% of women holding the rank of full professor (p=.031), although there was no significant difference in the rate of appointment to leadership positions. Similar findings were encountered among American Association of Neurological Surgeons spine fellowship faculty. CONCLUSIONS: The present study details the low rate of women in academic spine surgery. Furthermore, gender disparities exist in publication volume, impact, and h-indices. A much lower proportion of women hold higher-ranking academic positions compared to men, though appointment to leadership positions was similar between genders. Differences in seniority and publication metrics may in part be due to the relatively younger cohort of women faculty. These findings underscore the need for active investment in diversity and pipeline efforts that facilitate recruitment and support academic productivity of women in spine surgery.