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  • Item type:Publication,
    Gender Comparison of Scholarly Production in the Musculoskeletal Tumor Society Using the Hirsch Index Open PDF 
    (2015)
    Martinez, M.
    ;
    Lopez, S.
    ;
    Beebe, K.
    Objective Despite an increase in the proportion of female medical school graduates, the number of women in orthopedic surgery remains low. To examine the presence of gender disparities in scholarly production, the authors used the Hirsch index (h-index) to assess members of the Musculoskeletal Tumor Society (MSTS), a well-defined subspecialty of orthopedic surgery. Design Using the MSTS Membership Directory, the authors assessed those practicing at an academic institution in the United States. Members sex and rank was obtained from their department's website, and their h-index and years since initial publication was collected from the Scopus database. Setting Research was performed at New Jersey Medical School, an institution, using online databases. Participants A total of 247 members of the MSTS were eligible, of whom 125 practiced at a US academic medical center and were included in the study. Results The MSTS is composed of 247 members, 28 (11%) of whom are women. Within US academic medical centers, there are 125 members, including 17 (14%) women. Mean h-indices increased with rising academic rank from 5.42 for assistant professors to 19.28 for professors. Publication ranges showed an increase from 11.03 years for assistant professors to 29.52 years for professors. The h-index and publication years of chairpersons were nearly equal to those of professors. Using the h-index, it was found that men outproduce women - 13.4:7.9. Men outnumber women at every rank, increasingly so at higher ranks. The authors found that there was a significant difference in productivity between ranks (p < 0.01) and between sexes (p = 0.035), but not between sexes at the assistant professor, associate professor, or professor levels (p = 0.147, 0.581, and 0.263, respectively). Conclusions The h-index shows differing production among the sexes and ranks in the MSTS. No significant difference exists between the sexes when members are organized by academic title. © 2015 Association of Program Directors in Surgery.
  • Item type:Publication,
    What Are the Rates and Trends of Women Authors in Three High-impact Orthopaedic Journals from 2006-2017? Open PDF 
    (2020)
    Hiller, Kathryn P.
    ;
    Boulos, Alexandre
    ;
    Tran, Megan M.
    ;
    Cruz, Aristides I.
    BACKGROUND: The gender gap among authors publishing research in journals is narrowing in general medicine and various medical and surgical subspecialties. However, little is known regarding the gender gap among authors publishing research in orthopaedic journals. QUESTIONS/PURPOSES: (1) What is the proportion of women first and last authors of original research articles in three high-impact orthopaedic journals from 2006 to 2017? (2) What is the proportion women first authors of original research by orthopaedic subspecialty from 2006 to 2017? METHODS: A sample of original research publications from the even numbered months of issues of Clinical Orthopaedics and Related Research® (CORR®), the Journal of Bone and Joint Surgery, American volume (JBJS), and the American Journal of Sports Medicine (AJSM) were examined from 2006 to 2017. These journals were selected because of their clinical relevance, target audience, and relatively high impact factors. Over the studied period, a single author extracted and reviewed pertinent data, including the gender of the first and last authors and the primary subspecialty of the research article. The senior author refereed disputes regarding the primary subspecialty of each included article. The proportion of women first and last authors in each journal was compared between 2006 to 2017 using chi-square analysis. The proportion of women first authors according to orthopaedic subspecialty in which an article primarily focused its study was also compared between 2006 to 2017 using chi-square analysis. RESULTS: Data were collected from 6292 articles, 13% (800) of which were first-authored by women and 10% (604) of which were last-authored by women. From 2006 to 2017, the overall percentage of women first authors in the examined journals increased (from 11% in 2006 to 17% in 2017; odds ratio 1.6563 [95 % CI 1.4945 to 1.8356]; p < 0.001). Overall across the period studied, the percentage of women first authors in JBJS was 14% while 12% of first authors in CORR and AJSM were women. Regarding subspecialty, the percentage of women first authorship ranged from 9% in the shoulder subspecialty to 21% in pediatric orthopaedics across all three journals. CONCLUSIONS: There has been an increase in the percentage of women first authors in articles published in three high-impact orthopaedic journals from 2006 to 2017. This observed increase is encouraging in terms of promoting gender diversity in orthopaedics and may be reflective of a modest increase in the number of women entering the orthopaedic workforce. CLINICAL RELEVANCE: Between 2006 and 2017, the overall number of women first authors in CORR, JBJS, and AJSM modestly increased. This may suggest a nascent narrowing of the gender gap in orthopaedics. Although this is a welcome finding in terms of promoting and encouraging gender diversity in this man-dominated field, the overall percentage of women authorship remains modest, at best. Future investigations should examine whether the modest increase in women first authorship over time found in this study translates into an increased percentage of senior/last authorship in the future, as this may have implications for women orthopaedic workforce retention.
  • Item type:Publication,
    Gender and Geographic Origin as Determinants of Manuscript Publication Outcomes: JBMR® Bibliometric Analysis from 2017 to 2019 Open PDF 
    (2022)
    Rivadeneira, F.
    ;
    Loder, R.T.
    ;
    McGuire, A.C.
    ;
    Chitwood, J.R.
    ;
    Duffy, K.
    The Journal of Bone and Mineral Research (JBMR®), the flagship journal of the American Society for Bone and Mineral Research (ASBMR), enjoys a premiere position in its field and has a global reach. The journal uses a single-blind peer-review process whereby three editors are typically involved in assessing each submission for publication, in addition to external reviewers. Although emphasizing fairness, rigor, and transparency, this process is not immune to the influence of unconscious biases. The gender and geographic diversity of JBMR® authors, editors, and reviewers has increased over the last three decades, but whether such diversity has affected peer-review outcomes is unknown. We analyzed manuscript acceptance rates based on the gender and geographic origin of authors, reviewers, and Associate Editors. The analysis included 1662 original research articles submitted to JBMR® from September 2017 through December 2019. Gender was assigned using probabilities from an online tool and manually validated through internet searches. Predictor variables of manuscript outcome were determined with multivariate logistic regression analysis. The acceptance rate was highest when the first and last authors were of different genders, and lowest when both authors were men. Reviewer gender did not influence the outcome regardless of the genders of the first and last authors. Associate Editors from all geographical regions tended to select reviewers from their same region. The acceptance rate was highest when the Associate Editor was from Europe. Manuscripts with authors from North America and Australia/New Zealand had greater overall odds of acceptance than those from Europe and Asia. Manuscripts reviewed only by Editorial Board (EB) members had a lower acceptance rate than those refereed by non-EB reviewers or a mix of EB and non-EB reviewers. Overall, the geographical origin of authors, reviewers, and editors, as well as reviewers' EB membership may influence manuscript decisions. Yet, the JBMR® peer-review process remains largely free from gender bias. © 2022 American Society for Bone and Mineral Research (ASBMR). © 2022 American Society for Bone and Mineral Research (ASBMR).
  • Item type:Publication,
    Academic musculoskeletal radiology: influences for gender disparity Open PDF 
    (2018)
    Qamar, S.R.
    ;
    Khurshid, K.
    ;
    Jalal, S.
    ;
    Bancroft, L.
    ;
    Munk, P.L.
    Introduction: Research productivity is one of the few quintessential gauges that North American academic radiology departments implement to determine career progression. The rationale of this study is to quantify the relationship of gender, research productivity, and academic advancements in the musculoskeletal (MSK) radiology to account for emerging trends in workforce diversity. Methods: Radiology residency programs enlisted in the Fellowship and Residency Electronic Interactive Database (FREIDA), Canadian Resident Matching Service (CaRMS) and International Skeletal Society (ISS) were searched for academic faculty to generate the database for gender and academic profiles of MSK radiologists. Bibliometric data was collected using Elsevier’s SCOPUS archives, and analyzed using Stata version 14.2. Results: Among 274 MSK radiologists in North America, 190 (69.34%) were men and 84 (30.66%) were women, indicating a statistically significant difference (χ2 = 6.34; p value = 0.042). The available number of female assistant professors (n = 50) was more than half of the male assistant professors (n = 88), this ratio however, plummeted at higher academic ranks, with only one-fourth of women (n = 11) professors compared to men (n = 45). The male MSK radiologist had 1.31 times the odds of having a higher h-index, keeping all other variables constant. Conclusions: The trend of gender disparity exists in MSK radiology with significant underrepresentation of women in top tiers of academic hierarchy. Even with comparable h-indices, at the lower academic ranks, a lesser number of women are promoted relative to their male colleagues. Further studies are needed to investigate the degree of influence research productivity has, in determining academic advancement of MSK radiologists. © 2017, ISS.
  • Item type:Publication,
    Evolution and Trends in Male Versus Female Authorship of Articles in Flagship Orthopaedic Journals From 1995 to 2020 Open PDF 
    (2022)
    Powell, Sarah N.
    ;
    Hunting, John C.
    ;
    Frazier, Landon P.
    ;
    Keeling, Laura E.
    ;
    Janowski, Jessie
    INTRODUCTION: The gender disparity in orthopaedic surgery has been recognized for many years. Because research affects promotions, this study investigates trends in female authorship in three journals over the past 25 years for both first and senior authors. METHODS: All articles from Journal of Bone and Joint Surgery, Journal of the American Academy of Orthopaedic Surgeons, and Clinical Orthopaedics and Related Research from 1995 to 2020 in 5-year intervals were downloaded, and the data for first and senior authors were extracted. The sex of the first and senior authors was determined using the validated Genderize algorithm. The demographics of the first and senior author cohorts were analyzed using chi square tests. The trends in female authorship controlling for year and journal were assessed with logistic regression models. RESULTS: Within the studied journals, 5,636 individuals were identified as first authors and 4,572 as senior authors. Sex was determined for 82.59% of the authors. Female first authorship increased significantly from 1995 to 2020 (6.70% to 15.37%, P < 0.001). Similarly, female senior authorship increased significantly from 1995 to 2020 (8.22% to 13.65%, P < 0.001). Overall, there was no significant difference in gender composition of authors between journals (P = 0.700 first author and P = 0.098 senior author). Women were much more likely to publish as first or senior author in later years, regardless of the journal (P < 0.001 first author and P < 0.001 senior author). DISCUSSION: Female authorship in prominent orthopaedic journals has increased markedly from 1995 to 2020 with interjournal differences in senior author gender disparity. Although female orthopaedic surgeons publish at rates equal to or greater than their representation in the specialty, additional research is needed into the persistence of gender disparities in orthopaedics.
  • Item type:Publication,
    Potential Sex Bias Exists in Orthopaedic Basic Science and Translational Research Open PDF 
    (2018)
    Bryant, Jessica
    ;
    Yi, Paul
    ;
    Miller, Liane
    ;
    Peek, Kacy
    ;
    Lee, Daniel
    BACKGROUND: Potential sex bias has been shown in general surgery basic science and translational research, with unequal representation of male and female specimens. Because basic science research forms the foundation for clinical studies on which patient care is based, it is important that this research equally consider both sexes. The purpose of this study was to determine if potential sex bias exists in the basic science and translational orthopaedic literature. METHODS: A systematic review was conducted of all articles published in 2014 in The Journal of Bone & Joint Surgery, Clinical Orthopaedics and Related Research, The Bone & Joint Journal, and the Journal of Orthopaedic Research (JOR). All original research articles utilizing animals, cells, or cadavers were included. The data abstracted included study type, sex of specimen studied, and presence of sex-based reporting of data. A second review was performed of all basic science articles published in JOR in 1994, 2004, and 2014 to compare sex bias trends across 3 decades. Distributions of variables were compared using the Fisher exact test, with significance defined as p < 0.05. RESULTS: Of 1,693 articles reviewed, 250 (15%) were included: 122 animal-based studies (49%), 71 cell-based studies (28%), and 57 human cadaver-based studies (23%). Overall, authors in 88 studies (35%) did not report the sex of animals, cells, or cadavers used. Of 162 studies in which the authors did report sex, 69 (43%) utilized male only, 40 (25%) utilized female only, and 53 (33%) utilized both sexes. Of those studies that used both sexes, authors in only 7 studies (13%) reported sex-based results. A subanalysis of JOR articles across 3 decades revealed a significant increase in studies specifying sex (p = 0.01) from 2004 to 2014. CONCLUSIONS: Potential sex bias exists in orthopaedic surgery basic science and translational research, with an overrepresentation of male specimens. CLINICAL RELEVANCE: Inequality in sex representation must be addressed as basic science and translational research creates the foundation for subsequent clinical research, which ultimately informs clinical care.
  • Item type:Publication,
    Despite Growing Number of Women Surgeons, Authorship Gender Disparity in Orthopaedic Literature Persists Over 30 Years Open PDF 
    (2020)
    Brown, Meghan A.
    ;
    Erdman, Mary Kate
    ;
    Munger, Alana M.
    ;
    Miller, Anna N.
    BACKGROUND: The most recent demographic data reveal that only 6.5% of practicing orthopaedic surgeons are women, and as far as we know, only two women have held chair positions in academic orthopaedic programs in the United States. Furthermore, orthopaedic surgery is the least gender-diverse speciality recognized by the Accreditation Council for Graduate Medical Education. The factors that contribute to the lack of gender diversity in orthopaedics remain ill-defined. A lag in publication productivity may be a barrier to career advancement for women orthopaedic surgeons, but this has not been well studied. QUESTIONS/PURPOSES: (1) What is the proportion of orthopaedic studies published in six major orthopaedic journals by women first or senior authors from 1987 to 2017? (2) Did men and women orthopaedic surgeons publish in equal proportions during the study period (measured in 5-year intervals)? (3) Are there differences in the characteristics (such as study type or subject focus) of orthopaedic publications authored by women and those authored by men? (4) Has the increased proportion of practicing women orthopaedic surgeons been matched by an equal increase in authorship by women orthopaedic surgeons during the study timeframe? METHODS: A cross-sectional analysis was designed to characterize trends in authorship of orthopaedic studies by women over time. All publications from the first issue of each of six major orthopaedic journals were evaluated at seven time points (1987, 1992, 1997, 2002, 2007, 2012, and 2017). Characteristics of each first and senior author (including gender, academic degree, and specialty), and study category of each publication were collected. Articles for which this information was not available were excluded (35 of 1073, or 3.3% of published studies, no difference in proportion of excluded studies between journals). The proportions of women and men authors were compared at the seven time points and for six study categories (basic science, case report/technique article, clinical medicine, economics/practice management, editorial content [including true editorials, letters to the editor, commentaries, and book reviews] and review/meta-analysis) using a Fisher's exact test or chi-squared analysis. We compared the rates of change of women authorship, practicing women orthopaedic surgeons, and women orthopaedic residents during the study period using an ANOVA and Tukey's honestly significant difference (HSD) post-hoc test with Cohen's D measure of effect size. RESULTS: From 1987 to 2017, only 1.7% (15 of 880) of senior authors and 4.4% (46 of 1038) of first authors of orthopaedic publications were women orthopaedic surgeons. Based on population proportions (that is, percent of practicing women orthopaedic surgeons compared with men), the proportion of women senior authors was less than would be expected at each time point after 1987 compared with men. There were no differences between the types of studies authored by women or men. Finally, during the study period, the rate of growth of women senior authorship was less than the rates of growth of both practicing women orthopaedic surgeons (d = 5.3, 95% CI, 4.8-5.6; p = 0.023) and women first authorship (d = -4.3, 95% CI -4.6 to -3.6, p = 0.030; estimated mean 3.3, p = 0.013). CONCLUSIONS: Women orthopaedic surgeons published a small proportion of academic orthopaedic research from 1987 to 2017, and women senior authors consistently published less than would be expected based on their population proportion compared with men orthopaedic surgeons. Furthermore, the growth of practicing women orthopaedic surgeons has not been matched by growth in senior authorship by women over the same timeframe. CLINICAL RELEVANCE: This discrepancy warrants further exploration because a low rate of publication may negatively impact the career advancement of women orthopaedic surgeons and contribute to the overall lack of gender diversity in orthopaedics. We suggest that journals and publishers review their editorial processes to ensure blinding of author names during peer review and editorial decision-making, and to disclose those review processes to authors. We also suggest that institutions encourage women trainees and junior faculty to participate in mentorship programs and specialty societies that promote academic productivity.