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  • Item type:Publication,
    Gender inequity in leadership positions in spinal societies worldwide Open PDF 
    (Springer Science and Business Media LLC, 2026-05-14)
    Rawall, Saurabh
    ;
    Taylor, Sean
    ;
    Peterson, Asa
    ;
    Shrother, Ellyn
    ;
    Rajaram, Sakthivel
    PURPOSE: Orthopaedics and Neurosurgery rank as the worst with regards to the percentage of female residents. This trend carries on in spinal subspeciality training. The gap in gender equity increases significantly in academic leadership positions, including department chairs and full-time faculty, as well as speakers and faculty at conferences. The purpose of our study was to analyze the percentage of female representation in the leadership of spinal societies globally. METHODS: We evaluated the current leadership teams of national and international spine societies and recorded the percentage of females. RESULTS: We studied gender data of 73 spinal societies worldwide. 36 out of these had no female representation. Overall, 148 out of 1977 (7.5%) leadership positions were occupied by females. European Spine societies had the best gender ratio (16.9%), followed by North America (7.2%). Asia Pacific region had the worst gender ratio (1.2%). Middle East/Africa region and South America performed marginally better with 2.8% and 3.1%, respectively. CONCLUSION: Diversity improves innovation and quality of patient care. Female spinal surgeon leaders serve as role models and mentors. More needs to be done by our spinal societies to address gender disparity. Our article will provide data on an important aspect of gender disparity in spine surgery so that corrective measures can be initiated. There is an enormous gender disparity in leadership positions in spine societies worldwide. This phenomenon was observed across all regions, with Middle East/Africa and Asia Pacific regions recording the largest gender discrepancy.
  • Item type:Publication,
    Gender disparities among speakers at major spine conferences Open PDF 
    (Elsevier BV, 2025-10)
    Lee, Yunsoo
    ;
    Issa, Tariq Z.
    ;
    Lambrechts, Mark J.
    ;
    Carey, Preston
    ;
    Becsey, Alexander
    PURPOSE: To examine 10-year trends in gender representation in speaking roles at major spine conferences. BACKGROUND CONTEXT: Medical conferences play an important role in career opportunities. There is little analysis on gender representation of major spine conferences despite several studies demonstrating gender disparities within spine surgery. STUDY DESIGN: Observational study. SAMPLE: A total of 20,181 abstract speakers across 10 years of academic conferences for 6 spine societies. OUTCOME MEASURES: Percent of female abstract presenters. MATERIALS AND METHODS: We collated the annual meeting programs of six major spine conferences (North American Spine Society (NASS), Scoliosis Research Society (SRS), International Meeting on Advanced Spine Techniques (IMAST), Global Spine Congress (GSC), American Association of Neurological Surgeons/Congress of Neurological Surgeons (AANS/CNS) Spine Summit, and the Cervical Spine Research Society (CSRS)) dating from 2013 to 2022. Departmental websites, society webpages, or personal social media were identified for images or the use of gendered pronouns in order to determine speaker gender for each speaker type. All categorical variables were compared using Pearson chi-square analysis. RESULTS: Women constituted 1,816 (9.0%) of all 20,181 identified conference speakers. Female representation was highest at NASS (N=680, 12.2%) but lowest at CSRS (6.6%) and GSC (7.1%). Spine Summit (7.4%), IMAST (9.92%), and GSC (9.87%) demonstrated the largest annual percent increases in female representation. Institutions in Middle East and Africa (1.4%), and Central and South America (1.8%) supported the lowest percent of female speakers. Women were significantly less likely to be speakers or moderators/course faculty than to be podium abstract presenters (p<.001). The percent of women as invited speakers (10.4% vs 5.5%, p=.001) and moderators (11.4% vs 3.7%, p<.001) increased significantly over the study period, with annual increases of 8.8% and 20.8%, respectively, from 2013 to 2022 (p<.001). CONCLUSIONS: While academic spine societies have made significant progress in promoting gender representation, especially among invited speakers and session moderators, women continue to be underrepresented compared to the percent of women in orthopedic surgery and neurosurgery
  • Item type:Publication,
    How Does Representation of Women on Editorial Boards Compare Among Orthopaedic, General Surgery, and Internal Medicine Journals? Open PDF 
    (2021)
    Lin, James S.
    ;
    Weber, Kristy L.
    ;
    Samora, Julie Balch
    Background Women have historically been underrepresented as editors of peer-reviewed medical journals. Studies have demonstrated that there are differences in editorial board reviewer behavior based on gender, suggesting that greater representation by women on editorial boards may improve the quality and diversity of the review process. Therefore, the current representation of women on the editorial boards of orthopaedic journals, particularly compared with peer-reviewed surgical and medical journals, is of interest. Questions/purposes (1) What is the representation of women as members of editorial boards of prominent orthopaedic surgery journals? (2) How does it compare with representation on the editorial boards of journals in general surgery and internal medicine? Methods The top 15 journals with a strong clinical emphasis based on Impact Factor (Clarivate Analytics) calculated by the 2018 Journal Citation Reports were identified for orthopaedic surgery, general surgery (and all general surgical subspecialties), and internal medicine (with representative internal medicine subspecialties). Clinical publications with their primary editorial office located in the United States led predominantly by physicians or basic scientists were eligible for inclusion. The members of an editorial board were identified from the journals’ websites. The gender of editors with gender-neutral names (and editors whose gender we considered uncertain) was identified by an internet search for gender-specific pronouns and/or pictures from an institutional profile. Fisher exact tests and t-tests were used to analyze categorical and continuous variables, respectively. Significance was set at p < 0.05. Results Of the editors analyzed, women made up 9% (121 of 1383) of editorial boards in the orthopaedic journals with the highest Impact Factors, compared with 21% (342 of 1665) of general surgery journals (p < 0.001) and 35% (204 of 587) of internal medicine journals (p < 0.001). The overall mean composition of editorial boards of orthopaedic journals was 10% ± 8% women, compared with that of general surgery, which was 19% ± 6% women (p < 0.001), and that of internal medicine, which was 40% ± 19% women (p < 0.001). Conclusion Women make up a smaller proportion of editorial boards at orthopaedic surgery journals than they do at general surgery and internal medicine journals. However, their representation appears to be comparable to the proportion of women in orthopaedics overall (approximately 6%) and the proportion of women in academic orthopaedics (approximately 19%). Ways to improve the proportion of women on editorial boards might include structured mentorship programs at institutions and personal responsibility for championing mentorship and diversity on an individual level. Clinical Relevance Increasing representation of women on editorial boards may improve the diversity of perspectives and quality of future published research, generate visible role models for young women considering orthopaedics as a career, and improve patient care through enriching the diversity of our specialty.
  • Item type:Publication,
    Gender Disparity Trends in Authorship of Hand Surgery Research Open PDF 
    (2022)
    Xu, Raylin F.
    ;
    Varady, Nathan H.
    ;
    Chen, Antonia F.
    ;
    Earp, Brandon E.
    Purpose Despite an overall trend towards gender parity, women continue to remain underrepresented in surgical fields. Until recently, women’s representation in hand surgery literature was largely unexplored. The objective of this study was to examine how authorship gender trends among academic hand surgeons have evolved between 2006 and 2019. Methods Original research articles published from 2006 to 2019 in 3 leading clinical hand surgery journals were extracted from PubMed. Publications with a full author first name were analyzed, and the gender of each author was assigned with the validated Genderize algorithm. Analyses were performed to evaluate authorship publication trends, unique authors, and research career productivity. Results From 2006 to 2019, 4,769 articles met the inclusion criteria, and the genders of 17,102 authors were identified. There were 2,848 (16.6%) female authors and 14,254 (83.4%) male authors. The proportion of female authors increased from 13.4% to 19.9% from 2006 to 2019. Similarly, female representation as first and senior authors increased significantly, from 10.9% to 20.1% and 7.6% to 14.2%, respectively. Of the 8,417 unique authors, 1,775 (21.1%) were women and 6,642 (78.9%) were men. Only 3.3% of these unique female authors published 5 or more papers during the study period. Among the 10 most frequently published authors for each gender, 18 of the 20 authors were surgeons. Conclusions There has been substantial progress toward gender parity in academic hand surgery over the last 14 years, and the proportion of women publishing in leadership positions has increased. Clinical relevance Increased gender representation in medicine and research is important for both patients and providers, and these findings suggest that ongoing support and mentorship for women in academic careers should be a priority.
  • Item type:Publication,
    Trends in Gender Disparities in Authorship of Arthroplasty Research Open PDF 
    (2020)
    Xu, Raylin F.
    ;
    Varady, Nathan H.
    ;
    Chen, Antonia F.
    BACKGROUND: Despite efforts to address gender disparities in medicine, female representation in orthopaedics lags behind that of other fields, and little work has evaluated gender disparities within the subspecialty of arthroplasty surgery. The objective of this study was to analyze female authorship trends in arthroplasty research from 2002 to 2019. METHODS: Articles published from 2002 to 2019 in 12 clinical orthopaedic and arthroplasty journals were extracted from PubMed. Articles that provided the full name of the first author and contained the terms "arthroplasty," "hip replacement," "knee replacement," or "joint replacement" in the title and/or as keywords were analyzed. The gender of the author was determined with the validated Genderize algorithm, and publication trends were analyzed over time. Descriptive and comparative statistics were computed, and logistic regression was used to evaluate gender trends. RESULTS: From 2002 to 2019, 14,692 articles met the inclusion criteria, and the gender of 63,628 authors was identified. There were 23,626 unique authors; 4,003 (16.9%) were women and 19,623 (83.1%) were men. Female involvement in arthroplasty publications increased from 11.1% in 2002 to 12.6% in 2019 (p < 0.001), and the percentage of female first authors increased from 5.0% in 2002 to 11.3% in 2019 (p < 0.001). Critically, however, the proportion of women as senior authors significantly declined from 8.5% in 2002 to 6.2% in 2019 (p < 0.001). From our analysis of U.S. publications with physician senior authors, the proportion of female senior authors remained relatively stable from 1.7% in 2002 to 2.4% in 2019 without a significantly increasing trend (p = 0.88). Overall, on average, women published a mean (and 95% confidence interval) of 1.9 ± 0.1 publications, while men published 2.9 ± 0.1 publications (p < 0.001). The proportion of female senior authors in arthroplasty publications (6.6%) was lower than that of other orthopaedic subspecialties such as sports medicine (9.2%), spine (13.6%), and foot and ankle (13.1%). CONCLUSIONS: While overall female representation and first authorship in arthroplasty literature have increased over time, the paucity of women in senior author roles remains troubling. Future studies should examine why the proportion of women publishing in arthroplasty remains lower than that in most other orthopaedic subspecialties.
  • Item type:Publication,
    Trends in Gender Authorship and Collaborations: A 30-Year Comparative Bibliometric Analysis of Manuscripts from the Journal of Bone and Joint Surgery and the Bone and Joint Journal Open PDF 
    (2020)
    Squire, M.E.
    ;
    Schultz, K.
    ;
    Mcdonald, D.
    ;
    Meixner, C.
    ;
    Snyder, D.
    Publishing original peer-reviewed research is essential for advancement through all career stages. Fewer women than men hold senior-level positions in academic medicine and, therefore, examining publication trends relative to gender is important. The goal of this study was to examine and compare publication trends in The Journal of Bone and Joint Surgery (JBJS) and The Bone and Joint Journal (BJJ) with a particular emphasis on trends regarding author gender. Data was collected and analyzed for manuscripts published in JBJS and BJJ over the past 30 years. For manuscripts published in 1986, 1996, 2006, and 2016, we recorded the numbers of authors, manuscript pages, references, collaborating institutions, the position in the byline of the corresponding author, the country of the corresponding author, and the names of the first and corresponding author. We also calculated the normalized number of citations and corresponding author position. The number of authors, institutions, and countries collaborating on manuscripts published in both JBJS and BJJ increased over time. JBJS published more manuscripts from North America and BJJ published more manuscripts from Europe. In both journals, the percentage of women as first and/or corresponding author increased over time. Trends over the past 30 years have shown increased collaborations with greater citations in manuscripts published in JBJS and BJJ. In the same time period, both journals demonstrated a rise in the percentage of manuscripts with women first and/or corresponding authors, suggesting a decrease in the gender gap. © 2020 Maria E. Squire et al.
  • Item type:Publication,
    Gender disparities in shoulder and elbow publications Open PDF 
    (2022)
    Sequeira, S.B.
    ;
    Wright, M.A.
    ;
    Murthi, A.M.
    Hypothesis/Background: Female representation in orthopedics, and specifically shoulder and elbow surgery, lags behind other surgical subspecialities. There has been a growing interest in recent years to better characterize, and address, gender disparities in the field. The purpose of this investigation was to characterize gender trends in authorship in the shoulder and elbow literature from 2002 to 2020. Methods: Articles published from January 2002 to December 2020 in 15 clinical orthopedic and shoulder- and elbow-specific journals were extracted from the online PubMed database. Articles that included the first name of the first and senior authors and contained keywords related to the shoulder and elbow subspecialty were included. The Genderize algorithm was used to determine each author's gender. Gender-based publication trends from 2002 to 2020 were analyzed using descriptive and significance testing as well as logistic regression. Results: 34,695 articles met inclusion criteria and 52,497 unique authors were identified. Of these unique authors, 10,175 (19.4%) were female and 42,322 (80.6%) were male. On average, each unique female author published 1.7 ± 0.1 manuscripts since 2002 and each male author published 2.5 ± 0.2 (P < .001). Female representation in shoulder and elbow publications began at 10.2% in 2002 and rose to 15.9% in 2020 (P < .001). Female representation in the lead author position began at 4.1% in 2002 and rose to 5.8% in 2020 (P = .009). Female representation in the senior author position began at 6.0% in 2002 and rose to 9.1% in 2020 (P < .001). Conclusion: Although female representation in first, senior, and general authorship lags behind male representation in the shoulder and elbow literature, female authorship has significantly increased since 2002. The same men tend to publish more frequently while the number of unique female authors surpasses the annual representation of female authorship. Efforts to improve female representation in the field of orthopedic surgery should include efforts directed at improving female representation in academic literature. © 2022 Journal of Shoulder and Elbow Surgery Board of Trustees
  • 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,
    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.