PUBBLICAZIONE/PUBLICATION
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Item type:Publication, Representation of Women Authors in the 100 Most‐Cited Facial Plastic and Reconstructive Surgery Articles Open PDF(Wiley, 2025-02-25) ;Fleischer, Lindsay ;Ahn, Yoo Jin ;Urban, Matthew J. ;Revenaugh, Peter C.Smith, Ryan M.Objective This study aims to determine the representation of women among most‐cited facial plastic and reconstructive surgery articles. Study Design A bibliometric analysis of the most‐cited articles from 9 high‐impact facial plastic surgery journals. Setting Online database. Methods A retrospective analysis of the 100 most‐cited articles in facial plastic surgery was conducted using the Elsevier Scopus database. The representation of women among first, senior, and corresponding authors was assessed using the US Social Security Baby Names Database. Accredited websites were utilized for further clarification of gender, professional background, and title. A 2‐tailed t‐test was performed to compare the average number of citations by gender, while chi‐square analysis was used to compare the relative number of women authors between 5‐year intervals, citation rank, and nationalities. A significance level of 0.05 was used. Results The top 100 most‐cited articles had the highest total number of citations between 2000 and 2004. US institutions published 71% of these articles. The gender of 99% of first authors, 94% of senior authors, and 94% of corresponding authors was identified. Among these, 11% of first authors, 14% of senior authors, and 10% of corresponding authors were women. Of the 19 women authors, 11 were physicians. No statistically significant difference in the relative number of first, senior, and corresponding women authors was observed between years of publication, citation quartile, and article nationality. Conclusion Despite increasing women facial plastic surgery trainees, women's academic contributions continue to trail. Additional efforts are needed to support and highlight academic achievements of women facial plastic surgeons.Item type:Publication, Is the gender gap closing in otolaryngology subspecialties? An analysis of research productivity Open PDF(2020) ;Okafor, S. ;Tibbetts, K. ;Shah, G. ;Tillman, B.Agan, A.Objective: The proportion of women specializing in otolaryngology–head and neck surgery (Oto–HNS) and seeking fellowship training has steadily increased over the last several years. In academic Oto–HNS, gender differences exist in research productivity, scholarly impact, and funding. This study aims to evaluate gender differences in academic productivity between otolaryngologists in early, mid-, and later careers stages and within various subspecialties. Methods: Departmental websites for all Oto–HNS residency programs were accessed, and data including gender, academic rank, and fellowship training/subspecialty field was collected. Bibliometric data including h-index, publication years, number of citations, documents, and coauthors was obtained from the Scopus database. Career groups were defined as early (1–5 years), mid- (6–15 years), and later (16+ years). Continuous data was compared using the t test. Results: Data was collected on 1,754 academic otolaryngologists (412 women, 1,342 men). Overall, men exhibited significantly higher h-indices, number of documents, citations, and coauthors and actively published for more years compared to women (P < 0.0001 for all variables). Similar trends persisted across all subspecialties. When authors were broken down into career groups, women and men showed similar research productivity across all career groups in the subspecialties of otology, facial plastics, and rhinology; however, in head and neck, laryngology, and pediatrics, women continued to lag behind men. Conclusion: This study suggests that female otolaryngologists within certain subspecialties are keeping pace with their male counterparts in publication productivity in the early career time frame. This represents a change from prior studies which have shown women to be less productive in the early career period. Level of Evidence: NA. Laryngoscope, 130:1144–1150, 2020. © 2019 The American Laryngological, Rhinological and Otological Society, Inc.Item type:Publication, Female Authorship of Opinion Pieces in Leading Otolaryngology Journals between 2013 and 2018 Open PDF(2020) ;Miller, A.L. ;Rathi, V.K. ;Gray, S.T.Bergmark, R.W.Although women represent an increasing proportion of the physician workforce, barriers to the professional advancement of women persist, particularly within surgical fields such as otolaryngology. Authorship of scientific opinion articles serves as an important opportunity for professional development. We conducted a retrospective cross-sectional study to characterize the authorship patterns of scientific opinion articles by gender in leading otolaryngology journals between 2013 and 2018. Outcome measures were the number and proportion of female physician first authors and female last authors as compared with the proportion of the otolaryngology workforce. Between 2013 and 2018, female authors accounted for 24.1% of first of multiple authors, 30.4% of sole authors, and 25.3% of last authors. Women were equitably represented in comparison with the proportion of practicing female otolaryngologists (17.1% in 2017). The proportion of female first authorship increased from 20.0% in 2013 to 32.0% in 2018. Additional efforts are necessary to support the equitable advancement of women in otolaryngology. © American Academy of Otolaryngology–Head and Neck Surgery Foundation 2019.Item type:Publication, Sex distribution and sex data handling in published otolaryngology research Open PDF(2019) ;Liang, Jennifer J. ;Belcastro, AlexandraLevi, JessicaObjectives/Hypothesis To characterize the sex distribution and sex data handling in published otolaryngology research. Study Design Published research data analysis. Methods The total number of male and female participants, study characteristics, and sex data handling were abstracted from all original studies containing human participants published in five major otolaryngology journals from January 1, 2016 to December 31, 2016 and January 1, 2006 to December 31, 2006. Results Of the 1,128 studies from 2016 included in the analysis, 88.5% specified the sex of participants. There were 3,605,636 (42.1%) men and 4,515,508 (52.8%) women, with 429,006 (5.0%) participants unspecified. However, the average proportions of male and female participants (wherein studies are weighted the same, regardless of number of participants) were 0.579 and 0.421, respectively. Studies from the United States had a significantly higher proportion of women than studies from outside the United States. Subspecialties varied significantly in proportions. Average sex proportions in 2016 remained similar to those in 2006. For all studies, fewer than 40% of studies used any sex data for reporting of outcomes, for any sex-related analysis, or for discussion of results. Conclusions There was a higher average proportion of male participants than female. Studies originating in the United States included a greater number of female participants than those originating elsewhere, a possible result of explicit sex-inclusion policies governing research in the United States. Inclusion of women did not changed from 2006 to 2016, but analysis of sex data improved. Improvement of reporting, analysis, and discussion with regard to sex would benefit otolaryngology research and improve treatment for both sexes. Level of Evidence NA Laryngoscope, 129:E420–E427, 2019Item type:Publication, Gender Disparity in Non-ACGME (Accreditation Council for Graduate Medical Education) Otolaryngology Fellowship Leadership Open PDF(2024) ;Leyden, Kara ;Soeder, Mason ;Holdaway, Matthew ;Scagnelli, RobertMortensen, MelissaOBJECTIVE: Women are underrepresented among practicing otolaryngology physicians with increasing disparities in leadership roles and higher levels of professional attainment in academic medicine. The purpose of this study is to determine the gender gap among fellowship directors within specific otolaryngology subspecialties, and how this compares to disparities among all academic appointments held by otolaryngologists. Additionally, we seek to better understand how years practiced, H-index, professorship status, and academic productivity differ between men and women in fellowship director roles. DESIGN: Cross-sectional. Publicly available data from non-ACGME accredited otolaryngology fellowships was collected from department websites and Doximity including gender, years of practice, and professor status of fellowship directors. Scopus was used to find H-index for identified fellowship directors. Fisher's Exact tests were used to determine if significant gender disparity existed between each fellowship and academic otolaryngology as whole. H-index and years of practice were plotted for men and women comparing the slope of lines of best fit as a measure of academic productivity. SETTING: Non-ACGME accredited otolaryngology fellowships in the US. PARTICIPANTS: Fellowship directors in non-ACGME accredited otolaryngology fellowships. RESULTS: Among 174 fellowship positions in our analysis, head and neck (17.3% women), laryngology (17.2% women), rhinology (5.7% women), and facial plastics (8.1% women) had significantly lower overall women representation compared to academic otolaryngology (36.6% women) (p < 0.05). As fellowship directors, women were significantly more productive than men given years practiced and H-index (p = 0.008). CONCLUSIONS: Gender disparities among otolaryngologists are amplified in the role of fellowship directors compared to broader academic otolaryngology. This is true despite women in these roles demonstrating higher academic productivity.Item type:Publication, Declining racial and ethnic representation in clinical academic medicine: A longitudinal study of 16 US medical specialties Open PDF(2018) ;Lett, Elle ;Orji, Whitney U.Sebro, RonnieOBJECTIVE: To evaluate trends in racial, ethnic, and sex representation at US medical schools across 16 specialties: internal medicine, pediatrics, surgery, psychiatry, radiology, anesthesiology, obstetrics and gynecology, neurology, family practice, pathology, emergency medicine, orthopedic surgery, ophthalmology, otolaryngology, physical medicine and rehabilitation, and dermatology. Using a novel, Census-derived statistical measure of diversity, the S-score, we quantified the degree of underrepresentation for racial minority groups and female faculty by rank for assistant, associate, and full professors from 1990-2016. METHODS: This longitudinal study of faculty diversity uses data obtained from the American Association of Medical Colleges (AAMC) Faculty Roster from US allopathic medical schools. The proportion of professors of racial minority groups and female faculty by rank was compared to the US population based on data from the US Census Bureau. The Roster includes data on 52,939 clinical medical faculty in 1990, and 129,545 in 2016, at the assistant professor level or higher. The primary measure used in this study was the S-score, a measure of representation based on the probability of the observed frequency of faculty from a racial/ethnic group and sex, given the racial and ethnic distribution of the US. Pearson correlations and 95% confidence intervals for S-score with time were used to measure trends. RESULTS: Blacks and Hispanics showed statistically significant trends (p<0.05) towards increasing underrepresentation in most specialties and are more underrepresented in 2016 than in 1990 across all ranks and specialties analyzed, except for Black females in obstetrics & gynecology. White females were also underrepresented in many specialties and in a subset of specialties trended toward greater underrepresentation. CONCLUSIONS: Current efforts to improve faculty diversity are inadequate in generating an academic physician workforce that represents the diversity of the US. More aggressive measures for faculty recruitment, retention, and promotion are necessary to reach equity in academia and healthcare.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, EmmaJagsi, ReshmaImportance: 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, Gender Prevalence and Trends in Otology and Neurotology Publications Open PDF(2021) ;Schauwecker, N. ;Kaplan, A.Hunter, J.B.Objective:To assess otology and neurotology authorship by gender, subject, and country of origin from 2000 to 2019.Study Design:Retrospective review of otology and neurotology publications in 2000, 2005, 2010, 2015, and 2019 from 10 prominent journals within otolaryngology.Main Outcome Measures:Demographics for first through third and final authors, including gender, degree, coauthorship, as well as number of authors, subject matter, and region of origin for each publication.Results:A total of 4,411 neurotology articles published in 2000, 2005, 2010, 2015, and 2019 were analyzed. During the study period, the proportion of female authors increased from 22.3% in 2000 to 33.9% in 2019 (p<0.0001). However, authorship position analysis demonstrated no increase in final female authorship (22.5% in 2019, from 19.4% in 2000, p=0.112). Geographic region analysis demonstrated a similar overall global trend toward an increase in female authors. When considering author gender by position, North America, the Middle East, and Africa failed to demonstrate significant increasing trends for female final authors. Female final authors were also significantly less likely to have medical degrees than final male authors, (37.4% versus 78.6%, respectfully, p=<0.0001). Finally, women published more often within the subjects of pediatrics and audiology (46.5% and 37.3% of final authors, p<0.0001).Conclusions:Female authorship in otology and neurotology has increased globally. With the predominant number of articles originating from North America, and articles originating from North America failing to demonstrate an increase in female final authorship, overall, final female authorship did not change during the study period.Professional Practice Gap and Educational Need:There is no comprehensive study exploring gender distribution within only the specialty of otology and neurotology. While it is known that more women are becoming otolaryngologists, it is unknown if this increase is reflected in otology and neurotology publications, domestically and internationally.Learning Objective:To understand if gender biases and/or differences exist within otology and neurotology publications.Desired Result:Identify trends in otology and neurotology publications to address particular barriers to female publication within the field. © 2021 Lippincott Williams and Wilkins. All rights reserved.Item type:Publication, Sex Bias in Laryngology Research and Publishing Open PDF(2022) ;Pasick, Luke J. ;Yeakel, HeatherSataloff, Robert T.OBJECTIVE: To investigate sex bias in laryngology research and publishing. MATERIALS AND METHODS: Articles published in 2019 in seven mainstream otolaryngology journals were reviewed. Original manuscripts were included. Study type (medical, speech-language pathology, basic science, or pedagogy), subject sex, ≥50% sex-matching (SM≥50), sex-based analysis, and bibliometric data including author sex were recorded. RESULTS: Of 1619 publications reviewed, 259 patient-centered original laryngology studies were included, totaling 7,130,991 subjects (3,411,741 [47.8%] male; 3,718,694 [52.1%] female; 556 [0.0%] unreported). 29 studies included subjects of a single sex and 14 did not report sex. 114 (44%) studies met SM≥50, and 95 (37%) used sex-based analysis; no differences were found among study types or location. Sex-based analysis was used less in single-institution (33%) than database studies (62%, P = 0.01). No difference in SM≥50 was found among single or multi-institution, or database. There were 1340 total authors (578 [43%] female). First, corresponding, and senior authors were 47%, 39%, and 35% female, respectively. Studies that had female first and/or senior authors did not differ in rates of SM≥50 or sex-based analysis or mean enrollment of females compared to studies with male first and senior authors. The proportion of female physician first and senior authors did not differ from the proportion of female Association of American Medical Colleges otolaryngology faculty, but was non-significantly smaller than the proportion of female laryngology fellows at four academic institutions. CONCLUSION: Laryngology research exhibits sex bias in subject enrollment and sex-based analysis. Female authorship was representative of national demographics and author sex did not influence the rate of sex bias.