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  • Item type:Publication,
    Revisiting the Gender Gap in Orthopaedic Surgery: Investigating the Relationship Between Orthopaedic Surgery Female Faculty and Female Residency Applicants. Open PDF 
    (2019)
    Munger, Alana M.
    ;
    Heckmann, Nathanael
    ;
    McKnight, Braden
    ;
    Dusch, Marie N.
    ;
    Hatch, George F. 3rd
    INTRODUCTION: Although women now constitute approximately half of all graduating medical students, orthopaedic surgery continues to lag behind in its ability to recruit female applicants. One hypothesis for this discrepancy is the lack of female faculty mentors at academic institutions. The three objectives of this study were the following: (1) to quantify the proportion of female orthopaedic surgery residency applicants, (2) to quantify the proportion of female orthopaedic surgery faculty, and (3) to investigate the relationship between female orthopaedic surgery faculty at an academic institution and the corresponding number of female orthopaedic surgery residency applicants. METHODS: Data from the Association of American Medical Colleges from 2005 to 2014 were used to calculate the number of medical school graduates, the number of orthopaedic surgery residency applicants, and the number of orthopaedic full-time faculty in the United States. Institutions were excluded if they had incomplete data. A Spearman rank correlation was used to assess for a correlation between the 9-year total number of female orthopaedic surgery applicants and the average number of female orthopaedic surgery faculty members. RESULTS: A total of 101 U.S. medical schools were included in the final analysis. During the period examined, women accounted for 48.7% of medical school graduates, 14.9% of orthopaedic surgery applicants, and 13.2% of full-time orthopaedic surgery faculty. The percentage of female residency applicants increased from 13.91% in 2005 to 2006 to 16.02% in 2013 to 2014 while the percentage of female faculty increased from 12.26% in 2005 to 2006 to 15.79% in 2013 to 2014. No correlation was found between the average number of female orthopaedic surgery faculty at an institution and the total number of female orthopaedic surgery applicants from that institution during the study period examined (Rho, 0.0176; P = 0.5957). CONCLUSIONS: The data presented in this study failed to demonstrate a relationship between the number of female faculty and the number of women who apply into orthopaedic surgery, which highlights the complex nature of this issue. More research is needed to examine factors influencing the recruitment of female medical students.
  • Item type:Publication,
    Trends in gender of authors of original research in oncology among major medical journals: A retrospective bibliometric study Open PDF 
    (2021)
    Lee, S.F.
    ;
    Redondo Sánchez, D.
    ;
    Sánchez, M.
    ;
    Gelaye, B.
    ;
    Chiang, C.L.
    Objective We evaluated the temporal trend in gender ratios of first and last authors in the field of oncological research published in major general medical and oncology journals and examined the gender pattern in coauthorship. Design We conducted a retrospective study in PubMed using the R package RISmed. We retrieved original research articles published in four general medical journals and six oncology specialty journals. These journals were selected based on their impact factors and popularity among oncologists. We identified the names of first and last authors from 1 January 2002 to 31 December 2019. The gender of the authors was identified and validated using the Gender API database (https://gender-api.com/). Primary and secondary outcome measures The percentages of first and last authors by gender and the gender ratios (male to female) and temporal trends in gender ratios of first and last authors were determined. Results We identified 34 624 research articles, in which 32 452 had the gender of both first and last authors identified. Among these 11 650 (33.6%) had women as the first author and 7908 (22.8%) as the last author, respectively. The proportion of female first and last authors increased from 26.6% and 16.2% in 2002, to 32.9% and 27.5% in 2019, respectively. However, the gender ratio (male to female) of first and last authors decreased by 1.5% and 2.6% per year, respectively, which were statistically significant (first author: Incidence rate ratio (IRR) 0.98, 95% CI 0.97 to 1.00; last author: IRR 0.97, 95% CI 0.96 to 0.99). Male first and last authorship was the most common combination. Male-female and female-female pairs increased by 2.0% and 5.0%, respectively (IRR 1.02, 95% CI 1.01 to 1.03 and IRR 1.05, 95% CI 1.04 to 1.06, respectively). Conclusions The continued under-representation of women means that more efforts to address parity for advancement of women in academic oncology are needed. © 2021 Author(s). Published by BMJ.
  • Item type:Publication,
    Prospective analyses of sex/gender-related publication decisions in general medical journals: editorial rejection of population-based women's reproductive physiology Open PDF 
    (2022)
    Kalidasan, Dharani
    ;
    Goshtasebi, Azita
    ;
    Chrisler, Joan
    ;
    Brown, Helen L.
    ;
    Prior, Jerilynn C.
    OBJECTIVE: To assess whether editorial desk rejection at general medical journals (without peer review) of two clinical research manuscripts may relate to author gender or women's physiology topics. Given evidence for bias related to women in science and medicine, and editorial board attitudes, our hypothesis was that submissions by women authors, on women's reproductive, non-disease topics received differential editorial assessment. DESIGN: A prospective investigation of publications, author gender and topics in general medical journals in two issues following the editorial rejections of two clinical research manuscripts by five major English-language general medical journals. The rejected manuscripts (subsequently published in lower impact journals) described research funded by national granting bodies, in population-based samples, authored by well-published women scientists at accredited institutions and describing innovative women's reproductive physiology results. SETTING: Tertiary academic medical centre. MAIN OUTCOME MEASURES: All clinical research published in the two issues following rejection date by each of the five major general medical journals were examined for first/senior author gender. The publication topic was assessed for its gendered population relevance, whether disease or physiology focused, and its funding. Rejection letters assessed editor gender and status. RESULTS: Women were underrepresented as original research authors; men were 84% of senior and 69% of first authors. There were no, non-disease focused publications relating to women's health, although most topics were relevant to both genders. The majority (80%) of rejection letters appeared to be written by junior-ranked women editors. CONCLUSION: Sex/gender accountability is necessary for clinical research-based editorial decisions by major general medical journals. Suggestions to improve gender equity in general medical journal publication: (1) an editorial board sex/gender champion with power to advocate for manuscripts that are well-performed research of relevance to women's health/physiology; (2) an editorial rejection adjudication committee to review author challenges; and (3) gender parity in double-blind peer review.
  • Item type:Publication,
    Time trends, disease patterns and gender imbalance in the top 100 most cited articles in ophthalmology Open PDF 
    (2019)
    Heng Wong, M.Y.
    ;
    Tan, N.Y.Q.
    ;
    Sabanayagam, C.
    We analysed the 100 top cited articles in ophthalmology to identify and characterise the most influential articles of the past four decades. Two independent investigators searched the Scopus database to determine the 100 most frequently cited articles in ophthalmology (T100-Eye) and general non-ophthalmology journals (T100-Gen) published from 1975 to December 2017. The T100-Eye list consisted of 83 original articles and 17 reviews, and the number of citations ranged from 582 to 2833. Seventy-eight of these articles were published in three journals alone (impact factor (IF): 5.05-8.2), led by the Archives of Ophthalmology. The T100-Gen list consisted of 84 original articles and 16 reviews and the number of citations ranged from 358 to 3272. Forty-five of these articles were published in four journals alone (IF: 9.66-72.41). In both lists, majority of the first authors were from the USA (T100-Eye, n=80; T100-Gen, n=66), and were men (n=76 in T100-Eye; n=72 in T100-Gen). With regard to the article type, in the T100-Eye, among the 83 original research articles, most were randomised controlled trials (n=26) or clinical observational studies related to description of a new condition or new management (n=26). In the T100-Gen, of the 84 original research articles, many were clinical observational studies (n=27) or basic science research (n=26). In both lists, the most frequently examined diseases were age-related macular degeneration, diabetic retinopathy and glaucoma. Our analysis reveals landmark articles, trends and medical advancements in ophthalmology over the past four decades. It also highlights gender disparity and influence of the USA in seminal ophthalmic research. © 2019 Article author(s).
  • Item type:Publication,
    Gender and other potential biases in peer review: cross-sectional analysis of 38 250 external peer review reports Open PDF 
    (British Medical Journal Publishing Group Section: Epidemiology, 2020)
    Severin, Anna
    ;
    Martins, Joao
    ;
    Heyard, Rachel
    ;
    Delavy, François
    ;
    Jorstad, Anne
    Objectives To examine whether the gender of applicants and peer reviewers and other factors influence peer review of grant proposals submitted to a national funding agency. Setting Swiss National Science Foundation (SNSF). Design Cross-sectional analysis of peer review reports submitted from 2009 to 2016 using linear mixed effects regression models adjusted for research topic, applicant’s age, nationality, affiliation and calendar period. Participants External peer reviewers. Primary outcome measure Overall score on a scale from 1 (worst) to 6 (best). Results Analyses included 38 250 reports on 12 294 grant applications from medicine, architecture, biology, chemistry, economics, engineering, geology, history, linguistics, mathematics, physics, psychology and sociology submitted by 26 829 unique peer reviewers. In univariable analysis, male applicants received more favourable evaluation scores than female applicants (+0.18 points; 95% CI 0.14 to 0.23), and male reviewers awarded higher scores than female reviewers (+0.11; 95% CI 0.08 to 0.15). Applicant-nominated reviewers awarded higher scores than reviewers nominated by the SNSF (+0.53; 95% CI 0.50 to 0.56), and reviewers from outside of Switzerland more favourable scores than reviewers affiliated with Swiss institutions (+0.53; 95% CI 0.49 to 0.56). In multivariable analysis, differences between male and female applicants were attenuated (+0.08; 95% CI 0.04 to 0.13) whereas results changed little for source of nomination and affiliation of reviewers. The gender difference increased after September 2011, when new evaluation forms were introduced (p=0.033 from test of interaction). Conclusions Peer review of grant applications at SNSF might be prone to biases stemming from different applicant and reviewer characteristics. The SNSF abandoned the nomination of peer reviewers by applicants. The new form introduced in 2011 may inadvertently have given more emphasis to the applicant’s track record. We encourage other funders to conduct similar studies, in order to improve the evidence base for rational and fair research funding.
  • Item type:Publication,
    A framework to analyse gender bias in epidemiological research Open PDF 
    (BMJ Publishing Group, 2007)
    Ruiz-Cantero, M.T.
    ;
    Vives-Cases, C.
    ;
    Artazcoz, L.
    ;
    Delgado, A.
    ;
    Calvente, M.D.M.G.
    The design and analysis of research may cause systematic gender dependent errors to be produced in results because of gender insensitivity or androcentrism. Gender bias in research could be defined as a systematically erroneous gender dependent approach related to social construct, which incorrectly regards women and men as similar/different. Most gender bias can be found in the context of discovery (development of hypotheses), but it has also been found in the context of justification (methodological process), which must be improved. In fact, one of the main effects of gender bias in research is partial or incorrect knowledge in the results, which are systematically different from the real values.This paper discusses some forms of conceptual and methodological bias that may affect women's health. It proposes a framework to analyse gender bias in the design and analysis of research carried out on women's and men's health problems, and on specific women's health issues.Using examples, the framework aims to show the different theoretical perspectives in a social or clinical research context where forms of selection, measurement and confounding bias are produced as a result of gender insensitivity. Finally, this paper underlines the importance of reexamining results so that they may be reinterpreted to produce new gender based knowledge.
  • Item type:Publication,
    Plafond de verre pour les femmes dans les carrières hospitalo-universitaires en France Open PDF 
    (2019)
    Rosso, C.
    ;
    Leger, A.
    ;
    Steichen, O.
    OBJECTIVE: To determine whether career development in academic medicine is more difficult for women than for men, and, if any, the nature and level of barriers to this progression. METHODS: Extraction of full-time medical staff in a Parisian hospital group, through the SIGAPS platform; an online questionnaire survey of career choices and barriers experienced by full-time male and female physicians. The study population comprises 181 hospital practitioners and 141 academic physicians (49 associate professors and 92 full professors). RESULTS: Women represent 49% of the medical staff but 15% of full professors. This underrepresentation of women is more important among intensivists/anesthesiologists than technique-based specialists (such as radiologists, biologists…). There is no difference in scientific output, marital status and parenthood between women and men. On the other hand, there is a difference in attitudes highlighted by the EVAR risk-taking scale as well as in the burden of familial involvement and the prejudices felt by women during the academic selection process. CONCLUSION: The glass ceiling exists in one of the largest French hospital group. Career development principles promote merit, but should decrease the benefit of "masculine" attitudes in the competition for academic positions. Academic selection criteria should evolve to limit the disadvantage of women related to deeper familial involvement and less competitive strategies and risk-taking attitudes.
  • Item type:Publication,
    Where are the women? Gender inequalities in COVID-19 research authorship Open PDF 
    (2020)
    Pinho-Gomes, Ana-Catarina
    ;
    Peters, Sanne
    ;
    Thompson, Kelly
    ;
    Hockham, Carinna
    ;
    Ripullone, Katherine
    Women account for about a third of all authors who published papers related to COVID-19 since the beginning of the outbreak in January 2020. Women’s representation is lower still for first and last authorship positions. Gender biases seem to be affecting COVID-19 research similar to other scientific areas, highlighting that women are consistently being under-represented. This may have implications for the availability and interrogation of sex-disaggregated data and therefore our understanding of COVID-19. These gender biases hint at wider gender inequalities in our global response to the pandemic, which may reduce the chance of dealing with it robustly and speedily. Women are under-represented as authors of research papers in many scientific areas, particularly in senior authorship positions.
  • Item type:Publication,
    Is there a sex bias in choosing editors? Epidemiology journals as an example Open PDF 
    (1998)
    Dickersin, K.
    ;
    Fredman, L.
    ;
    Flegal, K. M.
    ;
    Scott, J. D.
    ;
    Crawley, B.
    CONTEXT: Editors, authors, and reviewers are influential in shaping science. The careers of women in public health have received less scrutiny than those of women in medicine and other branches of science. The performance of women as editors, authors, and reviewers in epidemiology has not been previously studied. OBJECTIVE: To examine changes over time in the representation of women at the editorial level in US epidemiology journals compared with the proportion of women authors and reviewers. DESIGN AND SETTING: Cross-sectional study of 4 US epidemiology journals, American Journal of Epidemiology, Annals of Epidemiology, Epidemiology, and the Journal of Clinical Epidemiology (formerly the Journal of Chronic Diseases), for 1982, 1987, 1992, and 1994. SUBJECTS: Editors, authors, and reviewers for the selected years. MAIN OUTCOME MEASURES: Sex of editors, authors, and reviewers. RESULTS: We identified 2415 reports associated with 8005 authors. One of 7 editors in chief was a woman, a position she shared with a man. For all journals, the proportion of editors who were women ranged from 5 (6.5%) of 77 in 1982 to 42 (16.3%) of 258 in 1994. Over all journals and all years, women comprised a higher proportion of authors (28.7% [2225/7743]) compared with reviewers (26.7% [796/2982]) or editors (12.8% [89/696]). CONCLUSIONS: Fewer women in public health hold editorial positions than are authors and reviewers. The reasons for this important discrepancy, including the possibility of a selection bias favoring men, should be further investigated.
  • Item type:Publication,
    Why are women underused in the JECH peer review process? Open PDF 
    (2003)
    Del Carmen Davo, M.
    ;
    Vives, C.
    ;
    Alvarez-Dardet, C.
    The quality of peer review is an essential part of the scientific process1 and nowadays its evaluation is an emergent area of research. The gender perspective is however, still rarely integrated in this kind of study. There is empirical evidence about sex bias in choosing referees. Women are still less required by editors than men in peer review processes. As other studies have shown, male reviewers took significantly longer to return manuscripts than did their female counterparts and male reviewers recommend acceptance and rejection at higher rates than their female counterparts, who were more prone to revisions. The under use of women as reviewers seems then not justified by any quality criteria, as has been shown as well by the measurement of variables of time to answer and referees recommendations to authors. In addition, the promotion of gender parity in the peer review process could contribute to a reduction in the traditional invisibility of women in scientific knowledge development. This study has been done with the main objective to detect gender bias in the Journal of Epidemiology and Community Health (JECH) peer review process and to identify differences, if any, between peer reviews with a gender perspective. The analysis includes the editors perceived quality of the review plus the other variables suggested by other studies as time to answer and referees recommendations to authors.