Trends in Gender Disparities in Authorship of Arthroplasty Research

Abstract

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.

Evolution and Trends in Male Versus Female Authorship of Articles in Flagship Orthopaedic Journals From 1995 to 2020

“…A 90% cutoff for gender certainty was used based on existing literature and methodology in similar bibliometric studies. 16,22 A total of 6,824 articles were analyzed for data extraction—3,021 from CORR, 3,077 from JBJS, and 726 from JAAOS. A total of 37 authors' first names were unable to be ascertained, and they were excluded from the analysis.…”

The effect of mentee and mentor gender on scientific productivity of applicants for NIH training fellowships

“…Of the mentee/mentor dyads in our dataset, 94.1% of mentees and 90.09% of mentors had self-identified records of gender. Genderize (genderize.io) was used to assign gender to those without self-identified gender information, as done in previous studies [12, 27, 28]. The agreement between self-identified gender and Genderize was 98%, allowing confidence in using Genderize to populate the small portion of non-self-identified records.…”

Female Authorship in the US Orthopaedics Literature: A Bibliometric Analysis of Trends

“…We based our design on several other papers studying gender discrepancies in medical peer-reviewed research and chose to use a gender predicting API because it has been used extensively in research and shown to be accurate. 3,[17][18][19][20][21] We acknowledge that the method of classifying gender is not 100% accurate because of the program's limited ability to classify unisex names. Finally, we recognize the complexity of studying gender and sex, as well as the intersectionality that affects each individuals' experiences and understand that there are many facets to gender equity that are unaddressed in this study.…”

“…2 While acknowledging this lack of representation, this statistic has been previously attributed to factors, such as limited exposure, lack of quality female mentorship and role models, sex-specific biases, and the perception of a challenging work-life balance. 3 Of the orthopaedic subspecialties, the lowest reported percentage of female physicians are seen in arthroscopy (0.7%), shoulder/elbow (2.4%), and adult spine (3.1%), while the highest percentages are seen in hand (24.0%) and pediatrics (22.6%). 4 Although there is potential for growth in female representation with a rising number of female residents, reducing this gender difference requires both time and continued intentional effort.…”