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Observational Study
. 2016 Mar 2:352:i847.
doi: 10.1136/bmj.i847.

Trends and comparison of female first authorship in high impact medical journals: observational study (1994-2014)

Giovanni Filardo  1 , Briget da Graca  2 , Danielle M Sass  3 , Benjamin D Pollock  3 , Emma B Smith  4 , Melissa Ashley-Marie Martinez  5
Affiliations
Observational Study

Trends and comparison of female first authorship in high impact medical journals: observational study (1994-2014)

Giovanni Filardo et al. BMJ. .

Abstract

Objective: To examine changes in representation of women among first authors of original research published in high impact general medical journals from 1994 to 2014 and investigate differences between journals.

Design: Observational study.

Study sample: All original research articles published in Annals of Internal Medicine, Archives of Internal Medicine, The BMJ, JAMA, The Lancet, and the New England Journal of Medicine (NEJM) for one issue every alternate month from February 1994 to June 2014.

Main exposures: Time and journal of publication.

Main outcome measures: Prevalence of female first authorship and its adjusted association with time of publication and journal, assessed using a multivariable logistic regression model that accounted for number of authors, study type and specialty/topic, continent where the study was conducted, and the interactions between journal and time of publication, study type, and continent. Estimates from this model were used to calculate adjusted odds ratios against the mean across the six journals, with 95% confidence intervals and P values to describe the associations of interest.

Results: The gender of the first author was determined for 3758 of the 3860 articles considered; 1273 (34%) were women. After adjustment, female first authorship increased significantly from 27% in 1994 to 37% in 2014 (P<0.001). The NEJM seemed to follow a different pattern, with female first authorship decreasing; it also seemed to decline in recent years in The BMJ but started substantially higher (approximately 40%), and The BMJ had the highest total proportion of female first authors. Compared with the mean across all six journals, first authors were significantly less likely to be female in the NEJM (adjusted odds ratio 0.68, 95% confidence interval 0.53 to 0.89) and significantly more likely to be female in The BMJ (1.30, 1.01 to 1.66) over the study period.

Conclusions: The representation of women among first authors of original research in high impact general medical journals was significantly higher in 2014 than 20 years ago, but it has plateaued in recent years and has declined in some journals. These results, along with the significant differences seen between journals, suggest that underrepresentation of research by women in high impact journals is still an important concern. The underlying causes need to be investigated to help to identify practices and strategies to increase women's influence on and contributions to the evidence that will determine future healthcare policies and standards of clinical practice.

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Conflict of interest statement

Competing interests: All authors have completed the ICMJE uniform disclosure form at www.icmje.org/coi_disclosure.pdf and declare: all authors had financial support from Bradley Family Endowment to the Baylor Health Care System Foundation for the submitted work; no financial relationships with any organizations that might have an interest in the submitted work in the previous three years; no other relationships or activities that could appear to have influenced the submitted work.

Figures

None
Fig 1 Adjusted association between female first author and time of publication by journal (February 1994 to June 2014). Model included the following independent variables: journal, time of publication, total number of listed authors, study type (experimental v non-experimental), continent where study was conducted, specialty/topic (general medicine, cardiovascular disease/surgery, infectious disease, oncology, HIV/AIDS, other) of study, and interaction terms between journal and time of publication, journal and study type, and journal and continent where study was conducted. Adjusted P value for association between time of publication and female first authorship was <0.001. Annals=Annals of Internal Medicine; Archives=Archives of Internal Medicine/JAMA-Internal Medicine; NEJM=New England Journal of Medicine
None
Fig 2 Adjusted odds ratios (reference=mean across six journals) for female first authorship by journal. Model included the following independent variables: journal, time of publication, total number of listed authors, study type (experimental v non-experimental), continent where study was conducted, specialty/topic (general medicine, cardiovascular disease/surgery, infectious disease, oncology, HIV/AIDS, other) of study, and interaction terms between journal and time of publication, journal and study type, and journal and continent where study was conducted. Annals=Annals of Internal Medicine; Archives=Archives of Internal Medicine/JAMA-Internal Medicine; NEJM=New England Journal of Medicine
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Comment in

References

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