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. 2023 Jun 27;13(1):56.
doi: 10.1186/s13613-023-01157-2.

Gender and racial differences in first and senior authorship of high-impact critical care randomized controlled trial studies from 2000 to 2022

Subhash Chander  1 , Sindhu Luhana  2 , Fnu Sadarat  3 , Lorenzo Leys  4 , Om Parkash  5 , Roopa Kumari  6
Affiliations

Gender and racial differences in first and senior authorship of high-impact critical care randomized controlled trial studies from 2000 to 2022

Subhash Chander et al. Ann Intensive Care. .

Abstract

Background: Females and ethnic minorities are underrepresented in the first and senior authorships positions of academic publications. This stems from various structural and systemic inequalities and discrimination in the journal peer-review process, as well as educational, institutional, and organizational cultures.

Methods: A retrospective bibliometric study design was used to investigate the representation of gender and racial/ethnic groups in the authorship of critical care randomized controlled trials in 12 high-impact journals from 2000 to 2022.

Results: In the 1398 randomized controlled trials included in this study, only 24.61% of the first authors and 16.6% of the senior authors were female. Although female authorship increased during the study period, authorship was significantly higher for males throughout (Chi-square for trend, p < 0.0001). The educational attainment [χ2(4) = 99.2, p < 0.0001] and the country of the author's affiliated institution [χ2(42) = 70.3, p = 0.0029] were significantly associated with gender. Male authorship was significantly more prevalent in 10 out of 12 journals analyzed in this study [χ2(11) = 110.1, p < 0.0001]. The most common race/ethnic group in our study population was White (85.1% women, 85.4% males), followed by Asians (14.3% females, 14.3% males). Although there was a significant increase in the number of non-White authors between 2000 and 2022 [χ2(22) = 77.3, p < 0.0001], the trend was driven by an increase in non-White male and not non-White female authors. Race/ethnicity was significantly associated with the country of the author's affiliated institution [χ2(41) = 1107, p < 0.0001] but not with gender or educational attainment.

Conclusions: Persistent gender and racial disparities in high-impact medical and critical care journals underscore the need to revise policies and strategies to encourage greater diversity in critical care research.

Keywords: Authorship; Critical care; Ethnic disparities; Gender disparities; RTCs; Racial disparities.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flowchart of inclusion/exclusion process of journal articles
Fig. 2
Fig. 2
Annual proportions (bar) and ratios (line) of male and female authors. Chi-square for trend p < 0.0001
Fig. 3
Fig. 3
Gender of Authorship by Journal of Publication. AJCC American Journal of Critical Care, AJRCCM American Journal of Critical Care Medicine, BMJ British Medical Journal, CCM Critical Care Medicine, ICM Intensive Care Medicine, JCC Journal of Critical Care, JICM Journal of Intensive Care Medicine, JAMA Journal of American Medical Association, NEJM New England Journal of Medicine
Fig. 4
Fig. 4
Annual proportions authors by race/ethnicity. Chi-square for trend p < 0.0001
See this image and copyright information in PMC

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