1
|
Shi H, Xu H, Huang S, Tan Z, Ma X, Zhang H, Zhang W, Shi L, Zhong X, Lü M, Chen X, Tang X. Gender disparity between first and senior authors on liver cancer research in the top journals of Gastroenterology and Hepatology. PLoS One 2024; 19:e0295648. [PMID: 38820519 PMCID: PMC11142674 DOI: 10.1371/journal.pone.0295648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 11/27/2023] [Indexed: 06/02/2024] Open
Abstract
BACKGROUND Gender disparity is pervasive in academic medicine. This study aimed to assess the disparity between men and women with regard to first and senior author positions in primary studies on liver cancer over the last two decades. METHODS We conducted a review of articles published in high-impact factor journals of the field of Gastroenterology and Hepatology in 2005, 2010, 2015 and 2020. First and senior authors of all ages were considered as the study population. The authors' genders were determined using the online artificial intelligence tool genderize.io (https://genderize.io/). The disparity between men and women authors was assessed using the linear-by-linear association test. RESULTS 665 original articles from 10 journals were reviewed. The point prevalence of first women authors was 25.0% compared with 75.0% for men. The point prevalence of senior women authors was 16.3% compared with 83.7% for men. From 2000 to 2020, the proportion of first women authors increased 14.4% to 26.8% compared with 85.6%-73.2% for men (P = 0.009), and the proportion of senior women authors increased from 7.4% to 19.5%, compared with 92.6%-80.5% for men (P = 0.035). The factor independently associated with a reduced representation of women among first authors was the region of author. The factor independently associated with a reduced representation of women among senior authors was the impact factor of journals. CONCLUSION The findings indicated a remarkable increase in the proportion of women, both first and senior authors, over the past two decades in the field of liver cancers. However, the representation of women authors in this area is far less than that of men.
Collapse
Affiliation(s)
- Huiqin Shi
- Department of Gastroenterology, The Affiliated Hospital of Southwest Medical University, Region Jiangyang, Luzhou, 646099, Sichuan Province, China
| | - Huan Xu
- Department of Gastroenterology, The Affiliated Hospital of Southwest Medical University, Region Jiangyang, Luzhou, 646099, Sichuan Province, China
| | - Shu Huang
- Department of Gastroenterology, The People’s Hospital of Lianshui, Lianshui, 223499, Huaian, Jiangsu Province, China
| | - Zhenju Tan
- Department of Gastroenterology, The Affiliated Hospital of Southwest Medical University, Region Jiangyang, Luzhou, 646099, Sichuan Province, China
| | - Xinyue Ma
- Department of Gastroenterology, The Affiliated Hospital of Southwest Medical University, Region Jiangyang, Luzhou, 646099, Sichuan Province, China
| | - Han Zhang
- Department of Gastroenterology, The Affiliated Hospital of Southwest Medical University, Region Jiangyang, Luzhou, 646099, Sichuan Province, China
| | - Wei Zhang
- Department of Gastroenterology, The Affiliated Hospital of Southwest Medical University, Region Jiangyang, Luzhou, 646099, Sichuan Province, China
| | - Lei Shi
- Department of Gastroenterology, The Affiliated Hospital of Southwest Medical University, Region Jiangyang, Luzhou, 646099, Sichuan Province, China
| | - Xiaolin Zhong
- Department of Gastroenterology, The Affiliated Hospital of Southwest Medical University, Region Jiangyang, Luzhou, 646099, Sichuan Province, China
| | - Muhan Lü
- Department of Gastroenterology, The Affiliated Hospital of Southwest Medical University, Region Jiangyang, Luzhou, 646099, Sichuan Province, China
| | - Xia Chen
- Department of Gastroenterology, Clinical Medical College and The First Affiliated Hospital of Chengdu Medical College, Xindu District, Chengdu City, 610500, Sichuan Province, China
| | - Xiaowei Tang
- Department of Gastroenterology, The Affiliated Hospital of Southwest Medical University, Region Jiangyang, Luzhou, 646099, Sichuan Province, China
| |
Collapse
|
2
|
Frentiu FD, Belvis AFV, Dupont-Rouzeyrol M, Edillo FE, Harishchandra J, Mariasua J, Nguyen TTT, O'Connor O, Santoso MS, Tran NTH, Yudhaputri FA. Arbovirus research in the Asia-Pacific needs more women in leadership. THE LANCET. INFECTIOUS DISEASES 2024; 24:231-232. [PMID: 38237615 DOI: 10.1016/s1473-3099(23)00817-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 12/19/2023] [Indexed: 02/25/2024]
Affiliation(s)
- Francesca D Frentiu
- School of Biomedical Sciences, Centre for Immunology and Infection Control, Queensland University of Technology, Brisbane, QLD 4001, Australia.
| | | | - Myrielle Dupont-Rouzeyrol
- Unité de Recherche et d'Expertise Dengue et Arboviroses, Institut Pasteur de Nouvelle-Calédonie, Noumea, New Caledonia
| | - Frances E Edillo
- Mosquito Research Laboratory, Biology Department, University of San Carlos Talamban Campus, Cebu City, Philippines
| | | | - Joanne Mariasua
- Department of Public Health, Ministry of Health, Port Vila, Vanuatu
| | - Thuy T T Nguyen
- Department of Virology, National Institute of Hygiene and Epidemiology, Hanoi, Vietnam
| | - Olivia O'Connor
- Unité de Recherche et d'Expertise Dengue et Arboviroses, Institut Pasteur de Nouvelle-Calédonie, Noumea, New Caledonia
| | | | - Ninh T H Tran
- National Hospital for Tropical Diseases, Hanoi, Vietnam
| | | |
Collapse
|
3
|
Offiah AC, Atalabi OM, Epelman M, Khanna G. Disparities in paediatric radiology research publications from low- and lower middle-income countries: a time for change. Pediatr Radiol 2024; 54:468-477. [PMID: 37773442 PMCID: PMC10902002 DOI: 10.1007/s00247-023-05762-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 08/25/2023] [Accepted: 09/03/2023] [Indexed: 10/01/2023]
Abstract
The positive impact of diversity on health research and outcomes is well-recognised and widely published. Despite this, published evidence shows that at every step of the research pathway, issues of equity, diversity and inclusion (EDI) arise. There is evidence of a lack of diversity within research teams, in the research questions asked/research participants recruited, on grant review/funding panels, amongst funded researchers and on the editorial boards and reviewer pools of the journals to which results are submitted for peer-reviewed publication. Considering the journal Pediatric Radiology, while its editorial board of 92 members has at least one member affiliated to a country in every region of the world, the majority are in North America (n=52, 57%) and Europe (n=30, 33%) and only two (2%) are affiliated to institutions in a lower middle-income country (LMIC) (India, Nigeria), with one (1%) affiliated to an institution in an upper middle-income country (UMIC) (Peru) and none in a low-income country (LIC). Pediatric Radiology is "…the official journal of the European Society of Paediatric Radiology, the Society for Pediatric Radiology, the Asian and Oceanic Society for Pediatric Radiology and the Latin American Society of Pediatric Radiology". However, of the total number of manuscripts submitted for potential publication in the four years 2019 through 2022, only 0.03% were from a LIC and only 7.9% were from a LMIC. Further, the frequency of acceptance of manuscripts from UMIC was seven times higher than that from LMIC (no manuscripts were published from LIC). Increased collaboration is required between researchers across the globe to better understand the barriers to equity in the funding, conduct and publication of research from LIC and LMIC and to identify ways in which we can overcome them together.
Collapse
Affiliation(s)
- Amaka C Offiah
- Division of Clinical Medicine, University of Sheffield, Sheffield Children's NHS Foundation Trust, Room 3, Damer Street Building, Western Bank, Sheffield, S10 2TH, UK.
- Department of Radiology, Sheffield Children's NHS Foundation Trust, Sheffield, UK.
| | - Omolola M Atalabi
- Department of Radiology, University College Hospital, Ibadan, Oyo State, Nigeria
| | - Monica Epelman
- Department of Radiology, Nicklaus Children's Hospital, Miami, FL, USA
| | - Geetika Khanna
- Department of Radiology & Imaging Sciences, Emory University and Children's Healthcare of Atlanta, Atlanta, GA, USA
| |
Collapse
|
4
|
Clavel MA, Van Spall HG, Mantella LE, Foulds H, Randhawa V, Parry M, Liblik K, Kirkham AA, Cotie L, Jaffer S, Bruneau J, Colella TJ, Ahmed S, Dhukai A, Gomes Z, Adreak N, Keeping-Burke L, Limbachia J, Liu S, Jacques KE, Mullen KA, Mulvagh SL, Norris CM. The Canadian Women's Heart Health Alliance ATLAS on the Epidemiology, Diagnosis, and Management of Cardiovascular Disease in Women - Chapter 8: Knowledge Gaps and Status of Existing Research Programs in Canada. CJC Open 2024; 6:220-257. [PMID: 38487042 PMCID: PMC10935691 DOI: 10.1016/j.cjco.2023.11.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Accepted: 11/14/2023] [Indexed: 03/17/2024] Open
Abstract
Despite significant progress in medical research and public health efforts, gaps in knowledge of women's heart health remain across epidemiology, presentation, management, outcomes, education, research, and publications. Historically, heart disease was viewed primarily as a condition in men and male individuals, leading to limited understanding of the unique risks and symptoms that women experience. These knowledge gaps are particularly problematic because globally heart disease is the leading cause of death for women. Until recently, sex and gender have not been addressed in cardiovascular research, including in preclinical and clinical research. Recruitment was often limited to male participants and individuals identifying as men, and data analysis according to sex or gender was not conducted, leading to a lack of data on how treatments and interventions might affect female patients and individuals who identify as women differently. This lack of data has led to suboptimal treatment and limitations in our understanding of the underlying mechanisms of heart disease in women, and is directly related to limited awareness and knowledge gaps in professional training and public education. Women are often unaware of their risk factors for heart disease or symptoms they might experience, leading to delays in diagnosis and treatments. Additionally, health care providers might not receive adequate training to diagnose and treat heart disease in women, leading to misdiagnosis or undertreatment. Addressing these knowledge gaps requires a multipronged approach, including education and policy change, built on evidence-based research. In this chapter we review the current state of existing cardiovascular research in Canada with a specific focus on women.
Collapse
Affiliation(s)
- Marie-Annick Clavel
- Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Québec, Québec, Canada
| | - Harriette G.C. Van Spall
- Department of Medicine, Department of Health Research Methods, Evidence, and Impact, McMaster University, Toronto, Ontario, Canada
| | - Laura E. Mantella
- Department of Biomedical and Molecular Sciences, Queen’s University, Kingston, Ontario, Canada
| | - Heather Foulds
- College of Kinesiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Varinder Randhawa
- Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - Monica Parry
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Kiera Liblik
- Department of Medicine, Kingston Health Science Center, Kingston, Ontario, Canada
| | - Amy A. Kirkham
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Ontario, Canada
- Toronto Rehabilitation Institute (KITE), University Health Network, Toronto, Ontario, Canada
| | - Lisa Cotie
- Toronto Rehabilitation Institute (KITE), University Health Network, Toronto, Ontario, Canada
| | - Shahin Jaffer
- General Internal Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Jill Bruneau
- Faculty of Nursing, Memorial University of Newfoundland and Labrador, St John, Newfoundland and Labrador, Canada
| | - Tracey J.F. Colella
- Toronto Rehabilitation Institute (KITE), University Health Network, Toronto, Ontario, Canada
| | - Sofia Ahmed
- Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Abida Dhukai
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Zoya Gomes
- Faculty of Medicine, Division of Cardiology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Najah Adreak
- Department of Surgery, University of British Columbia, Vancouver, British Columbia, Canada
| | - Lisa Keeping-Burke
- Department of Nursing and Health Sciences, University of New Brunswick, Saint John, New Brunswick, Canada
| | - Jayneel Limbachia
- Schulich School of Medicine, Western University, London, Ontario, Canada
| | - Shuangbo Liu
- Section of Cardiology, Department of Medicine, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Karen E. Jacques
- Person with lived experience, Canadian Women’s Heart Health Alliance, Ottawa, Ontario, Canada
| | - Kerri A. Mullen
- University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Sharon L. Mulvagh
- Faculty of Medicine, Division of Cardiology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Colleen M. Norris
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| |
Collapse
|
5
|
Skrivankova VW, Hossmann S, Cornell M, Ballif M, Dupont C, Huwa J, Seintaridis K, Kalua T, Wandeler G, Kassanjee R, Haas AD, Technau KG, Fenner L, Low N, Davies MA, Egger M. Authorship inequalities in global health research: the IeDEA Southern Africa collaboration. BMJ Glob Health 2023; 8:e013316. [PMID: 38103897 PMCID: PMC10729048 DOI: 10.1136/bmjgh-2023-013316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 11/01/2023] [Indexed: 12/19/2023] Open
Abstract
BACKGROUND The International epidemiology Databases to Evaluate AIDS conducts research in several regions, including in Southern Africa. We assessed authorship inequalities for the Southern African region, which is led by South African and Swiss investigators. METHODS We analysed authorships of publications from 2007 to 2020 by gender, country income group, time and citation impact. We used 2020 World Bank categories to define income groups and the relative citation ratio (RCR) to assess citation impact. Authorship parasitism was defined as articles without authors from the countries where the study was conducted. A regression model examined the probability of different authorship positions. RESULTS We included 313 articles. Of the 1064 contributing authors, 547 (51.4%) were women, and 223 (21.0%) were from 32 low-income/lower middle-income countries (LLMICs), 269 (25.3%) were from 13 upper middle-income countries and 572 (53.8%) were from 25 high-income countries (HICs). Most articles (150/157, 95.5%) reporting data from Southern Africa included authors from all participating countries. Women were more likely to be the first author than men (OR 1.74; 95% CI 1.06 to 2.83) but less likely to be last authors (OR 0.63; 95% CI 0.40 to 0.99). Compared with HIC, LLMIC authors were less likely to publish as first (OR 0.21; 95% CI 0.11 to 0.41) or last author (OR 0.20; 95% CI 0.09 to 0.42). The proportion of women and LLMIC first and last authors increased over time. The RCR tended to be higher, indicating greater impact, if first or last authors were from HIC (p=0.06). CONCLUSIONS This analysis of a global health collaboration co-led by South African and Swiss investigators showed little evidence of authorship parasitism. There were stark inequalities in authorship position, with women occupying more first and men more last author positions and researchers from LLMIC being 'stuck in the middle' on the byline. Global health research collaborations should monitor, analyse and address authorship inequalities.
Collapse
Affiliation(s)
| | - Stefanie Hossmann
- Institute of Social and Preventive Medicine (ISPM), Universität Bern, Bern, Switzerland
| | - Morna Cornell
- Centre for Infectious Disease Epidemiology & Research, School of Public Health, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Marie Ballif
- Institute of Social and Preventive Medicine (ISPM), Universität Bern, Bern, Switzerland
- Department of Infectious Diseases, Bern University Hospital, Inselspital, University of Bern, Bern, Switzerland
| | - Carole Dupont
- Institute of Social and Preventive Medicine (ISPM), Universität Bern, Bern, Switzerland
| | | | | | - Thokozani Kalua
- Department of HIV and AIDS, Malawi Ministry of Health, Lilongwe, Malawi
| | - Gilles Wandeler
- Institute of Social and Preventive Medicine (ISPM), Universität Bern, Bern, Switzerland
- Department of Infectious Diseases, Bern University Hospital, Inselspital, University of Bern, Bern, Switzerland
| | - Reshma Kassanjee
- Centre for Infectious Disease Epidemiology & Research, School of Public Health, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Andreas D Haas
- Institute of Social and Preventive Medicine (ISPM), Universität Bern, Bern, Switzerland
| | - Karl-Gunter Technau
- Department of Paediatrics and Child Health, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Lukas Fenner
- Institute of Social and Preventive Medicine (ISPM), Universität Bern, Bern, Switzerland
| | - Nicola Low
- Institute of Social and Preventive Medicine (ISPM), Universität Bern, Bern, Switzerland
| | - Mary-Ann Davies
- Centre for Infectious Disease Epidemiology & Research, School of Public Health, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Matthias Egger
- Institute of Social and Preventive Medicine (ISPM), Universität Bern, Bern, Switzerland
- Centre for Infectious Disease Epidemiology & Research, School of Public Health, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| |
Collapse
|
6
|
Sebo P. How well does NamSor perform in predicting the country of origin and ethnicity of individuals based on their first and last names? PLoS One 2023; 18:e0294562. [PMID: 37972002 PMCID: PMC10653483 DOI: 10.1371/journal.pone.0294562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 11/02/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND We aimed to evaluate NamSor's performance in predicting the country of origin and ethnicity of individuals based on their first/last names. METHODS We retrieved the name and country of affiliation of all authors of PubMed publications in 2021, affiliated with universities in the twenty-two countries whose researchers authored ≥1,000 medical publications and whose percentage of migrants was <2.5% (N = 88,699). We estimated with NamSor their most likely "continent of origin" (Asia/Africa/Europe), "country of origin" and "ethnicity". We also examined two other variables that we created: "continent#2" ("Europe" replaced by "Europe/America/Oceania") and "country#2" ("Spain" replaced by "Spain/Hispanic American country" and "Portugal" replaced by "Portugal/Brazil"). Using "country of affiliation" as a proxy for "country of origin", we calculated for these five variables the proportion of misclassifications (= errorCodedWithoutNA) and the proportion of non-classifications (= naCoded). We repeated the analyses with a subsample consisting of all results with inference accuracy ≥50%. RESULTS For the full sample and the subsample, errorCodedWithoutNA was 16.0% and 12.6% for "continent", 6.3% and 3.3% for "continent#2", 27.3% and 19.5% for "country", 19.7% and 11.4% for "country#2", and 20.2% and 14.8% for "ethnicity"; naCoded was zero and 18.0% for all variables, except for "ethnicity" (zero and 10.7%). CONCLUSION NamSor is accurate in determining the continent of origin, especially when using the modified variable (continent#2) and/or restricting the analysis to names with accuracy ≥50%. The risk of misclassification is higher with country of origin or ethnicity, but decreases, as with continent of origin, when using the modified variable (country#2) and/or the subsample.
Collapse
Affiliation(s)
- Paul Sebo
- University Institute for Primary Care (IuMFE), University of Geneva, Geneva, Switzerland
| |
Collapse
|
7
|
Abraham J, Panchal K, Varshney L, Lakshmi Narayan K, Rahman S. Gender Disparities in First Authorship in Publications Related to Attention Deficit Hyperkinetic Disorder (ADHD) and Artificial Intelligence (AI). Cureus 2023; 15:e49714. [PMID: 38161901 PMCID: PMC10757506 DOI: 10.7759/cureus.49714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/29/2023] [Indexed: 01/03/2024] Open
Abstract
The medical profession has experienced a significant increase in the number of women practitioners in recent decades, leading to a reduction in the gender gap. According to the United States Medical Association, approximately 25% of physicians in the United States are now women. Although this progress is evident in the clinical setting, women's representation in academic medicine remains disproportionately low. The underrepresentation of women in academia has various consequences, including limited access to academic resources and hindered career growth. Previous studies have attempted to analyze these disparities, but results have been inconsistent, and the issue's complexity has not been fully understood. This study aims to examine the disparity in the gender of first authors in academic publications related to " Artificial intelligence (AI) and Attention Deficit Hyperkinetic Disorder (ADHD)" between 2010 and 2023. Analysis was conducted on June 21st, 2023, using the database PubMed. The search term "AI" AND "ADHD" was used to derive all articles over a period of 13 years, from January 1st, 2010, to December 31st, 2022, excluding the year 2023 due to limited available publications. The relevant articles were downloaded in Microsoft Excel sheets. The gender of the first authors was determined using the NamSor app V.2, an application programming interface (API) with a large dataset of names and countries of origin. A total of 204 articles were considered for this study. There were 78 female first authors and 126 male first authors. The highest number of publications with a male first author occurred in 2022, with 32 publications. The Netherlands, Singapore, Turkey, and China have the highest gender ratios, indicating a more favourable representation of both genders. The p-value of 0.2664 suggests that there is no significant association between gender and country. The findings revealed a gender disparity, with a higher number of male first authors. By addressing and rectifying these disparities, we can enhance the overall quality, diversity, and inclusivity of research in the field of ADHD and Artificial Intelligence.
Collapse
Affiliation(s)
- Jeby Abraham
- General Medicine, Yenepoya Medical College, Mangalore, IND
| | - Kashyap Panchal
- Psychiatry and Behavioral Sciences, American University of Barbados, St. Michael, BRB
| | - Leena Varshney
- Preventive Medicine, Windsor University School of Medicine, Troy, USA
| | | | - Saman Rahman
- Internal Medicine, Jawaharlal Nehru Medical College, Belagavi, IND
| |
Collapse
|
8
|
Abdalla S, Abdalla M, Saad M, Jones D, Podolsky S, Abdalla M. Ethnicity and gender trends of UK authors in The British Medical Journal and the Lancet over the past two decades: a comprehensive longitudinal analysis. EClinicalMedicine 2023; 64:102174. [PMID: 37711218 PMCID: PMC10498178 DOI: 10.1016/j.eclinm.2023.102174] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 08/04/2023] [Accepted: 08/08/2023] [Indexed: 09/16/2023] Open
Abstract
Background While gender equity among academic authors has been extensively investigated, there is a significant gap in our understanding of racial/ethnic authorship trends, despite the recognition of barriers to authorship along both ethnic and gender lines. Leveraging the meta-data for all articles published in The British Medical Journal (The BMJ) and the Lancet and between 2002 and 2022 (inclusive), we explore demographic trends among UK academic medicine authors in two of the world's leading British medical journals. Methods We systematically searched PubMed's MEDLINE for all articles published in The BMJ and Lancet between January 1st 2002 and December 31st 2022. Filtering for articles with a UK affiliation, we predicted gender using a publicly-validated name-to-gender dictionary, while data was analysed to explore and investigate ethnicity using the Consumer Data Research Centre's (CDRC) Ethnicity Estimator. Data was analysed to explore and investigate: (a) the proportion of female/male author publications, (b) the proportion of the various UK author ethnicity groups, and (c) the overlap/intersection between gender and ethnic identities among first and last authors. This comprehensive longitudinal analysis was conducted on 82,143 articles (51,209 from The BMJ and 30,934 from the Lancet) which represents >97% of all published articles between 2002 and 2022. As we sought to understand how academic authorship reflects the diversity of the UK population, we limited our analysis to first and last authors who had a UK affiliation and excluded "news" and "comments" pieces (16,736 articles for The BMJ and 4678 articles from the Lancet). The main outcome measures were the trends in first and last authorship demographics of academic medicine, focusing on the proportion of female/male authors, ethnicity and their intersectionality. Findings Our findings show that, while women have made substantial headway towards equity among first and last authorship in The BMJ (peaking at 42% and 43%), they remain under-represented in the Lancet (35% and 27%). In both The BMJ and Lancet, Black authors have remained severely under-represented as both first and last authors (below 1% for most of the two decades), while Asian authors have increased proportionally to match their fraction in the general population (ranging from 2 to 10%). Interpretation Analysis over the past two decades has shown that the gender author gap is decreasing quickly in The BMJ and Lancet. However, despite the two journals' growing focus on structural inequalities in medical academia, little progress has been made in rectifying the large gap between White British authors and other ethnic groups, especially Black authors. Without more awareness, diversity initiatives which have resulted in positive gains for White women do not seem to translate well for authors of colour. Funding None.
Collapse
Affiliation(s)
- Salwa Abdalla
- Department of Computer Science, University of Toronto, Toronto, Canada
| | - Moustafa Abdalla
- Harvard Medical School, Boston, MA, USA
- Department of Statistics, University of Oxford, Oxford, UK
| | - Mohamed Saad
- University of Bahrain & The Royal Academy, Manama, Bahrain
| | - David Jones
- Harvard Medical School, Boston, MA, USA
- Department of the History of Science, Harvard University, Cambridge, MA, USA
| | - Scott Podolsky
- Harvard Medical School, Boston, MA, USA
- Center for the History of Medicine, Countway Medical Library, Harvard Medical School, Boston, MA, USA
| | - Mohamed Abdalla
- Department of Computer Science, University of Toronto, Toronto, Canada
- Institute for Better Health, Trillium Health Partners, Mississauga, Canada
| |
Collapse
|
9
|
Horstmann S, Hartig C, Kraus U, Palm K, Jacke K, Dandolo L, Schneider A, Bolte G. Consideration of sex/gender in publications of quantitative health-related research: Development and application of an assessment matrix. Front Public Health 2023; 11:992557. [PMID: 37081952 PMCID: PMC10110874 DOI: 10.3389/fpubh.2023.992557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 03/06/2023] [Indexed: 04/07/2023] Open
Abstract
During the last years the need to integrate sex and gender in health-related research for better and fairer science became increasingly apparent. Various guidelines and checklists were developed to encourage and support researchers in considering the entangled dimensions of sex/gender in their research. However, a tool for the assessment of sex/gender consideration and its visualization is still missing. We aim to fill this gap by introducing an assessment matrix that can be used as a flexible instrument for comprehensively evaluating the sex/gender consideration in quantitative health-related research. The matrix was developed through an iterative and open process based on the interdisciplinary expertise represented in our research team and currently published guidelines. The final matrix consists of 14 different items covering the whole research process and the publication of results. Additionally, we introduced a method to graphically display this evaluation. By developing the matrix, we aim to provide users with a tool to systematically compare sex/gender consideration qualitatively between different publications and even different fields of study. This way, the assessment matrix represents a tool to identify research gaps and a basis for future research. In the long term, the implementation of this tool to evaluate the consideration of sex/gender should contribute to more sex/gender equitable health-related research.
Collapse
Affiliation(s)
- Sophie Horstmann
- Department of Social Epidemiology, Institute of Public Health and Nursing Research, University of Bremen, Bremen, Germany
- Health Sciences Bremen, University of Bremen, Bremen, Germany
- *Correspondence: Sophie Horstmann,
| | - Christina Hartig
- Department of Social Epidemiology, Institute of Public Health and Nursing Research, University of Bremen, Bremen, Germany
- Health Sciences Bremen, University of Bremen, Bremen, Germany
| | - Ute Kraus
- Helmholtz Zentrum München, German Research Center for Environmental Health, Institute of Epidemiology, Neuherberg, Germany
| | - Kerstin Palm
- Gender and Science Research Unit, Institute of History, Humboldt University of Berlin, Berlin, Germany
| | - Katharina Jacke
- Gender and Science Research Unit, Institute of History, Humboldt University of Berlin, Berlin, Germany
| | - Lisa Dandolo
- Department of Social Epidemiology, Institute of Public Health and Nursing Research, University of Bremen, Bremen, Germany
- Health Sciences Bremen, University of Bremen, Bremen, Germany
| | - Alexandra Schneider
- Helmholtz Zentrum München, German Research Center for Environmental Health, Institute of Epidemiology, Neuherberg, Germany
| | - Gabriele Bolte
- Department of Social Epidemiology, Institute of Public Health and Nursing Research, University of Bremen, Bremen, Germany
- Health Sciences Bremen, University of Bremen, Bremen, Germany
| |
Collapse
|
10
|
Hallam L, Vassallo A, Hallam C, Thompson K, Shanthosh J, Chappell L, Wainer Z, Norton R, Woodward M, Carcel C. Sex and gender reporting in Australian health and medical research publications. Aust N Z J Public Health 2023; 47:100005. [PMID: 36669247 DOI: 10.1016/j.anzjph.2022.100005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 10/16/2022] [Accepted: 10/30/2022] [Indexed: 01/19/2023] Open
Abstract
OBJECTIVE This study aimed to determine how sex and gender are being incorporated into Australian medical research publications and if this is influenced by journals endorsing the International Committee of Medical Journal Editors (ICMJE) guidelines, which contain criteria for sex and gender reporting. METHODS Analysis of original research articles published in Australia's top 10 medical journals in 2020. RESULTS From the 10 leading journals, 1,136 articles were eligible for analysis, including 990 human participant populations. Sex and/or gender were reported for 873 (88.2%) human populations, with 480 using conflicting terminology. Only 14 (1.6%) described how sex and gender were determined. The primary outcome, or key aim, was stratified by sex and/or gender for 249 (29.2%) participant groups and the influence of sex and/or gender on the results was discussed for only 171 (17.3%). There was no significant association between endorsement of the ICMJE guidelines and adherence to any sex and gender criteria. CONCLUSIONS Sex and gender are poorly incorporated into Australian medical research publications and was not improved by journals endorsing the ICMJE guidelines. IMPLICATIONS FOR PUBLIC HEALTH Reporting and analysis of sex and gender data in health research in Australian medical journals requires improvement, for better health for all.
Collapse
Affiliation(s)
- Laura Hallam
- The George Institute for Global Health, University of New South Wales, Sydney, Australia; Australian Human Rights Institute, University of New South Wales, Sydney, Australia.
| | - Amy Vassallo
- The George Institute for Global Health, University of New South Wales, Sydney, Australia; Australian Human Rights Institute, University of New South Wales, Sydney, Australia
| | - Clare Hallam
- Australian Human Rights Institute, University of New South Wales, Sydney, Australia
| | - Kelly Thompson
- The George Institute for Global Health, University of New South Wales, Sydney, Australia; Nepean and Blue Mountains Local Health District, Sydney, Australia
| | - Janani Shanthosh
- The George Institute for Global Health, University of New South Wales, Sydney, Australia; Australian Human Rights Institute, University of New South Wales, Sydney, Australia
| | - Louise Chappell
- Australian Human Rights Institute, University of New South Wales, Sydney, Australia
| | - Zoe Wainer
- The University of Melbourne, Faculty of Medicine, Dentistry and Health Science, Melbourne, Australia; The Victorian Department of Health, Public Health Division, Melbourne, Australia
| | - Robyn Norton
- The George Institute for Global Health, University of New South Wales, Sydney, Australia; The George Institute for Global Health, Imperial College London, London, United Kingdom
| | - Mark Woodward
- The George Institute for Global Health, University of New South Wales, Sydney, Australia; The George Institute for Global Health, Imperial College London, London, United Kingdom
| | - Cheryl Carcel
- The George Institute for Global Health, University of New South Wales, Sydney, Australia
| |
Collapse
|
11
|
Ford CA, Boyer CB, Halpern CT, Katzman DK, Ross DA. The Journal of Adolescent Health's Commitment to Diversity, Equity, and Inclusion. J Adolesc Health 2023; 72:165-170. [PMID: 36604008 DOI: 10.1016/j.jadohealth.2022.11.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 11/08/2022] [Indexed: 01/04/2023]
|
12
|
Rinaldo N, Piva G, Ryder S, Crepaldi A, Pasini A, Caruso L, Manfredini R, Straudi S, Manfredini F, Lamberti N. The Issue of Gender Bias Represented in Authorship in the Fields of Exercise and Rehabilitation: A 5-Year Research in Indexed Journals. J Funct Morphol Kinesiol 2023; 8:jfmk8010018. [PMID: 36810502 PMCID: PMC9944464 DOI: 10.3390/jfmk8010018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 01/26/2023] [Accepted: 01/27/2023] [Indexed: 02/01/2023] Open
Abstract
Despite progress made in recent decades, gender bias is still present in scientific publication authorship. The underrepresentation of women and overrepresentation of men has already been reported in the medical fields but little is known in the fields of exercise sciences and rehabilitation. This study examines trends in authorship by gender in this field in the last 5 years. All randomized controlled trials published in indexed journals from April 2017 to March 2022 through the widely inclusive Medline dataset using the MeSH term "exercise therapy" were collected, and the gender of the first and last authors was identified through names, pronouns and photographs. Year of publication, country of affiliation of the first author, and ranking of the journal were also collected. A chi-squared test for trends and logistic regression models were performed to analyze the odds of a woman being a first or last author. The analysis was performed on a total of 5259 articles. Overall, 47% had a woman as the first author and 33% had a woman as the last author, with a similar trend over five years. The trend in women's authorship varied by geographical area, with the higher representation of women authors in Oceania (first: 53.1%; last: 38.8%), North-Central America (first: 45.3%; last: 37.2%), and Europe (first: 47.2%; last: 33.3%). The logistic regression models (p < 0.001) indicated that women have lower odds of being authors in prominent authorship positions in higher-ranked journals. In conclusion, over the last five years, in the field of exercise and rehabilitation research, women and men are almost equally represented as first authors, in contrast with other medical areas. However, gender bias, unfavoring women, still exists, especially in the last authorship position, regardless of geographical area and journal ranking.
Collapse
Affiliation(s)
- Natascia Rinaldo
- Department of Neuroscience and Rehabilitation, University of Ferrara, 44121 Ferrara, Italy
| | - Giovanni Piva
- PhD Program in Environmental Sustainability and Wellbeing, Department of Humanities, University of Ferrara, 44121 Ferrara, Italy
| | - Suzanne Ryder
- Department of Neuroscience and Rehabilitation, University of Ferrara, 44121 Ferrara, Italy
| | - Anna Crepaldi
- Instituto Maimonides de Investigation Biomedica, 14005 Cordoba, Spain
| | - Alba Pasini
- Department of Neuroscience and Rehabilitation, University of Ferrara, 44121 Ferrara, Italy
| | - Lorenzo Caruso
- Department of Environment and Prevention Sciences, University of Ferrara, 44121 Ferrara, Italy
| | - Roberto Manfredini
- Department of Medical Sciences, University of Ferrara, 44121 Ferrara, Italy
- University Center for Studies on Gender Medicine, University of Ferrara, 44121 Ferrara, Italy
| | - Sofia Straudi
- Department of Neuroscience and Rehabilitation, University of Ferrara, 44121 Ferrara, Italy
| | - Fabio Manfredini
- Department of Neuroscience and Rehabilitation, University of Ferrara, 44121 Ferrara, Italy
- Correspondence: ; Tel.: +39-0532236187
| | - Nicola Lamberti
- Department of Neuroscience and Rehabilitation, University of Ferrara, 44121 Ferrara, Italy
| |
Collapse
|
13
|
Towards a new paradigm for ‘journal quality’ criteria: a scoping review. Scientometrics 2022. [DOI: 10.1007/s11192-022-04520-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
|
14
|
Abouzeid M, Muthanna A, Nuwayhid I, El-Jardali F, Connors P, Habib RR, Akbarzadeh S, Jabbour S. Barriers to sustainable health research leadership in the Global South: Time for a Grand Bargain on localization of research leadership? Health Res Policy Syst 2022; 20:136. [PMID: 36536392 PMCID: PMC9761652 DOI: 10.1186/s12961-022-00910-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Accepted: 09/15/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Strong Global South (GS) health research leadership, itself both dependent on and a requisite for strong health research systems, is essential to generate locally relevant research and ensure that evidence is translated into policy and practice. Strong GS health research systems and leadership are important for health development and in turn for strong health systems. However, many GS countries struggle to produce research and to improve performance on widely used research metrics measuring productivity and reflecting leadership. Drawing on literature from a rapid review, this viewpoint paper considers the barriers to GS health research leadership and proposes strategies to address these challenges. FINDINGS GS researchers and institutions face numerous barriers that undermine health research leadership potential. Barriers internal to the GS include researcher-level barriers such as insufficient mentorship, limited financial incentives and time constraints. Institutional barriers include limited availability of resources, restrictive and poorly developed research infrastructures, weak collaboration and obstructive policies and procedures. Structural barriers include political will, politicization of research and political instability. External barriers relate to the nature and extent of Global North (GN) activities and systems and include allocation and distribution of funding and resources, characteristics and focus of GN-GS research collaborations, and publication and information dissemination challenges. CONCLUSIONS Strengthening GS health research leadership requires acknowledgement of the many barriers, and adoption of mitigating measures by a range of actors at the institutional, national, regional and global levels. Particularly important are leadership capacity development integrating researcher, institutional and systems initiatives; new GN-GS partnership models emphasizing capacity exchange and shared leadership; supporting GS research communities to set, own and drive their research agendas; addressing biases against GS researchers; ensuring that GS institutions address their internal challenges; enhancing South-South collaborations; diversifying research funding flow to the GS; and learning from models that work. The time has come for a firm commitment to improving localization of research leadership, supported by adequate funding flow, to ensure strong and sustainable research systems and leadership in and from the GS. Just as the humanitarian donor and aid community adopted the Grand Bargain commitment to improve funding flow through local and national responders in times of crisis, we strongly urge the global health research community to adopt a Grand Bargain for research leadership.
Collapse
Affiliation(s)
- Marian Abouzeid
- grid.22903.3a0000 0004 1936 9801The Lancet-American University of Beirut Commission on Syria, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon ,grid.22903.3a0000 0004 1936 9801Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon ,grid.1021.20000 0001 0526 7079Alfred Deakin Institute for Citizenship and Globalisation, Deakin University, Burwood, VIC Australia ,grid.1021.20000 0001 0526 7079Centre for Humanitarian Leadership, School of Humanities and Social Sciences, Deakin University, Burwood, VIC Australia
| | - Ahlam Muthanna
- grid.22903.3a0000 0004 1936 9801The Lancet-American University of Beirut Commission on Syria, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Iman Nuwayhid
- grid.22903.3a0000 0004 1936 9801The Lancet-American University of Beirut Commission on Syria, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon ,grid.22903.3a0000 0004 1936 9801Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Fadi El-Jardali
- grid.22903.3a0000 0004 1936 9801Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Phil Connors
- grid.1021.20000 0001 0526 7079Centre for Humanitarian Leadership, School of Humanities and Social Sciences, Deakin University, Burwood, VIC Australia
| | - Rima R. Habib
- grid.22903.3a0000 0004 1936 9801Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Shahram Akbarzadeh
- grid.1021.20000 0001 0526 7079Alfred Deakin Institute for Citizenship and Globalisation, Deakin University, Burwood, VIC Australia
| | - Samer Jabbour
- grid.22903.3a0000 0004 1936 9801The Lancet-American University of Beirut Commission on Syria, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon ,grid.22903.3a0000 0004 1936 9801Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| |
Collapse
|
15
|
Moser F, Bump JB. Assessing the World Health Organization: What does the academic debate reveal and is it democratic? Soc Sci Med 2022; 314:115456. [PMID: 36274457 DOI: 10.1016/j.socscimed.2022.115456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 09/17/2022] [Accepted: 10/09/2022] [Indexed: 11/05/2022]
Abstract
The World Health Organization (WHO), the leading global authority in public health, routinely attracts loud calls for reform. Although Member States negotiate reform internally, academic debate is more public, and can generate ideas and provide independent accountability. We investigate why authors advocate for WHO reform so commonly. We wondered if this literature had potentially useful themes for WHO, what methods and evidence were used, and we wanted to analyze the geography of participation. We conducted a systematic review using four databases to identify 139 articles assessing WHO or advocating for reform. We discuss these using categories we derived from the management literature on organizational performance. We also analyzed evidence, country of origin, and topic. The literature we reviewed contained 998 claims about WHO's performance or reform, although there were no standard methods for assessing WHO. We developed a framework to analyze WHO's performance and structure a synthesis of the claims, which find WHO imperiled. Its legitimacy and governance are weakened by disagreements about purpose, unequal Member State influence, and inadequate accountability. Contestation of goals and strategies constrain planning. Structure and workforce deficiencies limit coordination, agility, and competence. WHO has technical and normative authority, but insufficient independence and legal power to influence uncooperative states. WHO's identity claims transparency, independence, and courage, but these aspirations are betrayed in times of need. Most articles (88%) were commentaries without specified methods. More than three-quarters (76%) originated from the US, the UK, or Switzerland. A quarter of papers (25%) focused on international infectious disease outbreaks, and another 25% advocated for WHO reform generally. Many criticisms cite wide-ranging performance problems, some of which may relate to obstructive behavior by Member States. This literature is incomplete in the geographic representation of authors, evidence, methods, and topics. We offer ideas for developing more rigorous and inclusive academic debate on WHO.
Collapse
Affiliation(s)
- Fabian Moser
- Institute of Public Health, Charité - Universitätsmedizin Berlin, 10117, Berlin, Germany.
| | - Jesse B Bump
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, 665 Huntington Avenue, Boston, MA, 02115, USA; Bergen Center for Ethics and Priority Setting, University of Bergen, Norway; Initiative on the Future of Health and Economic Resilience in Africa, Boston MA 02115, USA.
| |
Collapse
|
16
|
Hunt L, Nielsen MW, Schiebinger L. A framework for sex, gender, and diversity analysis in research. Science 2022; 377:1492-1495. [PMID: 36173857 DOI: 10.1126/science.abp9775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Funding agencies have ample room to improve their policies.
Collapse
Affiliation(s)
- Lilian Hunt
- Equality, Diversity and Inclusion in Science and Health (EDIS), Culture, Equity, Diversity, and Inclusion, Wellcome Trust, London, UK
| | | | - Londa Schiebinger
- History of Science, Stanford University, Stanford, CA, USA.,Gendered Innovations in Science, Health and Medicine, Engineering, and Environment, Stanford, CA, USA
| |
Collapse
|
17
|
Luong VTT, Ho C, Aedo-Lopez V, Segelov E. Gender profile of principal investigators in a large academic clinical trials group. Front Surg 2022; 9:962120. [PMID: 35923437 PMCID: PMC9339678 DOI: 10.3389/fsurg.2022.962120] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Accepted: 07/04/2022] [Indexed: 11/25/2022] Open
Abstract
Introduction Gender equity in medicine has become a significant topic of discussion due to consistently low female representation in academia and leadership roles. Gender imbalance directly affects patient care. This study examined the gender and craft group of the Principal Investigators (PI) of clinical trials run by the Australasian Gastro-Intestinal Trials Group (AGITG) Methods Publicly available data was obtained from the AGITG website. Trials were divided into upper, lower gastrointestinal cancer, miscellaneous (neuroendocrine and gastrointestinal stromal tumours). Where multiple PIs were listed, all were counted. Craft group was assigned as surgical, medical, radiation oncology or other. Results There were 69 trials with 89 PI, where 52 trials were represented exclusively by male PIs. Of all PIs, 18 were women (20.2%); all were medical oncologists. Prior to 2005, all PIs were male. The craft group distribution of PIs was: 79% medical oncologists, 12% surgical oncologists, 8% radiation oncologist, 1% nuclear medicine physicians. Regarding trials with multiple PI's, there were 19 in total. Of these, 11 had only male PIs, which included 5 surgeons. Females were more likely to be a co-PI (42%) as opposed to sole PI (18%). There was no gender policy publicly available on the AGITG website. Conclusions There is a low percentage of female PIs in academic oncology trials in the portfolio of this large international trials group. No trial was led by a female surgical or radiation oncologist. There is a need to understand the reasons driving the disparity so that specific strategies can be put in place.
Collapse
Affiliation(s)
- Vi Thi Thao Luong
- Oncology Department, Monash Health, Melbourne VICAustralia
- Correspondence: Dr Vi Thi Thao Luong
| | - Cindy Ho
- School of Clinical Sciences, Monash University, Melbourne, VIC, Australia
| | | | - Eva Segelov
- Oncology Department, Monash Health, Melbourne VICAustralia
- School of Clinical Sciences, Monash University, Melbourne, VIC, Australia
| |
Collapse
|
18
|
Jarman AF, Hobgood CD, Madsen TE. Moving Beyond Gender Disparities: A Call to Action for Gender Parity and Equity. Ann Emerg Med 2022; 80:65-67. [PMID: 35717113 PMCID: PMC10046989 DOI: 10.1016/j.annemergmed.2022.05.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Indexed: 11/17/2022]
Affiliation(s)
- Angela F Jarman
- Department of Emergency Medicine, University of California-Davis School of Medicine, Sacramento, CA.
| | - Cherri D Hobgood
- Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis, IN
| | - Tracy E Madsen
- Department of Emergency Medicine, Alpert Medical School of Brown University, Providence, RI
| |
Collapse
|
19
|
Pinho-Gomes AC, Vassallo A, Woodward M, Peters S. Cross-sectional study of the relationship between women's representation among editors and peer reviewers in journals of the British Medical Journal Publishing Group. BMJ Open 2022; 12:e061054. [PMID: 35551081 PMCID: PMC9109081 DOI: 10.1136/bmjopen-2022-061054] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVES To investigate whether there is an association between women's representation as peer reviewers and editors of medical journals. METHODS In this cross-sectional study, the gender of editors and peer reviewers of journals of the British Medical Journal Publishing Group (BMJ-PG) in 2020 was determined based on given names. Trends over time were analysed for the BMJ between 2009 and 2017. RESULTS Overall, this study included 47 of the 74 journals in the BMJ-PG. Women accounted for 30.2% of the 42 539 peer reviewers, with marked variation from 8% to 50%. Women represented 33.4% of the 555 editors, including 19.2% of the 52 editors-in-chief. There was a moderate positive correlation between the percentage of women as editors and as reviewers (Spearman correlation coefficient 0.590; p<0.0001). The percentage of women as editors, excluding editors-in-chief, was higher when the editor-in-chief was a woman than a man (53.3% vs 29.2%, respectively; p<0.0001). Likewise, the percentage of women as peer reviewers was higher in journals that had a woman as editor-in-chief in comparison with a man (32.0% vs 26.4%, respectively; p<0.0001). There was a slight increase in the percentage of women as peer reviewers from 27.3% in 2009 to 29.7% in 2017 in the BMJ. CONCLUSIONS Women account for less than one in three peer reviewers of medical journals. Women's representation as peer reviewers is higher in journals with higher percentage of women as editors or with a woman as editor-in-chief. It is, thus, imperative to address the persisting gender gap at all levels of the publishing system.
Collapse
Affiliation(s)
- Ana-Catarina Pinho-Gomes
- The George Institute for Global Health, Imperial College London, London, UK
- School of Life Course & Population Sciences, King's College London, London, UK
| | - Amy Vassallo
- The George Institute for Global Health, University of New South Wales, Sidney, New South Wales, Australia
| | - Mark Woodward
- The George Institute for Global Health, Imperial College London, London, UK
- The George Institute for Global Health, University of New South Wales, Sidney, New South Wales, Australia
| | - Sanne Peters
- The George Institute for Global Health, Imperial College London, London, UK
- The George Institute for Global Health, University of New South Wales, Sidney, New South Wales, Australia
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| |
Collapse
|
20
|
Myatra SN, Gangakhedkar G. Gender balance in anaesthesia: Examining the glass ceiling for cracks. TRENDS IN ANAESTHESIA AND CRITICAL CARE 2022. [DOI: 10.1016/j.tacc.2022.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
21
|
Lew LA, Williams JS, Stone JC, Au AKW, Pyke KE, MacDonald MJ. Examination of Sex-Specific Participant Inclusion in Exercise Physiology Endothelial Function Research: A Systematic Review. Front Sports Act Living 2022; 4:860356. [PMID: 35399599 PMCID: PMC8990239 DOI: 10.3389/fspor.2022.860356] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Accepted: 02/23/2022] [Indexed: 11/19/2022] Open
Abstract
Background To combat historical underrepresentation of female participants in research, guidelines have been established to motivate equal participation by both sexes. However, the pervasiveness of female exclusion has not been examined in vascular exercise physiology research. The purpose of this study was to systematically quantify the sex-specific prevalence of human participants and identify the rationales for sex-specific inclusion/exclusion in research examining the impact of exercise on vascular endothelial function. Methods A systematic search was conducted examining exercise/physical activity and vascular endothelial function, assessed via flow mediated dilation. Studies were categorized by sex: male-only, female-only, or mixed sex, including examination of the sample size of males and females. Analysis was performed examining sex-inclusion criteria in study design and reporting and rationale for inclusion/exclusion of participants on the basis of sex. Changes in proportion of female participants included in studies were examined over time in 5 year cohorts. Results A total of 514 studies were identified, spanning 26 years (1996–2021). Of the total participants, 64% were male and 36% were female, and a male bias was identified (32% male-only vs. 12% female-only studies). Proportions of female participants in studies remained relatively constant in the last 20 years. Male-only studies were less likely to report sex in the title compared to female-only studies (27 vs. 78%, p < 0.001), report sex in the abstract (72 vs. 98%, p < 0.001) and justify exclusion on the basis of sex (15 vs. 55%, p < 0.001). Further, male-only studies were more likely to be conducted in healthy populations compared to female-only studies (p = 0.002). Qualitative analysis of justifications identified four themes: sex-specific rationale or gap in the literature, exclusion of females based on the hormonal cycle or sex-differences, maintaining congruence with the male norm, and challenges with recruitment, retention and resources. Conclusions This systematic review provides the first analysis of sex-based inclusion/exclusion and rationale for sex-based decisions in human vascular exercise physiology research. These findings contribute to identifying the impact of research guidelines regarding inclusion of males and females and the perceived barriers to designing studies with equal sex participation, in an effort to increase female representation in vascular exercise physiology research. Systematic Review Registration: CRD42022300388.
Collapse
Affiliation(s)
- Lindsay A. Lew
- Cardiovascular Stress Response Lab, School of Kinesiology and Health Studies, Queen's University, Kingston, ON, Canada
| | - Jennifer S. Williams
- Vascular Dynamics Lab, Department of Kinesiology, McMaster University, Hamilton, ON, Canada
| | - Jenna C. Stone
- Vascular Dynamics Lab, Department of Kinesiology, McMaster University, Hamilton, ON, Canada
| | - Alicia K. W. Au
- Vascular Dynamics Lab, Department of Kinesiology, McMaster University, Hamilton, ON, Canada
| | - Kyra E. Pyke
- Cardiovascular Stress Response Lab, School of Kinesiology and Health Studies, Queen's University, Kingston, ON, Canada
| | - Maureen J. MacDonald
- Vascular Dynamics Lab, Department of Kinesiology, McMaster University, Hamilton, ON, Canada
- *Correspondence: Maureen J. MacDonald
| |
Collapse
|
22
|
Dada S, van Daalen KR, Barrios-Ruiz A, Wu KT, Desjardins A, Bryce-Alberti M, Castro-Varela A, Khorsand P, Santamarta Zamorano A, Jung L, Malolos G, Li J, Vervoort D, Hamilton NC, Patil P, El Omrani O, Wangari MC, Sibanda T, Buggy C, Mogo ERI. Challenging the "old boys club" in academia: Gender and geographic representation in editorial boards of journals publishing in environmental sciences and public health. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0000541. [PMID: 36962476 PMCID: PMC10021803 DOI: 10.1371/journal.pgph.0000541] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Accepted: 05/05/2022] [Indexed: 11/19/2022]
Abstract
In light of global environmental crises and the need for sustainable development, the fields of public health and environmental sciences have become increasingly interrelated. Both fields require interdisciplinary thinking and global solutions, which is largely directed by scientific progress documented in peer-reviewed journals. Journal editors play a critical role in coordinating and shaping what is accepted as scientific knowledge. Previous research has demonstrated a lack of diversity in the gender and geographic representation of editors across scientific disciplines. This study aimed to explore the diversity of journal editorial boards publishing in environmental science and public health. The Clarivate Journal Citation Reports database was used to identify journals classified as Public, Environmental, and Occupational (PEO) Health, Environmental Studies, or Environmental Sciences. Current EB members were identified from each journal's publicly available website between 1 March and 31 May 2021. Individuals' names, editorial board roles, institutional affiliations, geographic locations (city, country), and inferred gender were collected. Binomial 95% confidence intervals were calculated for the proportions of interest. Pearson correlations with false discovery rate adjustment were used to assess the correlation between journal-based indicators and editorial board characteristics. Linear regression and logistic regression models were fitted to further assess the relationship between gender presence, low- and middle-income country (LMIC) presence and several journal and editor-based indicators. After identifying 628 unique journals and excluding discontinued or unavailable journals, 615 journal editorial boards were included. In-depth analysis was conducted on 591 journals with complete gender and geographic data for their 27,772 editors. Overall, the majority of editors were men (65.9%), followed by women (32.9%) and non-binary/other gender minorities (0.05%). 75.5% journal editorial boards (n = 446) were composed of a majority of men (>55% men), whilst only 13.2% (n = 78) demonstrated gender parity (between 45-55% women/gender minorities). Journals categorized as PEO Health had the most gender diversity. Furthermore, 84% of editors (n = 23,280) were based in high-income countries and only 2.5% of journals (n = 15) demonstrated economic parity in their editorial boards (between 45-55% editors from LMICs). Geographically, the majority of editors' institutions were based in the United Nations (UN) Western Europe and Other region (76.9%), with 35.2% of editors (n = 9,761) coming solely from the United States and 8.6% (n = 2,373) solely from the United Kingdom. None of the editors-in-chief and only 27 editors in total were women based in low-income countries. Through the examination of journal editorial boards, this study exposes the glaring lack of diversity in editorial boards in environmental science and public health, explores the power dynamics affecting the creation and dissemination of knowledge, and proposes concrete actions to remedy these structural inequities in order to inform more equitable, just and impactful knowledge creation.
Collapse
Affiliation(s)
- Sara Dada
- UCD Centre for Interdisciplinary Research, Education and Innovation in Health Systems, School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland
| | - Kim Robin van Daalen
- Department of Public Health and Primary Care, Cardiovascular Epidemiology Unit, Cambridge University, Cambridge, United Kingdom
| | - Alanna Barrios-Ruiz
- Escuela de Medicina y Ciencias de la Salud, Tecnológico de Monterrey, Monterrey, México
| | - Kai-Ti Wu
- Leibniz Institute for Freshwater Ecology and Inland Fisheries, Berlin, Germany
- Faculty of Mathematics and Natural Science, Department of Geography, Humboldt University of Berlin, Berlin, Germany
| | - Aidan Desjardins
- Department of Microbiology, School of Genetics and Microbiology, Moyne Institute of Preventive Medicine, Trinity College Dublin, Dublin, Ireland
| | | | | | - Parnian Khorsand
- Women in Global Health, Washington, District of Columbia, United States of America
| | | | - Laura Jung
- Leipzig University, Medical Faculty, Leipzig, Germany
| | - Grace Malolos
- College of Medicine, University of the Philippines Manila, Manila, Philippines
| | - Jiaqi Li
- University of Cambridge, School of Clinical Medicine, Addenbrooke's Hospital, Cambridge, United Kingdom
| | - Dominique Vervoort
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Nikita Charles Hamilton
- NCH Strategy Group, Nassau, The Bahamas
- The Department of Environmental Planning and Protection (DEPP), Nassau, Bahamas
| | - Poorvaprabha Patil
- Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | | | | | - Telma Sibanda
- Zimbabwe Red Cross Society, Harare, Gokwe South and North, Zimbabwe
| | - Conor Buggy
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Ebele R I Mogo
- MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| |
Collapse
|
23
|
El Bairi K, Al Jarroudi O, Afqir S. Practical Tools and Guidelines for Young Oncologists From Resource-Limited Settings to Publish Excellence and Advance Their Career. JCO Glob Oncol 2021; 7:1668-1681. [PMID: 34910583 PMCID: PMC8691496 DOI: 10.1200/go.21.00310] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 10/07/2021] [Accepted: 11/02/2021] [Indexed: 02/05/2023] Open
Abstract
Cancer research is evolving worldwide. However, publishing high-quality academic literature in oncology remains challenging for authors in the developing world. Young oncologists in low- and middle-income countries experience several barriers including lack of funding and research facilities, as well as inadequate training. Publication best practices, science integrity, and ethics are required to improve oncology research quality and therefore, improve patients' care in these countries. To achieve this goal, we propose some basic principles and tools that may help young oncologists especially in developing countries overcome these issues and boost their academic careers.
Collapse
Affiliation(s)
- Khalid El Bairi
- Department of Medical Oncology, Mohammed VI University Hospital, Oujda, Morocco
- Faculty of Medicine and Pharmacy, Mohammed Ist University, Oujda, Morocco
| | - Ouissam Al Jarroudi
- Department of Medical Oncology, Mohammed VI University Hospital, Oujda, Morocco
- Faculty of Medicine and Pharmacy, Mohammed Ist University, Oujda, Morocco
| | - Said Afqir
- Department of Medical Oncology, Mohammed VI University Hospital, Oujda, Morocco
- Faculty of Medicine and Pharmacy, Mohammed Ist University, Oujda, Morocco
| |
Collapse
|
24
|
Gurung D, Sangraula M, Subba P, Poudyal A, Mishra S, Kohrt BA. Gender inequality in the global mental health research workforce: a research authorship scoping review and qualitative study in Nepal. BMJ Glob Health 2021; 6:e006146. [PMID: 34880061 PMCID: PMC8655556 DOI: 10.1136/bmjgh-2021-006146] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 11/09/2021] [Indexed: 12/16/2022] Open
Abstract
INTRODUCTION Although women's health is prioritised in global research, few studies have identified structural barriers and strategies to promote female leadership and gender equality in the global health research workforce, especially in low-income and middle-income countries. METHODS We conducted a mixed-methods study to evaluate gender equality in the mental health research workforce in Nepal. The scoping review assessed gender disparities in authorship of journal publications for Nepal mental health research, using databases (PsycINFO, PubMed, Web of Science, NepJol, NepMed) for 5 years. Qualitative interviews were conducted with 22 Nepali researchers to identify structural barriers limiting women's leadership. RESULTS Of 337 articles identified, 61% were by Nepali first authors. Among Nepali first authors, 38.3% were women. Nepali women had half the odds of being first authors compared with men, when referenced against non-Nepali authors (OR 0.50, 95% CI 1.30 to 3.16). When limiting publications to those based on funded research, the odds were worse for first authorship among Nepali women (OR 0.37, 95% CI 0.19 to 0.71). The qualitative analysis supported the scoping review and identified a lack of gender-friendly organisational policies, difficulties in communication and mobility, and limited opportunities for networking as barriers to women's leadership in global health research. CONCLUSION Efforts are needed for greater representation of Nepali women in global mental health research, which will require transformative organisational policies to foster female leadership. Those in leadership need to recognise gender inequalities and take necessary steps to address them. Funding agencies should prioritise supporting organisations with gender equality task forces, policies and indicators.
Collapse
Affiliation(s)
| | - Manaswi Sangraula
- Department of Psychology, New School for Social Research, New York, New York, USA
| | | | - Anubhuti Poudyal
- Department of Sociomedical Sciences, Columbia University, New York, New York, USA
| | - Shelly Mishra
- Division of Global Mental Health, The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA
| | - Brandon A Kohrt
- Division of Global Mental Health, The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA
| |
Collapse
|
25
|
Vassallo A, Dunbar K, Ajuwon B, Lowbridge C, Kirk M, King C, Sheel M. Assessing the impact of polio supplementary immunisation activities on routine immunisation and health systems: a systematic review. BMJ Glob Health 2021; 6:bmjgh-2021-006568. [PMID: 34776411 PMCID: PMC8593720 DOI: 10.1136/bmjgh-2021-006568] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 10/12/2021] [Indexed: 12/23/2022] Open
Abstract
Introduction The Global Polio Eradication Initiative uses polio supplementary immunisation activities (SIAs) as a strategy to increase vaccine coverage and cease poliovirus transmission. Impact of polio SIAs on immunisation systems is frequently debated. We reviewed the impact of polio SIAs on routine immunisation and health systems during the modern era of polio eradication. Methods We searched nine databases for studies reporting on polio SIAs and immunisation coverage, financial investment, workforce and health services delivery. We conducted a narrative synthesis of evidence. Records prior to 1994, animal, modelling or case studies data were excluded. Results 20/1637 unique records were included. Data on vaccine coverage were included in 70% (14/20) studies, workforce in 65% (13/20) and health services delivery in 85% (17/20). SIAs positively contributed to vaccination uptake of non-polio vaccines in seven studies, neutral in three and negative in one. Some polio SIAs contributed to workforce strengthening through training and capacity building. Polio SIAs were accompanied with increased social mobilisation and community awareness building confidence in vaccination programmes. Included studies were programmatic in nature and contained variable data, thus could not be justly critically appraised. Conclusion Polio SIAs are successful at increasing polio vaccine coverage, but the resources and infrastructures were not always utilised for delivery of non-polio vaccines and integration into routine service delivery. We found a gap in standardised tools to evaluate SIAs, which can then inform service integration. Our study provides data to inform SIAs evaluations, and provides important considerations for COVID-19 vaccine roll-out to strengthen health systems. PROSPERO registration number CRD42020152195.
Collapse
Affiliation(s)
- Amy Vassallo
- The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia.,Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Kimberly Dunbar
- National Centre for Epidemiology and Population Health, ANU College of Health and Medicine, The Australian National University, Canberra, Australian Capital Territory, Australia
| | - Busayo Ajuwon
- National Centre for Epidemiology and Population Health, ANU College of Health and Medicine, The Australian National University, Canberra, Australian Capital Territory, Australia
| | - Christopher Lowbridge
- Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
| | - Martyn Kirk
- National Centre for Epidemiology and Population Health, ANU College of Health and Medicine, The Australian National University, Canberra, Australian Capital Territory, Australia
| | - Catherine King
- The Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.,National Centre for Immunisation Research and Surveillance, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - Meru Sheel
- National Centre for Epidemiology and Population Health, ANU College of Health and Medicine, The Australian National University, Canberra, Australian Capital Territory, Australia
| |
Collapse
|
26
|
Dessie A, Alvarez A, Lewiss RE. Standardizing terminology in academic medical journals: understanding sex and gender. Eur J Emerg Med 2021; 28:331-332. [PMID: 34433787 DOI: 10.1097/mej.0000000000000869] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- Almaz Dessie
- Department of Emergency Medicine, Columbia University Vagelos College of Physicians and Surgeons, New York, New York
| | - Al'ai Alvarez
- Department of Emergency Medicine, Stanford University School of Medicine, Stanford, California
| | - Resa E Lewiss
- Department of Emergency Medicine, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| |
Collapse
|
27
|
Evagora-Campbell M, Borkotoky K, Sharma S, Mbuthia M. From routine data collection to policy design: sex and gender both matter in COVID-19. Lancet 2021; 397:2447-2449. [PMID: 34118998 PMCID: PMC8192088 DOI: 10.1016/s0140-6736(21)01326-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 06/03/2021] [Indexed: 12/17/2022]
Affiliation(s)
| | | | - Sneha Sharma
- International Center for Research on Women, New Delhi, India
| | | |
Collapse
|
28
|
Hasan BS, Rasheed MA, Wahid A, Kumar RK, Zuhlke L. Generating Evidence From Contextual Clinical Research in Low- to Middle Income Countries: A Roadmap Based on Theory of Change. Front Pediatr 2021; 9:764239. [PMID: 34956976 PMCID: PMC8696471 DOI: 10.3389/fped.2021.764239] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 11/18/2021] [Indexed: 11/24/2022] Open
Abstract
Along with inadequate access to high-quality care, competing health priorities, fragile health systems, and conflicts, there is an associated delay in evidence generation and research from LMICs. Lack of basic epidemiologic understanding of the disease burden in these regions poses a significant knowledge gap as solutions can only be developed and sustained if the scope of the problem is accurately defined. Congenital heart disease (CHD), for example, is the most common birth defect in children. The prevalence of CHD from 1990 to 2017 has progressively increased by 18.7% and more than 90% of children with CHD are born in Low and Middle-Income Countries (LMICs). If diagnosed and managed in a timely manner, as in high-income countries (HICs), most children lead a healthy life and achieve adulthood. However, children with CHD in LMICs have limited care available with subsequent impact on survival. The large disparity in global health research focus on this complex disease makes it a solid paradigm to shape the debate. Despite many challenges, an essential aspect of improving research in LMICs is the realization and ownership of the problem around paucity of local evidence by patients, health care providers, academic centers, and governments in these countries. We have created a theory of change model to address these challenges at a micro- (individual patient or physician or institutions delivering health care) and a macro- (government and health ministries) level, presenting suggested solutions for these complex problems. All stakeholders in the society, from government bodies, health ministries, and systems, to frontline healthcare workers and patients, need to be invested in addressing the local health problems and significantly increase data to define and improve the gaps in care in LMICs. Moreover, interventions can be designed for a more collaborative and effective HIC-LMIC and LMIC-LMIC partnership to increase resources, capacity building, and representation for long-term productivity.
Collapse
Affiliation(s)
- Babar S Hasan
- Department of Paediatrics and Child Health, Aga Khan University, Karachi, Pakistan
| | - Muneera A Rasheed
- Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Asra Wahid
- Department of Paediatrics and Child Health, Aga Khan University, Karachi, Pakistan
| | | | - Liesl Zuhlke
- Division of Pediatric Cardiology, Department of Pediatrics, Red Cross Children's Hospital, University of Cape Town, Cape Town, South Africa.,Division of Cardiology, Department of Medicine, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa
| |
Collapse
|