Gender inequality in the authorship of medical articles: Analysis of Medicina Clínica, 1999 and 2014

Padilla-Navas, Isabel; Soler Sempere, María José; Zamora Molina, Lucía; García-Pachón, Eduardo
doi:10.1016/j.medcle.2016.04.011
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Women constitute a high percentage of professionals both in clinical activity and biomedical research&#46;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">1</span></a> However&#44; several international studies have indicated that there is inequality in the proportion of women in the authorship of medical publications&#44; but with a progressive increase in participation&#46;<a class="elsevierStyleCrossRefs" href="#bib0045"><span class="elsevierStyleSup">2&#44;3</span></a> In Spain&#44; Schiaffino et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">4</span></a> analysed the articles published by women in 1998 in 4 magazines and observed great differences&#59; depending on the journal&#44; between 9&#37; and 39&#37; of the first signatories were women&#44; being <span class="elsevierStyleSmallCaps">Medicina Cl&#237;nica</span> the magazine with more female participation&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">One might assume that inequality in women&#39;s authorship is being progressively resolved &#40;in recent years&#44; they have increased as first authors&#41;&#46; However&#44; a detailed analysis shows that in positions that could indicate more prestige&#44; as the last signatory &#40;or senior author&#41; or the authorship of leading articles&#44; a female underrepresentation remains&#46;<a class="elsevierStyleCrossRefs" href="#bib0045"><span class="elsevierStyleSup">2&#44;3&#44;5</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">To evaluate the progression of female authors&#44; we have analysed 2 periods of <span class="elsevierStyleSmallCaps">Medicina Cl&#237;nica</span> data&#58; 1999 and 15 years later&#44; in 2014&#46; This magazine has the advantage of being multidisciplinary&#44; with a high annual volume of published articles&#46; The names of the signatories of articles published in 1999 and in 2014 were reviewed from the magazine&#39;s website &#40;<a id="intr0010" class="elsevierStyleInterRef" href="http://www.elsevier.es/es-revista-medicina-clinica-2-numeros-anteriores">http&#58;&#47;&#47;www&#46;elsevier&#46;es&#47;es-revista-medicina-clinica-2-numeros-anteriores</a>&#41;&#46; Book reviews and reports were excluded&#44; and the clinicopathological conferences and articles in images because the volumes of 1999 did not allow to identify the sex of the authors&#46; Regarding the other articles&#44; authorship could not be identified in 37 of the year 1999 &#40;excluding the analysis&#41;&#44; while all the articles of 2014 could be identified&#46; We analysed the total number of authors &#40;corresponds to the number of signatures&#44; so that the same author will appear as often as his&#47;her signature appears&#41;&#44; first and last signatory in the total number of documents&#44; and a separate analysis was performed for the published articles&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">As shown in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#44; there has been a significant increase in the number of women who sign articles &#40;in general&#41; and signatories as first and last authors&#46; However&#44; the occurrence of first and&#44; in particular&#44; last authors is disproportionately low for the number of female doctors registered in the years prior to the publication&#44;<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">6</span></a> when the articles were prepared&#58; women in 1998 were 36&#37; of registered doctors&#44; and in 2013&#44; 48&#37;&#46; When we look at the editorials&#44; potential indicators of the influence of authors in publications&#44; it is very striking to see that the small increase in women did not reach statistical significance&#44; being only 18&#37; as first author of an editorial&#44; very similar to what happened 15 years earlier&#46; This situation also occurs in other countries of our environment and it is not exclusive to medicine&#46;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">5</span></a> Although the reason for this deterioration of authorship figures &#40;number and position&#41; in the published documents has not been studied&#44; a possible lower participation in collaborative studies has been suggested&#44; less negotiating effort to occupy the authorship positions or even the possibility of a bias in the evaluation of articles&#46;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">5</span></a> However&#44; the main reason could be related to the fact that women continue to hold less visible and less prestigious positions or activities within healthcare when compared to men&#46;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">7</span></a> But it is also clear that&#44; at least in the editorials that are prepared at the invitation of the Editorial Board&#44; women are not usually included&#44; even though nowadays there are more women than men holding important clinical and teaching positions&#44; compared to the small percentage that signs the editorials&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0025" class="elsevierStylePara elsevierViewall">Our data shows that even in a magazine with high female authorship as <span class="elsevierStyleSmallCaps">Medicina Cl&#237;nica</span>&#44; the number of female authors is proportionally lower than those who participate in clinical research&#44; even though there has been a significant increase in these 15 years&#46; However&#44; in editorials&#44; women are clearly underrepresented&#46; Therefore&#44; serious consideration should be given in order to encourage an equitable share in these type of articles&#46;</p></span>"
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">465&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">301&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleItalic">Total no&#46; authors</span>&#44; <span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Men&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">543 &#40;30&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">492 &#40;43&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">182 &#40;60&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " rowspan="2" align="left" valign="top">&#60;0&#46;0001</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Women&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleItalic">Last author</span>&#44;<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a><span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Men&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " rowspan="2" align="left" valign="top">0&#46;0005</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Women&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleItalic">Editorials</span> &#40;<span class="elsevierStyleItalic">total no&#46; authors</span>&#41;&#44; <span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Men&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">80 &#40;85&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " rowspan="2" align="left" valign="top">NS</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Women&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleItalic">Editorials</span> &#40;<span class="elsevierStyleItalic">first author</span>&#41;&#44; <span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Men&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">55 &#40;85&#41;&nbsp;\t\t\t\t\t\t\n
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