KEY TAKEAWAYS

• Fewer than 1 in 3 peer reviewers for medical journal publications are women.
• Greater proportions of women peer reviewers are linked to journals with women editors.

The academic peer review system is key in deciding which research gets published. However, as in other areas of academic publishing, women are still under-represented in the peer review system. In a recent article published in BMJ Open, women accounted for under a third of peer reviewers for medical journals, and the gender of editors and editors-in-chief had an impact on this figure.

Dr Ana-Catarina Pinho-Gomes et al analysed the representation of women as peer reviewers and editors of the British Medical Journal Publishing Group. A software-based analysis of given names for over 42,000 peer reviewers for 47 journals found that only 30% were women. Similarly, women made up around one-third of journal editors, but fewer than one-fifth of the editors-in-chief. Journals with a woman editor-in-chief had a greater percentage of women peer reviewers (32% versus 26% for journals with a male editor-in-chief).

Journals with a woman editor-in-chief had a greater percentage of women peer reviewers (32% versus 26% for journals with a male editor-in-chief).

With reference to other analyses, the authors noted that under-representation of women as peer reviewers is even more pronounced for other publishers, including in fields with predominantly women researchers.

The authors proposed a number of potential contributory factors, including:

• unconscious gender affinity bias
• men are over-represented in senior academic roles, making them more visible to an editor when nominating reviewers
• women are disproportionately burdened with invisible workloads, both in and out of work. This phenomenon has been both highlighted and exacerbated by the COVID-19 pandemic, during which there was a decrease in peer review acceptances by women but not by men.

The authors condemned a disappointing lack of change over time, advocating for promotion of gender equity in the pool of peer reviewers. They invite researchers, institutions, and publishing bodies to actively reflect on current practices and to expose any unfair behaviours identified.

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KEY TAKEAWAYS

• Estimated publication output of women was lower than that of men following the start of the COVID-19 pandemic.
• The gender gap was largest for productive scientists working in clinical medicine and biology.

High publication productivity is essential for furthering careers in academia. Gender disparity in publication output is a notable problem, with women traditionally publishing fewer articles than men on average. The reasons for this are multifactorial and vary by career stage, discipline, and country. Until recently, the gender gap in publication productivity was slowly diminishing; however, new evidence indicates that the COVID-19 pandemic has reversed this trend.

Recent meta-research from Dr Emil Bargmann Madsen and colleagues, published in eLife, quantified the impact of COVID-19 on the publishing rates of women and men. Using individual-level panel data on a global sample of more than 2 million publications from over 430,000 authors, the researchers found the following:

• The estimated output of women was 17% and 24% lower than that of men in 2019 (pre-pandemic) and 2020 (post-pandemic), respectively.
• The widening gender gap post-pandemic was evident for both early- and mid-career scientists, with the largest relative change in the former group.
• The increase in the gender gap was most pronounced among highly productive scientists working in clinical medicine and biology.
• Women continued to first-author publications at similar rates as in previous years, indicating a decrease in productivity rather than a shift in author roles.

The authors offer several reasons for the apparent increase in gender disparity following the start of the COVID-19 pandemic. For example, men with highest productivity may have been rewarded with access to additional workplace support, cushioning them against the impact of the pandemic. Additionally, high-achieving women scientists may have been more likely than men to allow their partner’s careers to take priority during the difficult months, which could have driven some of the differences observed.

“ The publication productivity of already prolific women scientists has been affected the most by the pandemic.”

Overall, the widening gender gap in publishing rates in the post-pandemic era is concerning, because it reflects an underlying disparity in the opportunity to succeed in science that is exacerbated by external factors. The authors call for universities, funding agencies, and policy makers to allocate resources and support to mitigate inequities resulting from the unequal disruption caused by the pandemic.

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KEY TAKEAWAYS

• In an analysis of >5,500 papers from top medical journals, articles with female primary and senior authors attracted half as many citations as did similar articles authored by men.
• Fewer citations may unfavourably impact female researchers’ career progression.

A study published in JAMA  Network Open has highlighted large gender disparities in academic medicine research, finding that papers authored by females receive significantly fewer citations than those authored by males.

Drs Paula Chatterjee and Rachel Werner evaluated citation data for 5,554 articles published in 5 prestigious medical journals between 2015–2018, using Genderize to assign gender to authors’ names. They found that original research articles with female primary or senior authorship attracted a third or a quarter fewer median citations than those with men as primary or senior authors, respectively. The trend was more pronounced when women wrote together as primary and senior authors – these articles had approximately half as many median citations as those with male primary and senior authors.

Dr Chatterjee suggests that gender bias in citations is likely unintentional and due to the higher visibility of men in the medical field and on social media. 

These patterns can have considerable impact on a researcher’s career progression. Because citations are often used as a measure of an article’s importance and an indicator of a researcher’s productivity, women may be at a disadvantage if their work is less widely disseminated. Gender disparities in academic medicine are well acknowledged; females have reported that they are less likely to be promoted, even when accomplishing the same research output as men of a similar career stage. Peer recognition, of which citations are one measure, is a key component of professional advancement for researchers.

Dr Chatterjee suggests that gender bias in citations is likely unintentional and due to the higher visibility of men in the medical field and on social media. The authors offered three suggestions for how to address this:

• Women should be encouraged to publish their research as open access; articles published without paywalls tend to receive more citations.
• Editors should measure and track the diversity of authors publishing in their journals and ensure equal promotion.
• Academic institutions should invest in mentoring female researchers and promote the increased representation of women.

While female representation in academic medicine has been increasing since 2009, the study highlights the ongoing barriers to career progression and recognition faced by women in the field.

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In academia, decisions regarding hiring, promotion, and tenure are often based on traditional evaluation metrics, such as citation counts and grant allocations, which have been found to disproportionately favour men. Altmetrics, on the other hand, measure the amount of online attention a paper receives on digital platforms, such as news sites and social media, and many journals now publish the Altmetric Attention Score (AAS) for individual journal articles.

Thanks to the broad nature of online audiences, altmetrics could effectively democratise research evaluation. To test this theory, the study by Fortin et al, published in Scientometrics, analysed the AAS of over 200,000 articles published between 2011–2018 in 7 major journals/preprint servers:

• Science
• PNAS
• PLOS One
• Nature
• Cell
• NEJM
• bioRχiv.

The authors found that articles by male and female authors generally received equal online attention one year after publication. The exception to this was in 2018, when marked gender bias against women was found in Science, the reasons for which are unknown.

By using altmetrics together with traditional citation-based metrics, a fairer, more equitable system for performance evaluation could be established for academics, whatever their gender.

The authors state that further research is required to determine why altmetrics did not show evidence of substantial gender bias for most journals. Understanding the underlying reasons may help to identify mechanisms that could be applied to eliminate bias from other performance assessment tools. The authors conclude that by using altmetrics together with traditional citation-based metrics, a fairer, more equitable system for performance evaluation could be established for academics, whatever their gender.

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Women are systematically under-represented in academic publishing as authors, referees and editors. But does the peer review system play a role in the publication gender gap? According to a recent study published in Science Advances, manuscripts submitted or co-authored by women are generally not penalised in the peer review process, and those with all-women or cross-gender author lists actually have a higher probability of being published.

Professor Flaminio Squazzoni and colleagues analysed data from almost 350,000 manuscript submissions to 145 journals across biomedicine and health, physical sciences, life sciences, social sciences and humanities. Most of the submitting authors (75%) and referees (79%) were men, supporting previous research on the gender disparity in publications.

Three possible sources of bias were investigated:

• Editorial selection of referees: manuscripts with a higher proportion of women among the authors were more likely to be reviewed by women. The authors note that this may be an intentional journal preference, or could reflect gender disparity in expert referee roles.
• Referee recommendations: manuscripts authored by women received more positive reviews in some fields of research. This could reflect manuscript quality: the authors highlight previous studies suggesting that women invest more in their manuscripts to overcome expected editorial bias. For all but one of the research fields, women referees provided more positive recommendations than men.
• Editorial decisions: in some fields, manuscripts with a higher proportion of woman authors were more likely to be accepted, but there was no systematic bias against manuscripts submitted by women across the journals and disciplines analysed.

Overall, Professor Squazzoni and colleagues found that manuscripts submitted or co-authored by women were generally not penalised during the peer review process.

Manuscripts submitted or co-authored by women were generally not penalised during the peer review process.

However, these results do not mean that peer review and editorial processes are free from bias. Factors such as age, ethnicity, or institutional prestige could influence editorial processes and have gender implications. Moving forward, the authors suggest that greater gender diversity in editorial teams and referee pools could help promote inclusion and participation of women.

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11 February 2019 marks the 4th International Day of Women and Girls in Science, an event led by United Nations (UN)-Women and the United Nations Educational, Scientific and Cultural Organization (UNESCO). The day promotes the involvement of women and girls in science, technology, engineering and mathematics (STEM).

Gender bias in medical publishing is an issue we’ve covered several times; from under-representation of women as authors and editors, to bias in the selection of peer reviewers. Reports indicate that this lack of gender parity begins early in academic publishing careers and currently only 28% of the world’s researchers are women. Gender bias also affects rates of ‘prestigious’ authorships — such as final or corresponding author, or authorship of articles published in high impact factor journals — and women are less likely than men to win awards for their research.

The UN and UNESCO highlight that addressing gender parity in STEM not only promotes full and equal access for women and girls but, through their increased inclusion, can ‘unlock innovation’ in the field. This theme is also emphasised by The Lancet in a new issue in their Lancet Women series. This year, the UN is holding a two-day forum entitled ‘Investment in Women in Science for Inclusive Green Growth’, to highlight the role that women and girls can play in achieving sustainable development goals, discuss best practice for investment in women in this area, and hear the perspectives of advocates for women and girls in science from around the world.

Get involved! Take a look at the A–Z of ways to take action now. Online, follow the ongoing movement @WomenScienceDay and join the conversation using #WomenInScience, #ChooseScience and #February11.

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Summary by Beatrice Tyrrell, DPhil from Aspire Scientific

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With thanks to our sponsors, Aspire Scientific Ltd and NetworkPharma Ltd

Peer review can be a source of frustration among researchers, potentially delaying publication and or biasing editorial decisions. However, in a recent article published by The New York Times, Professor Aaron E. Carroll, an editor at JAMA Pediatrics, argues that, “Throwing out the system — which deems whether research is robust and worth being published — would do more harm than good.”

Professor Carroll takes a look at the system’s weaknesses and provides some ideas for how to improve peer review. He acknowledges that reviewers often receive no specific training and may be overworked. He also highlights that peer review is not always consistent, drawing attention to a study published in 1982, in which 8 out of 12 previously published papers were rejected when resubmitted to the same journals 18–32 months later. He suggests that innovative research may face challenges surviving peer review and discusses the various biases that can occur during the review process, including gender bias.

Professor Carroll lists formal training, payment and incentives for reviewers, blinded peer review and public judgement of preprints as just some ideas for improving the system. He goes on to explain how the submission process is handled at JAMA Pediatrics, including how the journal follows the subsequent outcomes for rejected papers, as a way of reviewing and checking their own processes. Ultimately, he argues that we need to change how peer review is regarded, with it (and publication) as “steps on the road to assurance, not a final stamp of approval”. Indeed, studies have noted the value of peer review and its importance in improving the aspects of medical research that readers rely on most heavily to evaluate published findings, including the discussion of study limitations, generalisations, and use of confidence intervals. The onus may then be on the research community to conduct continued appraisal of the literature through post-publication peer-review.

Note: There is a poll embedded within this post, please visit the site to participate in this post's poll.

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Summary by Louise Niven DPhil, CMPP from Aspire Scientific

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With thanks to our sponsors, Aspire Scientific Ltd and NetworkPharma Ltd

Women are responsible for some of the most important medical and scientific breakthroughs in history, but gender bias continues to be a significant problem within STEMM (science, technology, engineering, mathematics and medicine). The view is similar in medical publishing, with women publishing at lower rates, less likely to be peer reviewers or last name authors (especially in high-tier journals), and under-represented at senior levels of medical research.

Thursday 8th March is International Women’s Day 2018 (#IWD2018). This global event aims to celebrate women’s achievements and accelerate gender parity (which is currently estimated as over 217 years away!). This year’s theme is #PressforProgress and medical, science, and publications professionals across the globe are getting involved. Here are just some of the places you can find out more:

• International Women’s Day: reflections from three women in science (Cancer Research UK)
• International Women’s Day: why is it important to FSG? (Future Science Group)
• International Women’s Day: women that pressed for progress (BMC Blog Network)
• Women who changed the word (Nobel Prize)
• International Women’s Day 2018 (Fishawack)
• Celebrating International Women’s Day: who is your inspirational hero? (Future Science Group)
• Opinion: how to tackle the childcare–conference conundrum (PNAS)
• International Women’s Day (epgonline)
• When computers were human: the black women behind NASA’s success (The New Scientist)
• Male Champions of Change
• International Women’s Day 2018 – supporting equity in the physical sciences (Nature)

With events being held worldwide and a multitude of discussions taking place online, you can join the conversation via #IWD2018 and #PressforProgress.

Meaningful change takes more than a day though — how will you press for progress in your field?

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By Aspire Scientific, an independent medical writing agency led by experienced editorial team members, and supported by MSc and/or PhD-educated writers

Gender bias is inherent in scholarly systems. Men publish at higher rates and receive more peer review invitations than women, while male PhD-educated scientists are more likely than their female counterparts to pursue tenure-track positions in academia. However, as recently reported by Inside Higher Ed, little effort has been spent trying to understand when and how gender bias in publishing originates – until now.

A new study of 1,285 recently-graduated doctoral students from an undisclosed US ‘Big Ten’ institute found that male students submitted, published and first-authored more papers than their female peers. Surprisingly, as well as being observed in male-dominated engineering and physical sciences, these gaps existed in more gender-balanced disciplines and in some potentially more female-dominated fields, such as social sciences and applied health. Preferential faculty support for males, differing career goals and the quality of student–supervisor relationships were all cited as reasons behind the gender gap. Higher levels of  research assistantships among males and of teaching roles among females were also potential contributing factors. Interestingly, this study has been backed by doctoral students from Boston University, many of whom believe the same trend exists at their institution.

These data indicate that gender differences in publishing originate early on the academic career ladder. Lead author Sarah Theule Lubienski summarised the findings as “disturbing” and contests claims that the gender gap is closing in STEM (science, technology, engineering and mathematics) subjects. The study concludes that research institutions should do more to encourage women to publish, and recommends that further research is carried out to identify the most important forms of gender bias in medical and scientific publishing.

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Summary by Emma Prest PhD from Aspire Scientific