Authorship diversity in general surgery-related Cochrane systematic reviews: a bibliometric study

Despite efforts to address fundamental inequities, surgical residencies lag behind their non-surgical counterparts in attracting women 1 .Equity of representation in authorship is an important aspect of evidence-based medicine.This study analysed representation in authorship of general surgery-related Cochrane systematic reviews with respect to gender and country.Data were collected from the Cochrane Library on 3 September 2022, using the keyword 'general surgery' in an advanced search under the subheading 'All Text'.An online search was used to confirm the gender and country of an author, by discovering a minimum of two web pages (such as LinkedIn, institutional websites, Loop profile, junior editorial profile, and ResearchGate) demonstrating them.The corresponding authors were contacted when deemed necessary.Some 250 publications that included 1420 authors were included.Four authors had affiliations to two countries.The leading five nations represented in authorship were the UK (562, 39.4 per cent), China (163, 11.5 per cent), Italy (144, 10.1 per cent), Canada (91, 6.4 per cent), and the USA (89, 6.2 per cent) (Fig. 1a).Syria was the only low-income country that had representation and constituted 0.3 per cent (5 authors).India (8, 0.6 per cent) and Nigeria (2, 0.1 per cent) were the only countries from lowermiddle-income groups that had representation.The male to female ratio in this study was 2.11 : 1 (957 : 453) (Fig. 1b).Gender data for 10 authors could not be retrieved and these were categorized as 'unknown'.There were 169 male (67.3 per cent) and 82 female (32.6 per cent) first authors (gender ratio 2.06 : 1).One study had designated two authors as co-first authors.Eighty-one women constituted 32.4 per cent of all the corresponding authors (male to female gender ratio 2.06 : 1).One article had no corresponding author.One hundred and fifty studies (60 per cent) did not have a female in a lead author (first or corresponding author) position.Fifty-eight studies (23.2 per cent) did not have any female authors, whereas only eight (3.2 per cent) did not have any male authors.In low-income countries, 1 in 5 authors were female.Similarly, in low-middle-income countries, 2 of 10 authors were female.There were no lead female authors

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