Abstract：
To assess American Academy of Neurology (AAN)-recommended Practice Guidelines (PGs) for equity in gender representation among physician authors.
This cross-sectional study included AAN-recommended PG publications from January 1, 2015, to December 31, 2020. Author degrees and gender were identified by 2 reviewers using the publication and/or online searches. Gender was determined from pronouns or photographs. Gender representation was compared with Association of American Medical Colleges (AAMC) data on academic neurologists. Data were analyzed using Z tests of 2 proportions and descriptive statistics.
AAMC benchmarks report academic women neurologists represented 35% of the specialty in 2015, 38% in 2018, and 39% in 2020. We identified 68 unique PG publications with 709 physician authors, 31% (223) women, 68% (484) men, and 0.3% (2) gender could not be identified. Representation of women physicians was low among PG authors across all benchmarks, significantly so for 2018 and 2020 (p < 0.01). Among physician first authors, women were significantly underrepresented across all benchmarks (18% [12/65], p < 0.01). Representation of women physicians was lower when men physicians were first authors vs women physicians (31% [161/524] vs 43% [50/118], p = 0.02). Among subspecialties with 10+ PGs, women physician authorship was highest in child neurology (48% [57/120]) and lowest in stroke and vascular neurology (16% [18/113]).
We found that women physicians were underrepresented as authors of AAN-recommended PGs. This suggests a missed opportunity for neurology because PGs that include expertise from women physicians may improve care and translation into practice. In addition, women physicians lose out on professional development from authorship. Further research is needed to understand causality and address gaps.
This cross-sectional study included AAN-recommended PG publications from January 1, 2015, to December 31, 2020. Author degrees and gender were identified by 2 reviewers using the publication and/or online searches. Gender was determined from pronouns or photographs. Gender representation was compared with Association of American Medical Colleges (AAMC) data on academic neurologists. Data were analyzed using Z tests of 2 proportions and descriptive statistics.
AAMC benchmarks report academic women neurologists represented 35% of the specialty in 2015, 38% in 2018, and 39% in 2020. We identified 68 unique PG publications with 709 physician authors, 31% (223) women, 68% (484) men, and 0.3% (2) gender could not be identified. Representation of women physicians was low among PG authors across all benchmarks, significantly so for 2018 and 2020 (p < 0.01). Among physician first authors, women were significantly underrepresented across all benchmarks (18% [12/65], p < 0.01). Representation of women physicians was lower when men physicians were first authors vs women physicians (31% [161/524] vs 43% [50/118], p = 0.02). Among subspecialties with 10+ PGs, women physician authorship was highest in child neurology (48% [57/120]) and lowest in stroke and vascular neurology (16% [18/113]).
We found that women physicians were underrepresented as authors of AAN-recommended PGs. This suggests a missed opportunity for neurology because PGs that include expertise from women physicians may improve care and translation into practice. In addition, women physicians lose out on professional development from authorship. Further research is needed to understand causality and address gaps.
摘要：
目的：评估美国神经病学学会（AAN）推荐的实践指南（PGs）在医生作者中性别代表性的公平性。
方法：这项横断面研究包括2015年1月1日至2020年12月31日AAN推荐的PG出版物。2名审稿人使用出版物和/或在线搜索确定了作者的学位和性别。根据代词或照片确定性别。将性别代表与美国医学院协会（AAMC）有关学术神经学家的数据进行了比较。数据采用2个比例的Z检验和描述性统计进行分析。
结果：AAMC基准报告称，2015年，学术女性神经学家占该专业的35％，2018年占38％，2020年占39％。我们确定了68种独特的PG出版物，其中有709位医师作者，31%（223）女性，68%（484）男性，0.3%(2)无法确定性别。在所有基准中，PG作者中女医生的代表性很低，2018年和2020年显著如此（p<0.01）。在医生第一作者中，在所有基准中，妇女的代表性明显不足(18%[12/65]，p<0.01)。当男性医生是第一作者时，女性医生的比例较低（31%[161/524]vs43%[50/118]，p=0.02)。在具有10个PG的亚专业中，女医师作者在儿童神经科中最高(48%[57/120]),在卒中和血管神经科中最低(16%[18/113]).
结论：我们发现，作为AAN推荐的PG的作者，女性医生的代表性不足。这表明神经学错失了机会，因为包括女医生专业知识的PG可能会改善护理并转化为实践。此外,女医生从作者身份中失去了专业发展。需要进一步的研究来理解因果关系并解决差距。
方法：这项横断面研究包括2015年1月1日至2020年12月31日AAN推荐的PG出版物。2名审稿人使用出版物和/或在线搜索确定了作者的学位和性别。根据代词或照片确定性别。将性别代表与美国医学院协会（AAMC）有关学术神经学家的数据进行了比较。数据采用2个比例的Z检验和描述性统计进行分析。
结果：AAMC基准报告称，2015年，学术女性神经学家占该专业的35％，2018年占38％，2020年占39％。我们确定了68种独特的PG出版物，其中有709位医师作者，31%（223）女性，68%（484）男性，0.3%(2)无法确定性别。在所有基准中，PG作者中女医生的代表性很低，2018年和2020年显著如此（p<0.01）。在医生第一作者中，在所有基准中，妇女的代表性明显不足(18%[12/65]，p<0.01)。当男性医生是第一作者时，女性医生的比例较低（31%[161/524]vs43%[50/118]，p=0.02)。在具有10个PG的亚专业中，女医师作者在儿童神经科中最高(48%[57/120]),在卒中和血管神经科中最低(16%[18/113]).
结论：我们发现，作为AAN推荐的PG的作者，女性医生的代表性不足。这表明神经学错失了机会，因为包括女医生专业知识的PG可能会改善护理并转化为实践。此外,女医生从作者身份中失去了专业发展。需要进一步的研究来理解因果关系并解决差距。
