Abstract：
BACKGROUND: Women are underrepresented in surgical authorship. Using big data analyses, we aimed to investigate women\'s representation as first and last authors in surgical publications worldwide and identify underlying predictors.
METHODS: We retrieved eligible surgical journals using Scimago Journal & Country Rank 2021. We queried articles indexed in PubMed from selected journals published between January 2018 and April 2022. We used the EDirect tool to extract bibliometric data, including first and last authors\' names, primary affiliation country, and publication year. Countries and dependent territories were classified following World Bank income levels and regions. Women\'s representation was predicted from forenames using the Gender-API software. Citations were included if gender accuracy was ≥80%.
RESULTS: We analyzed 210,853 citations containing both first and last authors\' forenames, representing 158 countries and 14 territories. Women constituted 23.8% (50,161/210,853) of the first and 14.7% (31,069/210,853) of the last authors. High-income economies had more women as first authors than other income categories (p < 0.001), but fewer women as last authors than upper-middle- and lower-middle-income economies (p < 0.001). The odds of the first author being a woman were more than three times higher when the last author was also a woman (OR 3.21, 95% CI 3.13-3.30) and vice versa (OR 3.25, 95% CI 3.16-3.34) after adjusting for income level and publication year.
CONCLUSIONS: Women remain globally underrepresented in surgical authorship. Our findings urge concerted global efforts to overcome identified disparities.
METHODS: We retrieved eligible surgical journals using Scimago Journal & Country Rank 2021. We queried articles indexed in PubMed from selected journals published between January 2018 and April 2022. We used the EDirect tool to extract bibliometric data, including first and last authors\' names, primary affiliation country, and publication year. Countries and dependent territories were classified following World Bank income levels and regions. Women\'s representation was predicted from forenames using the Gender-API software. Citations were included if gender accuracy was ≥80%.
RESULTS: We analyzed 210,853 citations containing both first and last authors\' forenames, representing 158 countries and 14 territories. Women constituted 23.8% (50,161/210,853) of the first and 14.7% (31,069/210,853) of the last authors. High-income economies had more women as first authors than other income categories (p < 0.001), but fewer women as last authors than upper-middle- and lower-middle-income economies (p < 0.001). The odds of the first author being a woman were more than three times higher when the last author was also a woman (OR 3.21, 95% CI 3.13-3.30) and vice versa (OR 3.25, 95% CI 3.16-3.34) after adjusting for income level and publication year.
CONCLUSIONS: Women remain globally underrepresented in surgical authorship. Our findings urge concerted global efforts to overcome identified disparities.
摘要：
背景：女性在外科手术作者中的代表性不足。利用大数据分析，我们旨在调查全球外科出版物中女性作为第一作者和最后作者的代表性，并确定潜在的预测因素。
方法：我们使用ScimagoJournal&CountryRank2021检索了符合条件的外科期刊。我们查询了2018年1月至2022年4月期间出版的部分期刊在PubMed中索引的文章。我们使用了EDirect工具来提取文献计量数据，包括第一作者和最后作者的名字，主要隶属国，和出版年。国家和附属领土按照世界银行的收入水平和地区进行分类。使用Gender-API软件从法医中预测了妇女的代表性。如果性别准确性≥80%，则包括引文。
结果：我们分析了210,853篇包含第一作者和最后作者的引文，代表158个国家和14个领土。女性占第一作者的23.8%(50,161/210,853)，占最后作者的14.7%(31,069/210,853)。高收入经济体作为第一作者的女性多于其他收入类别(p<0.001)，但作为最后作者的女性少于中上收入和中低收入经济体(p<0.001)。当最后一位作者也是女性时，第一作者是女性的几率高出三倍以上（OR3.21，95％CI3.13-3.30），反之亦然（OR3.25，95％CI3.16-3.34）。
结论：在全球范围内，女性在外科手术作者中的代表性仍然不足。我们的调查结果敦促全球共同努力克服已查明的差距。
方法：我们使用ScimagoJournal&CountryRank2021检索了符合条件的外科期刊。我们查询了2018年1月至2022年4月期间出版的部分期刊在PubMed中索引的文章。我们使用了EDirect工具来提取文献计量数据，包括第一作者和最后作者的名字，主要隶属国，和出版年。国家和附属领土按照世界银行的收入水平和地区进行分类。使用Gender-API软件从法医中预测了妇女的代表性。如果性别准确性≥80%，则包括引文。
结果：我们分析了210,853篇包含第一作者和最后作者的引文，代表158个国家和14个领土。女性占第一作者的23.8%(50,161/210,853)，占最后作者的14.7%(31,069/210,853)。高收入经济体作为第一作者的女性多于其他收入类别(p<0.001)，但作为最后作者的女性少于中上收入和中低收入经济体(p<0.001)。当最后一位作者也是女性时，第一作者是女性的几率高出三倍以上（OR3.21，95％CI3.13-3.30），反之亦然（OR3.25，95％CI3.16-3.34）。
结论：在全球范围内，女性在外科手术作者中的代表性仍然不足。我们的调查结果敦促全球共同努力克服已查明的差距。
