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Abstract
Background and Objectives To assess American Academy of Neurology (AAN)–recommended Practice Guidelines (PGs) for equity in gender representation among physician authors.
Methods 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.
Results 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]).
Discussion 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.
Glossary
- AAMC=
- Association of American Medical Colleges;
- AAN=
- American Academy of Neurology;
- ISD=
- interorganizational structural discrimination;
- PG=
- Practice Guideline
Footnotes
Go to Neurology.org/N for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
Submitted and externally peer reviewed. The handling editors were Roy Strowd III, MD, MEd, MS and José Merino, MD, MPhil, FAAN.
↵* These authors contributed to this work equally and are co-senior authors.
Editorial, page 221
- Received July 18, 2021.
- Accepted in final form March 4, 2022.
- © 2022 American Academy of Neurology
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- Author Response: Gender Representation Among Physician Authors of Practice Guidelines Developed, Endorsed, or Affirmed by the American Academy of Neurology
- Reader Response: Gender representation among physician authors of practice guidelines developed, endorsed, or affirmed by the American Academy of Neurology
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