Promising Trends in Female-Driven Vascular Surgery Research: A Systematic Comparison Within Surgical Subspecialties

Publication in peer-reviewed journals is integral to the dissemination of evidence-based research and strongly linked to professional achievement for academic surgeons. Within the field of vascular surgery, where engineering and innovation uniquely interface with operative technique, publications also serve as a major catalyst for growth within this dynamic field. Although recent data have demonstrated an increase in female authorship within vascular surgery, how these trends compare with other surgical subspecialties is unknown. This perspective is essential to understanding our progress and may provide an opportunity to access expertise to further enhance gender diversity within our field. This multijournal systematic review assessed trends in authorship gender diversity within the fields of vascular surgery, neurosurgery, and ophthalmology. The Journal of Vascular Surgery (JVS), the Journal of Neurosurgery, and the Journal of Ophthalmology were chosen as the representative journals from each subspecialty given their consistent top rankings within their respective fields. All articles from the first issue of each year were reviewed between 2010 and 2020 and assessed for female authorship trends. A total of 963 articles were analyzed (JVS: 470, Neurosurgery: 223, Ophthalmology: 270). In JVS, there was a statistically evident linear increase in female first authorship over time (2010: 5.3% vs 2020: 19.6%; P = .05) (Fig 1). In the Journal of Neurosurgery, there was no significant increase in female first authorship (2010: 5.0% vs 2020: 5.0%; P = .21). In the Journal of Ophthalmology, there was a strong trend toward a linear increase in female first authorship (2010: 25.0% vs 2020: 35.7%; P = .06). Notably, ophthalmology demonstrated a significantly greater proportion of female first authors overall when compared with vascular (34.8% vs 17.7%; P < .01). In JVS, a female last author was associated with a 2.29 higher odds of having a female first author (confidence interval [CI]: 1.10-4.75, P = .03) (Fig 2). This predictive pattern was not seen with neurosurgery (odds ratio: 0.57, CI: 0.07-4.59; P = .57) or ophthalmology (odds ratio: 1.25, CI: 0.68-2.30; P = .48). As women continue to comprise a larger proportion of vascular trainees and surgeons, there has been an encouraging increase in the academic footprint of female-driven research. This trend is significantly greater than other surgical subspecialties, such as neurosurgery and ophthalmology. Yet, the proportionally greater amount of female representation within ophthalmology provides a benchmark for goal-directed growth. The predictive value of female last authorship on female first authorship is specific to vascular surgery and indicates a promising benefit of sex-concordant mentorship within the field.Fig 2Sex concordance of female last authorship on female first authorship compared between the Journal of vascular Surgery, the Neurosurgery Journal, and the Ophthalmology. Journal.View Large Image Figure ViewerDownload Hi-res image Download (PPT)