United States

&lt;p&gt;Sue Kim,&lt;sup&gt;1&lt;/sup&gt; Soo Young Kim,&lt;sup&gt;2&lt;/sup&gt; Hyun Jung Yi&lt;sup&gt;3&lt;/sup&gt;&lt;/p&gt;
&lt;h4&gt;Objective&lt;/h4&gt;
&lt;p&gt; Data sharing is strongly recommended for replicability, trustworthy findings, and generation of new hypotheses.&lt;sup&gt;1&lt;/sup&gt; Although a data availability statement (DAS) reveals whether data are shared and how to access data, little is known on DAS patterns. This study aimed to evaluate the proportion of articles presenting a DAS according to journal policies in Korea.&lt;/p&gt;
&lt;h4&gt;Design &lt;/h4&gt;
&lt;p&gt;This cross-sectional study was conducted from July 2024 to January 2025. Articles in KoreaMed member journals published in 2023 were randomly selected (5%) by generating random numbers using the RANDBETWEEN function in Microsoft Excel 2021. The inclusion criterion was human studies in Korean or English. Narrative reviews, letters, editorials, or case studies were excluded. Selected articles (600 of 12,000) were evaluated by the following parameters: presence of a DAS, its appropriateness, and whether the journal has a DAS policy statement. The research design, adherence to the International Committee of Medical Journal Editors (ICMJE) clinical trials data sharing requirement,&lt;sup&gt;2&lt;/sup&gt; mention of reporting guidelines in the journal’s guidelines, and health discipline were also assessed as related factors. Two researchers independently reviewed the full text and discussed for consensus, using the Design Algorithm for Medical Literature on Intervention tool&lt;sup&gt;3&lt;/sup&gt; to determine study design.&lt;/p&gt;
&lt;h4&gt;Results &lt;/h4&gt;
&lt;p&gt;After excluding irrelevant articles, 243 articles (including surveys, cohort studies, randomized clinical trials [RCTs], systematic reviews, and integrative reviews) were identified from 126 journals; 74 journals (58.7%) had a DAS policy and 155 articles (63.8%) were published in such journals. Of these, however, 96 articles (61.9%) did not comply with the journal’s policy of specifying data sharing. Of the 243 articles, only 67 (27.6%) articles (from 35 journals) presented a DAS, of which 19 (28.4%) were inappropriate, 41 (61.2%) were generic cliché statements, and only 4 (6%) provided a hyperlink to the data. Of the 74 journals with a DAS policy, 7 (9.5%) presented mixed results ranging from inappropriate to satisfactory DAS, suggesting the need for editorial consistency. Of the 16 experimental studies (from 13 journals), only 6 (3 RCTs, 3 non-RCTs) complied with ICMJE’s policy requiring a DAS, of which only 1 linked to a data registry. For observational studies, 58 of 216 (26.8%) presented a DAS. Journal policy on reporting guidelines (52 articles) was not significant for DAS or health discipline, but variation in the proportion of articles with an acceptable DAS was observable: 66% of articles from medicine (31), 67% from dentistry (2), 100% from nursing (9), and 75% from public health or nutrition (6).&lt;/p&gt;
&lt;h4&gt;Conclusions&lt;/h4&gt;
&lt;p&gt; Although roughly 62% of journals had a DAS policy, less than half of articles presented a DAS, with only 6% providing actual data. Given this gap, greater awareness of DASs among researchers and editorial consistency is needed, especially considering that ICMJE policy requires a DAS in clinical trials involving humans.&lt;/p&gt;
&lt;h4&gt;References &lt;/h4&gt;
&lt;p&gt;1. Hulsen T. Sharing is caring-data sharing initiatives in healthcare. Int J Environ Res Public Health. 2020;17(9):3046. doi:10.3390/ijerph17093046&lt;/p&gt;
&lt;p&gt;2. Taichman DB, Sahni P, Pinborg A, et al. Data sharing statements for clinical trials: a requirement of the International Committee of Medical Journal Editors. JAMA. 2017;317(24):2491-2492. doi:10.1001/jama.2017.6514&lt;/p&gt;
&lt;p&gt;3. Seo HJ, Kim SY, Lee YJ, et al. A newly developed tool for classifying study designs in systematic reviews of interventions and exposures showed substantial reliability and validity. J Clin Epidemiol. 2016;70:200-205. doi:10.1016/j.jclinepi.2015.09.013&lt;/p&gt;
&lt;sup&gt;1&lt;/sup&gt;College of Nursing, Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, South Korea, suekim@yuhs.ac; &lt;sup&gt;2&lt;/sup&gt;Department of Family Medicine, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, South Korea; &lt;sup&gt;3&lt;/sup&gt;Medical Library, Hanyang University Guri Hospital, Guri, South Korea.&lt;/p&gt;
&lt;h4&gt;Conflict of Interest Disclosures &lt;/h4&gt;
&lt;p&gt;None reported.&lt;/p&gt;
&lt;h4&gt;Funding/Support &lt;/h4&gt;
&lt;p&gt;This study was supported by the Korean Council of Science Editors.&lt;/p&gt;
&lt;h4&gt;Role of the Funder/Sponsor &lt;/h4&gt;
&lt;p&gt;The funder supported the costs of the research and was not involved in the planning, analysis, or interpretation of the results of the study.&lt;/p&gt;


The 10th Peer Review Congress

Data availability Statements in Health Research in Articles and Journal Policies in Korea

data sharing and access

editorial and peer review process

quality assurance

<p>Sue Kim,<sup>1</sup> Soo Young Kim,<sup>2</sup> Hyun Jung Yi<sup>3</sup></p>
<h4>Objective</h4>
<p> Data sharing is strongly recommended for replicability, trustworthy findings, and generation of new hypotheses.<sup>1</sup> Although a data availability statement (DAS) reveals whether data are shared and how to access data, little is known on DAS patterns. This study aimed to evaluate the proportion of articles presenting a DAS according to journal policies in Korea.</p>
<h4>Design </h4>
<p>This cross-sectional study was conducted from July 2024 to January 2025. Articles in KoreaMed member journals published in 2023 were randomly selected (5%) by generating random numbers using the RANDBETWEEN function in Microsoft Excel 2021. The inclusion criterion was human studies in Korean or English. Narrative reviews, letters, editorials, or case studies were excluded. Selected articles (600 of 12,000) were evaluated by the following parameters: presence of a DAS, its appropriateness, and whether the journal has a DAS policy statement. The research design, adherence to the International Committee of Medical Journal Editors (ICMJE) clinical trials data sharing requirement,<sup>2</sup> mention of reporting guidelines in the journal’s guidelines, and health discipline were also assessed as related factors. Two researchers independently reviewed the full text and discussed for consensus, using the Design Algorithm for Medical Literature on Intervention tool<sup>3</sup> to determine study design.</p>
<h4>Results </h4>
<p>After excluding irrelevant articles, 243 articles (including surveys, cohort studies, randomized clinical trials [RCTs], systematic reviews, and integrative reviews) were identified from 126 journals; 74 journals (58.7%) had a DAS policy and 155 articles (63.8%) were published in such journals. Of these, however, 96 articles (61.9%) did not comply with the journal’s policy of specifying data sharing. Of the 243 articles, only 67 (27.6%) articles (from 35 journals) presented a DAS, of which 19 (28.4%) were inappropriate, 41 (61.2%) were generic cliché statements, and only 4 (6%) provided a hyperlink to the data. Of the 74 journals with a DAS policy, 7 (9.5%) presented mixed results ranging from inappropriate to satisfactory DAS, suggesting the need for editorial consistency. Of the 16 experimental studies (from 13 journals), only 6 (3 RCTs, 3 non-RCTs) complied with ICMJE’s policy requiring a DAS, of which only 1 linked to a data registry. For observational studies, 58 of 216 (26.8%) presented a DAS. Journal policy on reporting guidelines (52 articles) was not significant for DAS or health discipline, but variation in the proportion of articles with an acceptable DAS was observable: 66% of articles from medicine (31), 67% from dentistry (2), 100% from nursing (9), and 75% from public health or nutrition (6).</p>
<h4>Conclusions</h4>
<p> Although roughly 62% of journals had a DAS policy, less than half of articles presented a DAS, with only 6% providing actual data. Given this gap, greater awareness of DASs among researchers and editorial consistency is needed, especially considering that ICMJE policy requires a DAS in clinical trials involving humans.</p>
<h4>References </h4>
<p>1. Hulsen T. Sharing is caring-data sharing initiatives in healthcare. Int J Environ Res Public Health. 2020;17(9):3046. doi:10.3390/ijerph17093046</p>
<p>2. Taichman DB, Sahni P, Pinborg A, et al. Data sharing statements for clinical trials: a requirement of the International Committee of Medical Journal Editors. JAMA. 2017;317(24):2491-2492. doi:10.1001/jama.2017.6514</p>
<p>3. Seo HJ, Kim SY, Lee YJ, et al. A newly developed tool for classifying study designs in systematic reviews of interventions and exposures showed substantial reliability and validity. J Clin Epidemiol. 2016;70:200-205. doi:10.1016/j.jclinepi.2015.09.013</p>
<sup>1</sup>College of Nursing, Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, South Korea, suekim@yuhs.ac; <sup>2</sup>Department of Family Medicine, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, South Korea; <sup>3</sup>Medical Library, Hanyang University Guri Hospital, Guri, South Korea.</p>
<h4>Conflict of Interest Disclosures </h4>
<p>None reported.</p>
<h4>Funding/Support </h4>
<p>This study was supported by the Korean Council of Science Editors.</p>
<h4>Role of the Funder/Sponsor </h4>
<p>The funder supported the costs of the research and was not involved in the planning, analysis, or interpretation of the results of the study.</p>


poster

The Tenth Peer Review Congress featured 3 days for presentations of new research into peer review and all aspects of scientific publication, bias, quality of reporting, and information access and dissemination.

This year’s meeting was hybrid, and all plenary sessions were livestreamed with opportunities to view presentations and engage with participants in person and virtually during and after the meeting. All recordings are now available on Underline for viewing.

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#### Why? 
Our aim is to encourage research into the quality and credibility of peer review and scientific publication, to establish the evidence base on which scientists can improve the conduct, reporting, and dissemination of scientific research.

#### Who? 
Participants include editors and publishers of scientific peer-reviewed journals, researchers, funders, bibliometric and informatics experts, information innovators, librarians, journalists, policymakers, ethicists, scientific information disseminators, and anyone interested in the progress of the scientific information enterprise and the quality of scientific evidence.

The Congress embraces a wide range of disciplines, including biomedicine, health and life sciences, applied sciences, basic sciences, physical and chemical sciences, mathematics, computer sciences, engineering, economics, and social sciences as well as new and emerging disciplines.

#### What? 
The Congress provides a forum for the presentation and discussion of new research into the quality and credibility of editorial and funding peer review, scientific and scholarly publication, research methods and reporting practices, identification and management of biases, transparency, reproducibility, access, publication and dissemination metrics, identification and management of threats to the integrity of science, and advances in information exchange.

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The Tenth Peer Review Congress features 3 days for presentations of new research into peer review and all aspects of scientific publication, bias, quality of reporting, and information access and dissemination.

<p>Erfan Taherifard,<sup>1</sup> Hollin R. Hakimian,<sup>1</sup> Maryam Mooghali,<sup>1</sup> Sahil R. Mane,<sup>1</sup> Mengyuan Fu,<sup>1</sup> Stephen Bamford,<sup>2</sup> Karla Childers,<sup>3</sup> Nihar R. Desai,<sup>4</sup> Cary P. Gross,<sup>1,5,6</sup> Debbie Hewens,<sup>2</sup> Harlan M. Krumholz,<sup>4,7,8</sup> Richard Lehman,<sup>9</sup> Jessica D. Ritchie,<sup>7</sup> Tamsin Sargood,<sup>2</sup> Joshua D. Wallach,<sup>10</sup> Molly K. Willeford,<sup>7</sup> Joseph S. Ross<sup>1,7,8</sup></p>
<h4>Objective</h4>
<p> Sharing clinical trial data can advance scientific knowledge, maximize research impact, and reduce duplication, costs, and risks.<sup>1</sup> However, the impact of such initiatives has not been systematically evaluated. The Yale Open Data Access (YODA) Project is an academic-based data-sharing initiative housed at Yale University.<sup>2</sup> This study evaluated the impact of studies published using data from clinical trials sponsored by Johnson &amp; Johnson that are shared on the YODA Project platform, distinguishing between studies led by the primary study investigators and external investigators.</p>
<h4>Design</h4>
<p> We conducted a cross-sectional study of clinical trials sponsored by Johnson &amp; Johnson that were shared on the YODA Project platform as of December 31, 2021; trials without a primary publication were excluded. Primary publications—defined as the first full-length peer-reviewed published article reporting the trial’s primary end point—were identified. Secondary publications—defined as peer-reviewed published studies using individual-level participant data—were retrieved by screening citations to each trial’s primary publication in the Web of Science. The primary searches in the Web of Science were conducted from September 15 to December 15, 2024, with all searches updated as of December 15, 2024. We collected metrics for primary and secondary publications, including Impact Factors of publishing journals and annual citation counts, Altmetric scores, and Mendeley reader counts. Annual metrics were calculated by dividing each metric by the number of days since publication, then multiplying by 365. Secondary publications were categorized as internal (authored by primary study investigators) or external. Comparisons were performed using Mann-Whitney <i>U</i> tests.</p>
<h4>Results</h4>
<p> There were 294 trials with a primary publication sharing data on the YODA Project platform, 218 (74.1%) of which had at least 1 secondary publication, totaling 1699 secondary publications. Most were pooled analyses (1302 [76.6%]), as opposed to secondary analyses (397 [22.4%]). Trials of heart and blood disease interventions had the highest number of secondary publications per trial (median [IQR], 10.5 [2-19] publications). Compared with primary publications, secondary publications were published in journals with lower median (IQR) journal Impact Factors (8.4 [4.5-22.5] vs 4.9 [3.0-8.5]) and had lower annual citation counts (15.9 [7.8-45.4] vs 5.1 [2.5-11.4]), Altmetric scores (0.8 [0.3-3.1] vs 0.6 [0.2-3.1]), and Mendeley reader counts (10.1 [5.1-17.9] vs 8.4 [3.3-15.5]) (<b>Table 25-1008</b>). Secondary publications were predominantly internal (1169 [68.8%]), which, when compared with external secondary publications, were published in journals with higher median (IQR) Impact Factors (5.1 [3.2-10.3] vs 4.5 [2.9-7.0]) and had higher annual citation counts (5.8 [2.7-12.6] vs 3.2 [1.9-7.5]), Altmetric scores (0.7 [0.2-2.8] vs 0.5 [0.1-3.8]), and Mendeley reader counts (8.9 [4.3-16.3] vs 6.9 [0.9-13.1]).</p>

![](https://assets.underline.io/markdown_image/1/image/88c652a19e052b6b8cf00ea59f085232.png)

<h4>Conclusions</h4>
<p> Clinical trial data sharing through the YODA Project has fostered substantial scholarship, with nearly one-third of secondary studies published using these trials’ data by external investigators not affiliated with the primary study team. While secondary publications generally had lower impact metrics than primary publications, they still demonstrated meaningful scientific dissemination and usage, underscoring their contributions to the broader medical research enterprise.</p>
<h4>References</h4>
<p>1. Angraal S, Ross JS, Dhruva SS, Desai NR, Welsh JW, Krumholz HM. Merits of data sharing: the Digitalis Investigation Group trial. J Am Coll Cardiol. 2017;70(14):1825-1827. doi:10.1016/j.jacc.2017.07.786</p>
<p>2. Ross JS, Waldstreicher J, Bamford S, et al. Overview and experience of the YODA Project with clinical trial data sharing after 5 years. Sci Data. 2018;5:180268. doi:10.1038/sdata.2018.268</p>
<sup>1</sup>Section of General Internal Medicine, Yale School of Medicine, New Haven, CT, US, erfan.taherifard@yale.edu; <sup>2</sup>Johnson &amp; Johnson, London, England, UK; <sup>3</sup>Johnson &amp; Johnson, New Brunswick, NJ, US; <sup>4</sup>Section of Cardiovascular Medicine, Yale School of Medicine, New Haven, CT, US; <sup>5</sup>Cancer Outcomes, Public Policy, and Effectiveness Research Center, Yale School of Medicine, New Haven, CT, US; <sup>6</sup>Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, US; <sup>7</sup>Yale–New Haven Hospital Center for Outcomes Research and Evaluation, New Haven, CT, US; <sup>8</sup>Department of Health Policy and Management, Yale School of Public Health, New Haven, CT, US; <sup>9</sup>Institute of Applied Health Research, University of Birmingham, Birmingham, England, UK; <sup>10</sup>Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, US.</p>
<h4>Conflict of Interest Disclosures</h4>
<p> Erfan Taherifard is an academic editor of PLOS One. Stephen Bamford, Karla Childers, Debbie Hewens, and Tamsin Sargood are current employees and shareholders of Johnson &amp; Johnson. Nihar R. Desai, Cary P. Gross, Harlan M. Krumholz, Jessica D. Ritchie, Joshua D. Wallach, Molly K. Willeford, and Joseph S. Ross are members of the YODA Project leadership team and receive support from Johnson &amp; Johnson to support data sharing through the YODA Project. Nihar R. Desai reported working under contract with the Centers for Medicare and Medicaid Services to develop and maintain performance measures used for public reporting and pay-for-performance programs and receiving research grants from and consulting for Amgen, AstraZeneca, Bayer, Boehringer Ingelheim, Bristol Myers Squibb, CSL Behring, Cytokinetics, Merck, Novartis, scPharmaceuticals, and Vifor. Cary P. Gross has received research funding from the NCCN Foundation (AstraZeneca) and Genentech and is an associate editor of JAMA Internal Medicine. Harlan M. Krumholz reported receiving options for Element Science and Identifeye and payments from F-Prime for advisory roles, being a cofounder of and holding equity in Hugo Health, Refactor Health, and ENSIGHT-AI, being associated with research contracts through Yale University from Janssen, Kenvue, and Pfizer, and being editor in chief of JACC. Jessica D. Ritchie reported receiving support from the US Food and Drug Administration (FDA) and Arnold Ventures. Joshua D. Wallach reported receiving support from the FDA and Arnold Ventures, having previously served as a consultant to Hagens Berman Sobol Shapiro LLP and Dugan Law Firm APLC, and being an associate editor of JACC. Joseph S. Ross reported receiving support from the FDA, Arnold Ventures, Agency for Healthcare Research and Quality, and National Heart, Lung, and Blood Institute and being an expert witness at the request of the relator’s attorneys, the Greene Law Firm, in a qui tam suit alleging violations of the False Claims Act and Anti-Kickback Statute against Biogen Inc that was settled in September 2022, and being a deputy editor of JAMA.</p>
<h4>Funding/Support</h4>
<p> This work was supported in part by a research grant from Johnson &amp; Johnson through Yale University to establish a platform for clinical trial data sharing.</p>
<h4>Role of the Funder/Sponsor</h4>
<p> The funder had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the abstract; or decision to submit the abstract for presentation.</p>


Assessing the Impact of Clinical Trial Data Sharing: A Cross-Sectional Study of Clinical Trials Sharing Data on the YODA Project Platform

<p>Eli Paul,<sup>1</sup> Griffin Hughes,<sup>1</sup> Alex Hagood,<sup>1</sup> Matt Vassar<sup>1,2</sup></p>
<h4>Objective</h4>
<p> Data sharing promotes secondary use, transparency, and reproducibility, yet prior studies have revealed gaps in policy standardization and implementation.<sup>1</sup> Although some evaluations have explored data sharing statement (DSS) practices within specific fields or policy contexts, no broad, comparative assessment across medical specialties exists.<sup>2,3</sup> This meta-analysis assesses DSS prevalence across 19 medical specialties and examines variability in adoption rates.</p>
<h4>Design</h4>
<p> We conducted a meta-analysis using harmonized article-level data from 19 separate studies, each prospectively designed and executed by our research team using the same methodology, with each study focused on a distinct medical specialty. Between December 2023 and July 2024, all studies systematically searched PubMed for original research articles published between 2018 and 2023. Study designs included in our study were clinical trials, cohort studies, cross-sectional studies, case series, case-control studies, cost-effectiveness analyses, qualitative research, survey-based studies, and other designs that involved human participants. Reviews, editorials, and commentaries were excluded. For each article, we assessed the presence of a DSS and whether data were publicly accessible. Two independent reviewers performed screening and data extraction per specialty, with discrepancies resolved by consensus. We conducted a random-effects meta-analysis using inverse-variance weights based on standard errors of DSS proportions. Influential study diagnostics were applied to identify and mitigate the impact of extreme specialty effects. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guideline was followed for the design and execution of our study.</p>
<h4>Results</h4>
<p> Among 20,095 eligible articles, 6092 (30.3%) reported a DSS (<b>Figure 25-1134</b>). Prevalence varied substantially by specialty, from 63.9% in Rheumatology to 1.5% in Plastic Surgery. The pooled DSS reporting rate was 29.8% (prediction interval, 0-65.9%), with high heterogeneity (<i>I</i><span lang="ar-SA">² = 99.60%). After removing influential specialties (rheumatology, neurology, and plastic surgery), the adjusted pooled rate was 27.5% (prediction interval, 0-54.9%), with high heterogeneity persisting (</span><i>I</i><span lang="ar-SA">² = 99.14%).</span></p>

![](https://assets.underline.io/markdown_image/1/image/7555504ed421a8bde9c394748385e4c8.png)

<h4>Conclusions</h4>
<p> Despite increasing emphasis on open science, DSS reporting remains low and inconsistent across medical specialties. The high heterogeneity suggests that DSS reporting is shaped more by specialty-specific norms and editorial practices than by standardized policy. By conducting 19 internally coordinated studies using identical methodology, our team generated a uniquely standardized dataset that enabled robust, cross-specialty comparisons. Stronger policy enforcement and cross-disciplinary coordination among journals, funders, and regulatory bodies are needed to improve transparency and foster responsible data sharing in medical research.</p>
<h4>References</h4>
<p>1. Johnson AL, Anderson JM, Bouvette M, et al. Clinical trial data-sharing policies among journals, funding agencies, foundations, and other professional organizations: a scoping review. <i>J Clin Epidemiol</i>. 2023;154:42-55. doi:10.1016/j.jclinepi.2022.11.009</p>
<p>2. Tedersoo L, Küngas R, Oras E, et al. Data sharing practices and data availability upon request differ across scientific disciplines. <i>Sci Data</i>. 2021;8:192. doi:10.1038/s41597-021-00981-0</p>
<p>3. Vassar M, Jellison S, Wendelbo H, Wayant C. Data sharing practices in randomized trials of addiction interventions. <i>Addict Behav</i>. 2020;102:106193. doi:10.1016/j.addbeh.2019.106193</p>
<sup>1</sup>Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, US, eli.paul@okstate.edu; <sup>2</sup>Department of Psychiatry and Behavioral Sciences, Oklahoma State University Center for Health Sciences, Tulsa, OK, US.</p>
<h4>Conflict of Interest Disclosures </h4>
<p>Matt Vassar reported receiving funding from the National Institute on Drug Abuse, the National Institute on Alcohol Abuse and Alcoholism, the US Office of Research Integrity, and the Oklahoma Center for Advancement of Science and Technology and internal grants from the Oklahoma State University Center for Health Sciences outside the submitted work. No other disclosures were reported.</p>


Data Sharing Statement Reporting Across Medical Specialties

<p>John P. A. Ioannidis,<sup>1,2,3,4</sup> Angelo Maria Pezzullo,<sup>4,5</sup> Antonio Cristiano,<sup>4,5</sup> Guillaume Roberge,<sup>6</sup> Stefania Boccia,<sup>5,7</sup> Jeroen Baas<sup>8</sup></p>
<h4>Objective</h4>
<p><i> </i>Although retractions are increasingly frequent, they remain a small fraction of publications. We have previously incorporated retraction data into Scopus-based databases of top-cited (top 2%) scientists to facilitate linkage of retractions with impact metrics at the individual scientist level.<sup>1</sup> Here, we explored whether gender disparities in the likelihood of having retractions exist, both among highly cited authors and among all authors with at least 5 publications.</p>
<h4>Design </h4>
<p>On August 15, 2024, we screened 55,237 Retraction Watch records, excluding nonretractions, those clearly unrelated to author error, those tied to republished papers, or those not linkable to Scopus, leaving 39,468 eligible retractions. We examined demographics of scientists with and without retractions among highly cited authors (career-long: n = 217,097) and among all authors with at least 5 publications (n = 10,361,367). We were able to assign gender using NamSor<sup>2</sup> to 186,466 and 8,267,888 authors, respectively. We stratified authors by publication age, field,<sup>3</sup> country income level (high, other), and publication volume, identifying for all these strata and for individual countries, men and women, and with and without retractions. We computed gender-specific retraction rates and calculated the relative propensity (R) of women vs men to have at least 1 retraction.</p>
<h4>Results </h4>
<p>Authors with retractions were more common among highly cited scientists (3.3%) than among non–highly cited scientists (0.7%). Overall, gender differences were modest: among highly cited authors, retraction rates were 2.9% for women and 3.1% for men; among all authors, retraction rates were 0.7% for both genders. Men consistently showed slightly higher retraction rates than women within both income groups. Field-specific analysis among all authors revealed women’s rates were at least one-third lower than men’s (R &lt; 0.67) in biology, biomedical research, and psychology and cognitive sciences, but higher (R &gt; 1.33) in economics and business, engineering, and information and communication technology. Among highly cited scientists, the highest women to men retraction ratios were in mathematics and statistics (R = 3.06) and engineering (R = 1.78), while biomedical research (R = 0.64) and built environment and design (R = 0.65) had lower rates for women. Across publication age cohorts, gender differences in retraction rates among all authors were minimal; however, among highly cited authors, younger cohorts showed increasingly higher rates among men (4.2% of men and 3.0% of women in those starting to publish in 2002-2011; 8.7% of men and 4.9% of women in those starting to publish post-2011). Country-level data revealed particularly large gender gaps in Pakistan (men, 28.7%; women, 14.3%), Iran (12.4% vs 9.3%), and India (9.2% vs 6.6%) among highly cited authors. Among all authors, country-level gender gaps were small.</p>
<h4>Conclusions </h4>
<p>Gender differences in retraction rates were small in most settings but varied by field, country, and publication cohort. Overall, field and country were more strongly associated with retraction rates than gender. These results highlight the need to account for structural and contextual factors when interpreting gender disparities.</p>
<h4>References</h4>
<p>1. Ioannidis JPA, Pezzullo AM, Cristiano A, Boccia S, Baas J. Linking citation and retraction data reveals the demographics of scientific retractions among highly cited authors. <i>PLoS Biol.</i> 2025;23(1):e3002999. doi:10.1371/journal.pbio.3002999</p>
<p>2. NamSor. Accessed July 14, 2025. <a href="https://NamSor.app"><span class="Hyperlink CharOverride-6">https://NamSor.app</span></a></p>
<p>3. Archambault É, Beauchesne OH, Caruso J. Towards a multilingual, comprehensive and open scientific journal ontology. In: <i>Proceedings of the 13th International Conference of the International Society for Scientometrics and Informetrics</i>. 2011;13:66-77.</p>
<sup>1</sup>Department of Medicine, Stanford University, Stanford, CA, US, jioannid@stanford.edu; <sup>2</sup>Department of Epidemiology &amp; Population Health, Stanford University, Stanford, CA, US; <sup>3</sup>Department of Biomedical Data Science, Stanford University, Stanford, CA, US; <sup>4</sup>Meta-Research Innovation Center at Stanford (METRICS), Stanford University, Stanford, CA, US; <sup>5</sup>Section of Hygiene, Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy; <sup>6</sup>Analytics and Data Services, Elsevier B.V., Montreal, Canada; <sup>7</sup>Department of Women, Children and Public Health Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy; <sup>8</sup>Research Intelligence, Elsevier B.V., Amsterdam, the Netherlands.</p>
<h4>Conflict of Interest Disclosures</h4>
<p> Guillaume Roberge and Jeroen Baas are employees of Elsevier. John P. A. Ioannidis is a member of the Peer Review Congress Advisory Board but was not involved in the review or decision for this abstract.</p>
<h4>Additional Information </h4>
<p>Elsevier runs Scopus, which is the source of these data, and also runs the repository where the database of highly cited scientists is now stored.</p>


Retraction Prevalence and Gender Imbalance Among Highly-Cited Authors and Among All Authors Across Scientific Disciplines

<p>Ulrike K. Müller,<sup>1</sup> M. Janneke Schwaner,<sup>2</sup> Ksenia Keplinger<sup>2</sup></p>
<h4>Objective</h4>
<p> Despite decades of diversity initiatives, inequality persists, including in academic publishing. Promising trends remain weak when intersectionality is considered.<sup>1,2</sup> Inspired by the concept of intersectionality, we hypothesize that relying solely on gender as an indicator underestimates inequality, as decades of tokenistic inclusion measures have masked the true extent of inequality. The central idea of this study requires us to go beyond direct equity indicators, such as gender, race, and geographic location, and to identify indirect indicators. We predict that indirect indicators of inequality that correlate with gender due to intersectionality (eg, type of institution, as the proportion of women faculty is lower at research-intensive institutions<sup>3</sup>) will show higher levels of inequality, with more extreme disparities at higher rungs of the academic power ladder.</p>
<h4>Design</h4>
<p> In this cross-sectional study, we quantified inequality predicted by gender vs type of institution by collecting data from 50 top-ranked journals (SCImago ranking) for 6 academic fields (<b>Table 25-1014</b>) on lead editors, on editorial boards for 5 of those journals, on corresponding authors for 1 journal, and the editorial board for 1 journal from 1979 to 2022. All data were accessed in 2022. We determined gender from pronouns used in self-authored or self-edited documents whenever possible, such as editorial biographical sketches, and otherwise used text written by authors with a high likelihood of knowing correct pronouns, such as acknowledgments. When collecting data on lead editors, we excluded publications led by large subject-specific editorial teams.</p>

![](https://assets.underline.io/markdown_image/1/image/7700941f95b0ea61cfbbc7bdf2d7e778.png)

<h4>Results</h4>
<p> This study included 407 lead editors, 340 editorial board members, and 607 corresponding authors. Overall, women accounted for 51% of corresponding authors, 34% of editorial board members, and 37% of lead editors. Between 1979 and 2023, the proportion of women editors increased steadily from a median of 10% in the 1980s to more than 50% in the 2020s. In contrast, the proportion of PUI editors remained largely flat, with a median near 10%, only increasing in the 2020s under the tenure of a PUI lead editor. Inequality was higher for type of institution. Although more US faculty worked at primarily undergraduate institutions (PUIs) than PhD-granting institutions, only 12% of corresponding authors, 5% of editorial board members, and less than 1% of editors in chief worked at PUIs.</p>
<h4>Conclusions</h4>
<p> The observed trends are consistent with our central idea—indirect indicators of inequality that reflect intersectionality, such as type of institution, reveal more severe inequality in academic publishing than direct inequality indicators, such as gender.</p>
<h4>References</h4>
<p>1. Memon AR, Ahmed I, Ghaffar N, Ahmed K, Sadiq I. Where are female editors from low-income and middle-income countries? a comprehensive assessment of gender, geographical distribution and country’s income group of editorial boards of top-ranked rehabilitation and sports science journals. <i>Br J Sports Med</i>. 2022;56(8):458-468. doi:0.1136/bjsports-2021-105042</p>
<p>2. Bates DC, Borland E. Fitting in and stalling out: collegiality, mentoring, and role strain among professors in the sciences at a primarily undergraduate institution. <i>Polymath</i>. 2014;4(2):50-68.</p>
<p>3. Curtis JW. Faculty gender equity indicators 2021: data report. Accessed July 16, 2025. <a href="https://mountainscholar.org/bitstreams/78250ae2-8a5c-4bc0-b43d-4417d53adba9/download"><span class="Hyperlink CharOverride-6">https://mountainscholar.org/bitstreams/78250ae2-8a5c-4bc0-b43d-4417d53adba9/download</span></a></p>
<sup>1</sup>Fresno State University, Fresno, CA, US, umuller@csufresno.edu; <sup>2</sup>Max Planck Institute for Intelligent Systems, Stuttgart, Germany.</p>
<h4>Conflicts of Interest Disclosures </h4>
<p>Ulrike K. Müller is the editor in chief of <i>Integrative and Comparative Biology</i>, a journal included in the dataset analyzed for this study. No other disclosures were reported.</p>


Academic Institutional Affiliations and Gender of Authors, Editorial Board Members, and Editors of Journals

<p>Navita Goyal,<sup>1</sup> Ivan Stelmakh,<sup>2</sup> Nihar B. Shah,<sup>3</sup> Hal Daumé III<sup>1</sup></p>
<h4>Objective</h4>
<p> Peer review often involves multiple reviewers to reduce bias and broaden perspectives.<sup>1,2</sup> We examined the role of diversity among reviewers assigned to evaluate a paper as a factor in diversifying perspectives and improving the utility of the peer review process.<sup>3</sup> We proposed 2 desiderata: reviews should cover most contents of the paper (high coverage) and reviews should add information not already present in other reviews (low redundancy). We hypothesized that reviews from diverse reviewers would exhibit higher coverage and lower redundancy.</p>
<h4>Design</h4>
<p> We conducted a cohort study using data from the International Conference on Machine Learning, a top-tier venue in computer science. Data were collected in February to April 2020 and analyzed January to April 2024. Reviewer diversity was defined along 5 binary dimensions: whether reviewers belonged to the same organization, same geographical region, similar seniority levels, similar research topics, or had common coauthors or papers. Organization and geographical data were obtained from reviewer profiles, seniority was based on h-index, coauthorship was determined from Google Scholar publications records, and topics were inferred using a topic model applied to the abstracts of reviewers’ prior publications. Seniority and topical diversity were binarized using median h-index and topical similarity scores, respectively. Coverage was measured by the breadth of review criteria addressed—specifically, the aspects of the paper discussed (eg, summary, motivation, originality, soundness) and the types of arguments used (eg, fact, request, reference, quote)—and lexical and semantic overlap between the reviews and the paper abstract. Redundancy was measured as the lexical and semantic overlap among different reviews. Both measures were computed using natural language processing tools. To isolate the relationship between diversity and review coverage and redundancy, we controlled for potential confounders, including reviewers’ expertise (measured as similarity between reviewer’s published papers and the submitted paper), reviewer characteristics (organization, location, topic, coauthors, and seniority), and paper content (by comparing diverse and nondiverse slates of reviewers for the same paper). We used a weighted linear regression model with review coverage or redundancy as the dependent variable and diversity and confounding factors as independent variables. Statistical significance was assessed using <i>t</i> tests.</p>
<h4>Results</h4>
<p> This study included 4991 submitted papers and 3637 reviewers. Diversity in publication networks and seniority were associated with broader coverage of review criteria (<span class="CharOverride-4">Table 25-1066</span>). Topical diversity was associated with a broader coverage of the paper. No significant association was found between coverage and organizational and geographical diversity. Except for geographical diversity, diversity in organizations, seniority, topics, or publications networks were associated with lower redundancy among reviews. Furthermore, publication network-based diversity alone was associated with varying perspectives (that is, low redundancy) within specific review criteria.</p>
<h4>Conclusions</h4>
<p> Our study revealed that, in addition to optimizing individual reviewer expertise, choosing diverse slates of reviewers can lead to better reviews with higher coverage and lower redundancy. The findings are limited to certain aspects of review utility, namely redundancy and coverage, operationalized through specific measures. We recognize that there may be other factors that are crucial, either generally or specific to a particular conference or journal, which we have not addressed.</p>
<h4>References</h4>
<p>1. Shah NB. Challenges, experiments, and computational solutions in peer review. Comm ACM. 2022;65(6):76-87. doi:10.1145/3528086</p>
<p>2. Lee CJ, Sugimoto CR, Zhang G, Cronin B. Bias in peer review. J Am Soc Inf Sci Technol. 2013;64(1):2-17. doi: 10.1002/asi.22784</p>
<p>3. Jackson SE, May KE, Whitney K, Guzzo RA, Salas E. Understanding the dynamics of diversity in decision making teams. Team Effectiveness Decision Making Organ. 1995;204:261.</p>
<sup>1</sup>University of Maryland, College Park, MD, US, navita@umd.edu; <sup>2</sup>New Economic School, Moscow, Russia; <sup>3</sup>Carnegie Mellon University, Pittsburgh, PA, US.</p>
<h4>Conflict of Interest Disclosures</h4>
<p> Nihar B. Shah is a member of the Peer Review Congress Advisory Board but was not involved in the review or decision for this abstract.</p>
<h4>Funding/Support</h4>
<p> This research was supported by National Science Foundation award 1942124 and Office of Naval Research award N000142212181.</p>
<h4>Role of the Funder/Sponsor</h4>
<p> The funders played no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the abstract; or decision to submit the abstract for presentation.</p>
<h4>Additional Information</h4>
<p> We thank the current and former members of the University of Maryland Computational Linguistics and Information Processing laboratory, especially Alexander Hoyle and Connor Baumler, for their useful suggestions and feedback on this work. This study was approved by the University of Maryland Institutional Review Board.</p>


Diversity Among Reviewers Assigned to Evaluate a Paper as a Factor in Diversifying Perspective and Improving the Peer Review Process in Computer Science

<p>James M. Zumel Dumlao,<sup>1</sup> Misha Teplitskiy<sup>1</sup></p>
<h4>Objective</h4>
<p> This study tested whether (1) peer reviewers from the same country as the corresponding author are more favorable compared with those from a different country and (2) corresponding authors have differential access to these same-country reviewers (SCRs). While reviewer geographic diversity was previously considered,<sup>1,2</sup> attempts to establish same-country preferences were confounded<sup>2</sup> or had small samples.<sup>3</sup></p>
<h4>Design</h4>
<p> This cross-sectional study (using the STROBE reporting guideline) took place from October 2022 to May 2025. Using metadata from 204,718 submissions to 60 STEM journals published by the Institute of Physics Publishing from 2018 to 2022, the study employed linear models with fixed effects and 
	t tests for significance at the 1% level. Standard errors were clustered at the level of the fixed effects. Only first-round reviews were included to avoid autocorrelation (2.10 first-round reviewers per submission on average; 14.67% were SCRs). Fixed effects limit analysis to within-group comparisons. For example, manuscript fixed effects control for time-invariant variation across manuscripts like quality and proportion of SCRs on the review panel. To test the first hypothesis, this study compared the likelihood of a positive review (outcome) between SCRs and non-SCRs (exposure) using manuscript and reviewer fixed effects. Review positivity is equal to 0 if a reviewer recommended to reject the submission and 1 otherwise. To test the second hypothesis, this study estimated the likelihood a reviewer is an SCR (outcome) by corresponding author country income category (exposure) using journal fixed effects and controls for logged team size and anonymization status. Of 156 corresponding author countries, 60 were high-income countries (HIC), 39 were upper-middle income (UMIC), and 57 were low- and lower-middle income (LLMIC), according to World Bank classification.</p>
<h4>Results</h4>
<p> SCRs were more likely to give positive reviews compared with non-SCRs on the same manuscript (4.78 percentage points higher [95% CI, 3.78-5.78]; n = 181,228). Estimates of relative SCR positivity were positive for all country income groups (<b>Figure 25-1099</b>). HIC authors received SCRs over twice as often as LLMIC authors (4.97% [95% CI, 3.50%-6.44%] vs 2.66% [95% CI, 1.41%-3.91%]; n = 237,823). Authors from countries most represented among reviewers—the US, China, and India—had the greatest likelihood of receiving SCRs (30.27% [95% CI, 30.26%-30.28%], 26.59% [95% CI, 24.41%-28.77%], and 13.69% [95% CI, 10.77%-16.61%], respectively; n = 237,823).</p>

![](https://assets.underline.io/markdown_image/1/image/5893761af38fd09800d0ef2976033283.png)

<h4>Conclusions</h4>
<p> Lack of geographical diversity among reviewers—possibly reflecting historical patterns of scientific production associated with country wealth—may introduce structural advantages if reviewers favor work from their own country, as this study demonstrated. However, diversification may be challenging if qualified reviewer capacity is low in underrepresented countries. Further research should examine generalizability across fields and test potential remedies.</p>
<h4>References</h4>
<p>1. Smith OM, Davis KL, Pizza RB, et al. Peer review perpetuates barriers for historically excluded groups. <i>Nat Ecol Evol</i>. 2023;7(4):512-523. doi:10.1038/s41559-023-01999-w</p>
<p>2. Murray D, Siler K, Larivière V, et al. Author-reviewer homophily in peer review. scientific communication and education <i>bioRxiv</i>. 2018. doi:10.1101/400515</p>
<p>3. Tomkins A, Zhang M, Heavlin WD. Reviewer bias in single- versus double-blind peer review. <i>Proc Natl Acad Sci USA</i>. 2017;114(48):12708-12713. doi:10.1073/pnas.1707323114</p>
<sup>1</sup>University of Michigan School of Information, Ann Arbor, MI, US, jamesmzd@umich.edu.</p>
<h4>Conflict of Interest Disclosures</h4>
<p> None reported.</p>
<h4>Funding/Support</h4>
<p> This study received funding from the Institute of Physics Publishing, Schmidt Futures, and Science for Progress Initiative.</p>
<h4>Role of the Funder/Sponsor</h4>
<p> The Institute of Physics Publishing was involved in the collection, management, analysis, and interpretation of the data and preparation, review, or approval of the abstract. Schmidt Futures and Science for Progress Initiative contributed personnel funding.</p>
<h4>Acknowledgment</h4>
<p> We thank the Institute of Physics Publishing, and particularly Kim Eggleton and Mikka Pers, for supporting this project. We thank Schmidt Futures and the Science for Progress Initiative for financial support.</p>


Geographical Representation of Author Country among Peer Reviewers and Publishing Success at 60 STEM Journals

<p>Mabel Chew,<sup>1</sup> Taissa Vila,<sup>2</sup> Jashelle Caga-Meller,<sup>3</sup> Zoë Mullan,<sup>4</sup> Diana Samuel<sup>5</sup></p>
<h4>Objective</h4>
<p> As part of The Lancet<i> </i>Group’s commitment to advancing equity, diversity, and inclusion, we implemented the Sex and Gender Equity in Research (SAGER) guidelines<sup>1</sup> in 2023, and <i>The Lancet</i> guidance on reporting race and ethnicity<sup>2</sup> in June 2024 across 24 Lancet Group journals. Although data exist on the reporting of race and ethnicity in published articles after similar guidelines were launched,<sup>3</sup> less is known about how authors view and engage with guidelines, which is crucial to implementing and refining editorial policy. Thus, we aimed to examine authors’ awareness of and responses to these guidelines and identify challenges to guideline implementation.</p>
<h4>Design</h4>
<p> Corresponding authors of research or review articles submitted to a <i>Lancet</i> journal, who had received a request for revision between July and December 2024, were invited to participate in an online survey in January 2025. The survey asked authors about their awareness of the guidelines, changes they made to their manuscripts in response to editorial advice, the ease with which they made those changes, any challenges encountered, and how these guidelines might influence their next project.</p>
<h4>Results</h4>
<p><i> </i>The survey response rate was 22% (484 of 2185 invitations). The largest proportion of respondents was from the US (68 [14%]), followed by China (65 [13%]), the UK (59 [12%]), Australia (30 [6%]), the Netherlands (27 [6%]), Germany (21 [4%]), Canada (19 [4%]), and Sweden (17 [4%]). Fifty-four percent identified as a man (n=262), 41% as a woman (n=197), 1% as non-binary or gender diverse (n=5), and 4% preferred not to say (n=20); (64%) were involved in research and/or development, and 191 (40%) were senior researchers or in middle management. Of the 484 respondents, 193 (40%) and 220 (46%) were aware of the sex and gender and race and ethnicity reporting guidelines before submitting, respectively. A total of 246 respondents (51%) and 266 (55%), respectively, were not required to collect these data, and 9 (2%) and 33 (7%) were not permitted to collect these data. Among 153 respondents (32%) who amended their manuscript as a result of the sex and gender guidance, 104 found this easy or very easy to do. Fewer respondents (90 [19%]) made changes in response to the race and ethnicity guidance, with 55 finding this easy or very easy. <b>Box 25-1122</b> includes open-text responses on challenges in addressing these guidelines. Approximately one-half of respondents said they were likely or very likely to do things differently in their next project as a result of these guidelines (255 [53%] and 221 [46%] for each guidance, respectively).</p>

<h4>Conclusions</h4>
<p> Less than one-half of the authors surveyed reported awareness of sex and gender or race and ethnicity reporting guidelines before submission, suggesting that increasing awareness could enhance engagement. Most authors who amended their manuscript in response to these guidelines found this to be easy. The challenges identified provide opportunities for journals to refine editorial processes.</p>

![](https://assets.underline.io/markdown_image/1/image/f556edaec2af5850b8b81ae3c23ff545.png)

<h4>References</h4>
<p>1. Heidari S, Babor TF, De Castro P, Tort S, Curno M. Sex and gender equity in research: rationale for the SAGER guidelines and recommended use. <i>Res Integr Peer Rev</i>. 2016;1:2. doi:10.1186/s41073-016-0007-6</p>
<p>2. Chew M, Samuel D, Mullan Z, Kleinert S; Lancet Group for Racial Equity (GRACE). The Lancet Group’s new guidance to authors on reporting race and ethnicity. <i>Lancet</i>. 2024;403(10442):2360-2361. doi:10.1016/S0140-6736(24)01081-X</p>
<p>3. Flanagin A, Cintron MY, Christiansen SL, et al. Comparison of reporting race and ethnicity in medical journals before and after implementation of reporting guidance, 2019-2022. <i>JAMA Netw Open</i>. 2023;6(3):e231706. doi:10.1001/jamanetworkopen.2023.1706</p>
<sup>1</sup><i>The Lancet, </i>Elsevier Australia, Chatswood, Sydney, Australia, mabel.chew@lancet.com; <sup>2</sup><i>The Lancet Regional Health—Americas, </i>Rio de Janeiro, Brazil; <sup>3</sup><i>The Lancet Regional Health—Western Pacific</i>, Sydney, Australia; <sup>4</sup><i>The Lancet Global Health</i> London, UK; <sup>5</sup><i>The Lancet Digital Health</i>, London, UK.</p>
<h4>Conflict of Interest Disclosures</h4>
<p> Mabel Chew is a member and former co-chair of The Lancet Group for Racial Equity and has received funding for conference travel expenses from the World Conference on Research Integrity, Committee on Publication Ethics, and Nuffield Department of Primary Care Health Sciences. Taissa Vila is co-chair of and a member of The Lancet Group for Racial Equity. Jashelle Caga-Meller is honorary clinical senior lecturer at the Faculty of Medicine and Health, University of Sydney, Australia, and a member of The Lancet Group for Racial Equity. Diana Samuel is a member and former co-chair of The Lancet Group for Racial Equity, and a member and former Chair of the European Association of Science Editors’ (EASE) EDI Committee.</p>
<h4>Acknowledgments </h4>
<p>We thank all authors who responded to the survey; Marco Conforti for database support; Louise Hall and Adrian Mulligan for their help in conducting the survey and in preliminary reporting and analysis; Pooja Jha, Rupa Sarkar, Lan-Lan Smith, Richard Horton, and members of the <i>Lancet’s</i> Group for Racial Equity (GRacE) for advice and support.</p>


Author Responses to Editorial Guidance on Reporting of Sex, Gender, Race and Ethnicity Data

<p>Harleen K. Marwah,<sup>1</sup> Abarna Pearl,<sup>1</sup> Christos P. Kotanidis,<sup>1,2,3</sup> Sarah Gorey,<sup>1,4</sup> Darren Taichman,<sup>1,5</sup> Mary Beth Hamel<sup>1,6</sup></p>
<h4>Objective</h4>
<p> Trials increasingly include participants from low- and middle-income countries (LMICs),<sup>1</sup> but authorship representation may not be proportional. LMIC-affiliated authors on trials recruiting from LMICs offer important perspectives, which have implications for equity, expertise, and capacity building. Prior data have looked at specialty journals or non-Western country categories,<sup>2</sup> but author representation specifically in trials with participants from LMICs is not known. This study evaluated trends over time in LMIC-affiliated authorship among trials recruiting participants from LMICs.</p>
<h4>Design</h4>
<p> Using PubMed, we extracted trials published during alternating months (6 mo/y) in the years 2008, 2013, 2018, and 2023 from 4 high-impact medical journals: the <i>New England Journal of Medicine</i>, <i>The Lancet</i>, <i>JAMA</i>, and <i>BMJ</i>. Four investigators manually identified trials that recruited participants from LMICs, defined by the Wellcome Trust<i> </i>as countries with low-income or middle-income economies<i>.</i><sup>3</sup> We designed and calculated 3 metrics for each trial: (1) an enrolling country ratio (the number of recruiting LMICs divided by the total number of recruiting countries), (2) an author ratio (the number of LMIC-affiliated authors divided by the total number of authors in a trial), and (3) a representation index (RI) (the author ratio divided by the enrolling country ratio). The RI controlled for the proportion of recruiting LMICs in each trial. An RI less than 1 indicated that the proportion of LMIC-affiliated authors was lower than the proportion of recruiting LMICs. An RI of 1 indicated that the 2 ratios were exactly proportionate.</p>
<h4>Results</h4>
<p> The PubMed search yielded 865 trials, 302 of which recruited participants from LMICs. Of these, 139 (46.0%) were published in the <i>New England Journal of Medicine</i>, 117 (38.7%) in <i>The Lancet</i>, 35 (11.6%) in <i>JAMA</i>, and 11 (3.6%) in <i>BMJ</i>. The number and proportion of trials recruiting participants from LMICs increased between 2008 (52/174, 29.9%) and 2023 (117/262, 44.7%). The mean enrolling country ratio decreased over time, from 0.62 in 2008 to 0.41 in 2023 (<b>Figure 25-1131</b>, blue line). The mean author ratio decreased after 2008 and then remained similar; in 2008, it was 0.34 and in 2023, it was 0.23 (<b>Figure 25-1131</b>, gray line). Between 2008 and 2023, the RI increased modestly from 0.49 to 0.53 (<b>Figure 25-1131</b>, teal line).</p>

![](https://assets.underline.io/markdown_image/1/image/8b793884c95e0b12aa0c86e9d286c00d.png)

<h4>Conclusions</h4>
<p> This study highlights that LMIC-affiliated authorship in LMIC-recruiting trials has increased modestly over time but remains disproportionate to LMIC participant recruitment sites. Limitations of the study include the lack of information on the proportion of LMIC-recruited participants for each trial. This information could be a stronger indicator as to what LMIC-affiliated authorship representation should look like. Also, LMIC definitions may change over time and by defining organization. While there has been modest improvement in author representation, increased attention may help promote representative and ethical research.</p>
<h4>References</h4>
<p>1. Number of clinical trials by year, country, WHO region and income group (1999-2024). World Health Organization. December 2024. Accessed April 15, 2025. <a href="https://www.who.int/observatories/global-observatory-on-health-research-and-development/monitoring/number-of-clinical-trials-by-year-country-who-region-and-income-group"><span class="Hyperlink CharOverride-6">https://www.who.int/observatories/global-observatory-on-health-research-and-development/monitoring/number-of-clinical-trials-by-year-country-who-region-and-income-group</span></a></p>
<p>2. De Oliveira-Gomes D, Guilliod C, Gebran K, et al. Equity and representation in cardiology research: a comprehensive analysis of authorship from low and low-middle income countries in cardiology journals. <i>Curr Probl Cardiol</i>. 2024;49(8):102667. doi:10.1016/j.cpcardiol.2024.102667</p>
<p>3. Low- and middle-income countries. Wellcome Trust. Accessed January 8, 2025. <a href="https://wellcome.org/grant-funding/guidance/prepare-to-apply/low-and-middle-income-countries"><span class="Hyperlink CharOverride-6">https://wellcome.org/grant-funding/guidance/prepare-to-apply/low-and-middle-income-countries</span></a></p>
<sup>1</sup><i>New England Journal of Medicine</i>, Boston, MA, US, hmarwah@nejm.org; <sup>2</sup>Heart and Vascular Center, Division of Cardiovascular Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, US; <sup>3</sup>Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, UK; <sup>4</sup>Stroke Clinical Trials Network Ireland, University College Dublin Clinical Research Centre, Mater Misericordiae University Hospital, Dublin, Ireland; <sup>5</sup>Department of Medicine, Division of Pulmonary, Allergy and Critical Care Medicine, University of Pennsylvania School of Medicine, Philadelphia, PA, US; <sup>6</sup>Division of General Medicine and Primary Care, Department of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, MA, US.</p>
<h4>Conflict of Interest Disclosures</h4>
<p> Harleen K. Marwah, Abarna Pearl, Christos P. Kotanidis, and Sarah Gorey are editorial fellows at the <i>New England Journal of Medicine</i> (2024-2025). Darren Taichman is a deputy editor and Mary Beth Hamel is executive editor of the <i>New England Journal of Medicine</i>. No other disclosures were reported.</p>


Representation of Authors From Low- and Middle-Income Countries (LMIC) in Trials With Participants From LMICs

<p><span lang="fr-FR">Vincent Kipkorir,</span><sup>1</sup><span lang="fr-FR"> Godfrey Sama,</span><sup>1</sup><span lang="fr-FR"> Mumba Chalwe,</span><sup>1</sup><span lang="fr-FR"> Tihitena Negussie,</span><sup>1</sup><span lang="fr-FR"> Michael Mwachiro,</span><sup>1</sup><span lang="fr-FR"> Robert Parker,</span><sup>1</sup><span lang="fr-FR"> Seke Kazuma,</span><sup>1</sup><span lang="fr-FR"> Stella Itungu,</span><sup>1</sup><span lang="fr-FR"> Abebe Bekele</span><sup>1</sup></p>
<h4>Objective</h4>
<p> Underrepresentation along geographical and gender lines has historically been observed in academic surgery.<sup>1</sup> However, efforts have been made in recent years to ensure equity and inclusion in the surgical learning environment to increase female representation and ensure geographically diversified research engagements.<sup>2</sup> We set out to explore the evolution of authorship diversity in African surgical research using publications featured in an African surgical journal.</p>
<h4>Design</h4>
<p> This was a retrospective cross-sectional study. Data were collected from all articles published in the <i>East and Central African Journal of Surgery</i> between 2003 and 2023. Article metadata and author biodata were extracted from each article for subsequent analysis. Author gender was established by 2 independent reviewers through an online search, confirmed by a minimum of 2 web pages including LinkedIn, editorial profiles, institutional websites, and ResearchGate. For original articles, case series, and case reports, geographical location was determined by the primary study site. For the other articles, we used the author’s institutional affiliation.</p>
<h4>Results </h4>
<p>A total of 889 articles were included featuring 3001 authors; 2609 (86.9%) were male and 392 (13.1%) were female. In total, 92 females (3.1%) were designated as first authors, 93 (3.1%) as corresponding authors, and 90 (3.0%) as last authors. There was a predominance of males in the positions of first, last, and corresponding author. Despite this, the number of females represented in these categories had a steady increase over the years. The gender disparity ratio increased in the first 15 years, then dropped in the last 5 years. There were 2523 African authors (84.1%), with Ethiopia having the largest number of authors (155 [5.2%]). The distribution according to country and the trends in female authorship are presented in <b>Figure 25-1149</b>.</p>

![](https://assets.underline.io/markdown_image/1/image/21e0e5a9b54c9d6917f17d43e8d66dbb.png)

<h4>Conclusions </h4>
<p>Our findings show disparities in the ratio of male to female authors, with a substantial male predominance. While it is encouraging to note the steady increase in the number of female authors over the years, a wide gap remains. The steady rise may be attributed to the overall rise in female surgeons following the recent establishment of women in surgery associations and better advocacy and funding toward empowerment of female surgeons in Africa. With a female surgical workforce density of about 11% in College of Surgeons of East, Central and Southern Africa member countries, further efforts are needed to ensure that these potential female authors are well represented, especially as first, last, and corresponding authors.<sup>3</sup> Strategies currently in place to foster surgical research in Africa need to be sustained to maintain the current trajectory of African representation in the global surgical research landscape. This study is limited by the subjective nature of ascertaining gender and location; however, the level of bias was reduced by having 2 independent assessors.</p>
<h4>References</h4>
<p>1. Rathna RB, Biswas J, D’Souza C, Joseph JM, Kipkorir V, Dhali A. Authorship diversity in general surgery-related Cochrane systematic reviews: a bibliometric study. <i>BJS</i>. 2023;110(8):989-990. doi:10.1093/bjs/znad117</p>
<p>2. Burks CA, Russell TI, Goss D, et al. Strategies to increase racial and ethnic diversity in the surgical workforce: a state of the art review. <i>Otolaryngol Head Neck Surg</i>. 2022;166(6):1182-1191.</p>
<p>3. Osei-Kuffour D, Banda CH, Campion A, et al. The evolution of the specialist surgeon workforce in East, Central and Southern Africa. World J Surg. 2025;49(4):946-954. doi:10.1002/wjs.12545</p>
<sup>1</sup><i>East and Central African Journal of Surgery</i>, College of Surgeons of East, Central and Southern Africa; managing_editor@cosecsa.org.</p>
<h4>Conflict of Interest Disclosures </h4>
<p>None reported.</p>


Evolution of Authorship Diversity in African Surgical Research Over 2 Decades

<p>Tais Freire Galvão,<sup>1,2</sup> Everton Nunes da Silva,<sup>2</sup> Jorge Otávio Maia Barreto,<sup>3</sup> Marcus Tolentino Silva<sup>4</sup></p>
<h4>Objective</h4>
<p> Detailed descriptions of journals’ workflows exist,<sup>1</sup> but empirical studies assessing their effects are scarce. In 2024, a new workflow was implemented at <i>Epidemiologia e Serviços de Saúde: revista do SUS</i> (<i>RESS</i>) aimed at getting timely and quality reviews. This study assessed the effect of a new workflow on the journal’s time to decision-making.</p>
<h4>Design</h4>
<p> This before and after study using historical controls assessed submissions to <i>RESS</i> from June to December 2024 (intervention) and June to December 2023 (control), followed up until January 2025. The intervention started in June 2024, based on inclusion of a peer review administrator in charge of reviewers’ assignments and adding new and trained associate editors<sup>2</sup>; previous evaluation by the editor in chief (scope) and scientific editor (methodological quality); and checklists to standardize reviews.<sup>3</sup> The comparator was the previous workflow, centralized on the associate editor’s assignment of reviewers, and final decisions made by the editor in chief and a member of the editorial committee. Outcomes were processing time from submission to decision, number of reviewers invited, and reviews received. We summarized means and SDs or medians and IQRs. Normality was tested using the Shapiro-Wilk test and square root or logarithmic transformations preceded t-tests, with the Levene test used to assess variances’ homogeneity. In unsuitable t-tests, the Mann-Whitney test was applied. Residual normality and heteroscedasticity were examined by Breusch-Pagan test. We adjusted by the length of the paper (full or short) to minimize potential confounding.</p>
<h4>Results</h4>
<p> Out of 928 submissions in 2024, 218 proceeded to peer review (140 ongoing until cohort closure) and 78 had a decision (36 accepted, 42 rejected). In 2023, from 970 submissions, 77 were peer reviewed and resulted in 28 acceptances and 49 rejections (<i>P</i> = .22). Mean (SD) time in days to decision was significantly shorter in the intervention (62.8 [40.5]) than in the controls (130.1 [64.5]; <i>P</i> &lt; .001), which was also faster in the intervention according to acceptance (92.8 [39.8] vs 133.5 [61.6]; <i>P</i> = .002) or rejection (37.1 [16.0] vs 128.1 [66.7]; <i>P</i> &lt; .001). The mean (SD) number of invited reviewers per manuscript was higher in the intervention (10.1 [6.3]) than in the controls (7.8 [5.5]; <i>P</i> = .02), without significant difference according to decision when compared with the historical controls (approved, 10.0 [7.0] vs 6.3 [2.8]; <i>P</i> = .07; rejected, 10.3 [5.8] vs 8.6 [6.5]; adjusted <i>P</i> = .11). The median (IQR) number of reviews received was also higher (4 [4-4] vs 2 [2-3]; <i>P</i> &lt; .001), and was similarly higher when comparing decisions across groups (approved, 4 [4-4] vs 2 [2-3]; <i>P</i> &lt; .001; rejected, 4 [4-4] vs 2 [2-3]; <i>P</i> &lt; .001) (<b>Table 25-0909</b>).</p>

![](https://assets.underline.io/markdown_image/1/image/c5b3c1bf721bf5ccfd8c212b70f07e17.png)

<h4>Conclusions</h4>
<p> The new workflow reduced the duration of editorial processing and allowed a higher number of peer reviews to inform decision-making. The outcomes were not defined before the intervention was planned; the length of follow-up, new editors, and submission system were confounders that may have influenced the findings.</p>
<h4>References</h4>
<p>1. Mark H, Ragon T, Funning G, et al. Editorial workflow of a community-led, all-volunteer scientific journal: lessons from the launch of Seismica. <i>Seismica</i>. 2023;2(2):1091. doi:10.26443/seismica.v2i2.1091</p>
<p><span lang="pt-PT">2. Galvão TF, Silva EN, Araújo WN, Barreto JOM. Editorial improvement in </span><i>Epidemiologia e Serviços de Saúde</i><span lang="pt-PT"> in 2024. </span><i>Epidemiol Serv Saude</i><span lang="pt-PT">. 2024;33:e20241002. doi:</span><a href="https://doi.org/10.1590/S2237-96222024v33e20241002.en"><span class="Hyperlink CharOverride-6" lang="pt-PT">10.1590/S2237-96222024v33e20241002.en</span></a></p>
<p><span lang="pt-PT">3. Silva MT, Galv</span><span lang="ar-SA">ã</span><span lang="pt-PT">o TF. Systematization of peer review in </span><i>Epidemiologia e Serviços de Saúde</i><span lang="pt-PT">. </span><i>Epidemiol Serv Saude</i><span lang="pt-PT">. 2024;33:e20241001. doi:</span><a href="https://doi.org/10.1590/S2237-96222024v33e20241001.en"><span class="Hyperlink CharOverride-6" lang="pt-PT">10.1590/S2237-96222024v33e20241001.en</span></a></p>
<p class="abstract_conflict" lang="fr-FR"><sup>1</sup>Faculdade de Ciências Farmacêuticas<span lang="pt-PT">, Universidade Estadual de Campinas, Campinas, Brazil, taisgalvao@gmail.com; </span><sup>2</sup><span lang="pt-PT">Secretaria de Vigilância em Saúde e Ambiente, Ministério da Saúde</span>, Brasília, Brazil; <sup>3</sup><span lang="pt-PT">Faculdade d</span>e Ciências e Tecnologias em Saúde, Universidade de Brasília, Brasília, Brazil; <sup>4</sup><span lang="pt-PT">Gerência Regional de Brasília, Fundação Oswaldo Cruz, </span>Brasília, Brazil; <sup>5</sup><span lang="pt-PT">Faculdade d</span>e Ciências da Saúde, Universidade de Brasília, Brasília, Brazil.</p>
<h4>Conflict of Interest Disclosures </h4>
<p>Tais Freire Galv<span lang="ar-SA">ã</span>o, Everton Nunes da Silva, and Jorge Otávio Maia Barreto are editors of <i>Epidemiologia e Serviços de Saúde: revista do SUS</i>. Marcus Tolentino Silva has no conflicts of interest to declare. Tais Freire Galv<span lang="ar-SA">ã</span>o is a member of the Peer Review Congress Advisory Board but was not involved in the review or decision for this abstract.</p>


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