Objective In 2019, Neurology appointed 2 equity, diversity, and inclusion (EDI) editors to review manuscripts dealing with sex and gender, race and ethnicity, and other categories of marginalization. 1,2 Manuscripts requiring EDI review are identified by the EDI editor by title review or selected by the handling editor during the review process. The EDI review is obtained only for manuscripts that are being considered for publication if suitably revised. Final editorial decisions are made considering the EDI reviews and the responses from the authors. The objectives of this retrospective analysis were to describe the outcomes of the process and highlight the issues identified by the EDI editors.

Design For this mixed methods study, the research articles that were reviewed by the EDI editors between May 1, 2019, and December 31, 2021, were identified. For this analysis, 75 of these manuscripts were selected at random. Two raters with expertise in EDI issues read the reviews and classified the issues raised by the EDI reviewers as related to terminology or conceptual issues in reference to sex and gender, race or ethnicity, or other marginalization categories. The analysis was limited to initial reviews. The data were summarized with descriptive statistics.

Results In the study time frame, 7841 research articles were submitted to the journal. The EDI editors reviewed 101 manuscripts (1.3%). After evaluating the 75 reviews selected for analysis, 2 were excluded because the EDI editor reviewed them as a topic expert and not for EDI concerns. Among the 73 papers included in the analysis, the EDI reviewers identified at least 1 terminology or conceptual issue in 64, and there were at least 2 issues in 41 manuscripts. In relation to sex and gender, the EDI editors identified terminology and conceptual issues in 23 and 19 manuscripts, respectively; the matching numbers in relation to race or ethnicity were 23 and 56; and for other categories, 6 manuscripts had conceptual issues. The main themes identified during the EDI review process are presented in Table 5. As of May 31, 2022, 45 of the 73 manuscripts in the analysis had been accepted, 27 had been rejected, and 1 was undergoing major revision. The proportion of rejected manuscripts was lower for those in which an issue was identified by the EDI editor (22 of 64 vs 5 of 9; difference, 22%; 95% CI, −9.4% to 49.5%).

Conclusions The EDI editors identified several conceptual and nomenclature issues spanning various themes. The fact that the proportion of rejected manuscripts was lower when EDI concerns were identified suggests that the authors were able to address the concerns raised. The implementation of EDI review led to identification and substantive corrections related to categories of marginalization in manuscripts submitted to Neurology.

References 1. Baskin PK, Pieper KM, Gross RA. Efforts by the journal to promote perspectives of equity, diversity, and inclusion and address disparities. Neurology. 2019;93(12):521-522. doi:10.1212/WNL.0000000000008021

2. Hamilton RH, Hinson HE. Introducing the associate editors for equity, diversity, and inclusion: aligning editorial leadership with core values in Neurology®. Neurology. 2019;93(15):651-652. doi:10.1212/WNL.0000000000008235

1 Neurology, Minneapolis, MN, USA, jose.g.merino@gunet. georgetown.edu; 2 Department of Neurology, University of Pennsylvania, Philadelphia, PA, USA; 3 Department of Neurology, Oregon Health and Science University, Portland, OR, USA; 4 Department of Neurology, Dana-Farber Cancer Institute, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; 5 Department of Neurology, University of California, San Francisco, CA, USA; 6 Department of Neurology, University of Rochester, Rochester, NY, USA; 7 Department of Pharmacology and Physiology, University of Rochester, Rochester, NY, USA; 8 Department of Neurology, Georgetown University Medical Center, Washington, DC, USA

Conflict of Interest Disclosures Roy H. Hamilton receives salary support from the American Academy of Neurology for his role as associate editor for Equity, Diversity, and Inclusion. H. E. Hinson receives salary support from the American Academy of Neurology for her role as associate editor for Equity, Diversity, and Inclusion. She consults for Biogen and conducts research supported by National Institute of Neurological Disorders and Stroke grant 1K23NS110828. Joshua A. Budhu receives salary support from the American Academy of Neurology for his role as section editor for Inclusion, Diversity, Equity, Anti-racism, and Social Justice. The Commonwealth Fund provides salary and research support. Nicole Rosendale receives research support from the American Academy of Neurology. Patricia K. Baskin’s salary is paid by the American Academy of Neurology. José G. Merino receives salary support from the American Academy of Neurology for his role as editor in chief of Neurology. No other disclosures were reported.

Additional Information Roy H. Hamilton and H. E. Hinson are co–first authors.