Perceptions of gender inequality among academic authors of outcomes research

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Objectives Concerns about implicit bias and the associated risks of unethical or abusive authorship practices have been raised across academic disciplines. Due to these concerns, we examined the associations between sociodemographic characteristics and dimensions of reported difficulty receiving accurate author attribution among academic researchers. Investigating author experiences may facilitate the identification of factors that drive author inequality and/or unethical or abusive practices, which could disadvantage historically underrepresented groups in terms of career advancement, recognition, and academic opportunities. 

Participants The target population for the study included all US-affiliated academic authors of sponsored original research published in one of 12 target journals that cover outcomes research, pharmacoepidemiology, and pharmacoeconomic disciplines from October 2018 through September 2019.

Methods We identified eligible authors and acknowledged individuals by hand-searching 12 months of issues for the 12 target journals. We developed an online survey to collect data on subjects’ authorship experiences in the context of their entire academic careers. We asked about demographic and career characteristics as well as 6 dimensions of authorship conflict including (a) authorship exclusion, (b) first-author demotion, (c) last-author demotion, (d) middle-author demotion, (e) cancelled (or non-definitively postponed) publication, or (f) other conflicts. Respondents were asked to report the likelihood that they had experienced these dimensions of conflict on a 5-point Likert scale.

Results We identified 12,560 individuals listed as authors or acknowledged on 1,623 original research papers published from September 2018 through October 2019 in the selected journals. Of that, the survey was sent by email to 988 eligible authors, representing 10% of identified authors, and 5 acknowledged individuals. A total of 267 persons responded and completed the survey, including 144 males and 123 females. Males reported an average of 24.7 more publications than females (95% confidence interval [CI] 16.1, 33.2), a difference that was reduced to only 7.1 (95% CI 0.9, 13.2) when controlling for demographic and career characteristics. Across all six dimensions of authorship conflict, except dimension 4 regarding whether or not the respondent was placed later in a list of authors than was warranted, males were more likely to report a conflict. Only dimension 5, whether or not a paper’s publication was cancelled or delayed indefinitely because of a disagreement about authorship was statistically significant for gender in the univariable analysis, and males were 3 times as likely to report the conflict compared to females (odds ratio=3.2; 95% CI=1.03-10; p=0.045). However, when we adjusted for number of publications and/or years of experience, the magnitude of the difference was attenuated, and the model was no longer significant. 

Conclusions Despite the establishment of ICMJE authorship criteria, disputes over authorship are reported by both genders. Additionally, the disparity in number of publications by gender, despite years’ of experience, is suggestive of gender-inequity in the academic publishing environment. This highlights the need for an enhanced role in educating investigators about ethical authorship, and for determining author responsibilities and hierarchy in advance to minimize the risk of disputes.  

Recommend0 recommendationsPublished in College of Pharmacy, Virtual Poster Session Spring 2021


  1. Monet, awesome poster and narration! I’m wondering if you’ve heard of (or already watched) the new documentary, “Picture a Scientist?” Based on your project, I believe you would find it very interesting as it follows along the same theme. Mainly, it outlines the historic struggle of women to develop equality within the sciences and how implicit bias has impacted the role and credibility of women within STEM. Let me know if you’d like to talk about it more!

    1. Hi Kelsey,
      I have not watched “Picture a Scientist” but it sounds fascinating. There is certainly evidence of a gender gap within STEM fields, resulting in additional challenges for women. I would love to be further educated on how implicit bias has impacted the role of women, and other disadvantaged individuals within those fields. Thank you for the wonderful comment and documentary suggestion!

      1. Oh, I definitely agree with Kelsey. You should watch “Picture a Scientist!”

  2. It looks very good, Monet. I can’t wait until we can finalize the whole paper.

    1. Thank you so much Dr. LaFleur. Your continually support and guidance has been the foundation of our success. It will be a great accomplishment once we finalize the paper!

  3. Great work, Monet! It is important to shine a light on these issues so steps can be taken to address inequality. What was the most important lesson you learned about doing survey-based research during your project?

    1. Hello Dr. Witt,
      This is a very insightful question. I learned many aspects of conducting survey-based research during this project from implementation, to audience usability, to formulating questions in an understandable manner. I would say the most important lesson to conducting survey based research is to make sure it is piloted before sending it out to the study population. We had the foresight to pilot our survey to local investigators within the University of Utah to provide feedback on coherence, difficulty, response time, and face- and content-validity. These are all extremely important aspects to consider when developing a survey to maximize the probability of complete responses. In my experience, survey-based research is highly dependent on the number of responses that are received to determine the most accurate picture.

      Thank you so much for question! I hope you are staying safe and healthy!

  4. This is an incredible important topic – and I appreciate the work you put into making it an exceptional research work. I hope to see this published soon! Agree on the comments about watching picture a scientist…. very impactful for me.

    1. Thank you so much Dr. Gunning. As soon as we get it published, I will let you know!

  5. Monet, Such important and exciting work. Your poster, in addition, is logically developed, clearly presented and aesthetically pleasing! Thank you for all of the effort that you have clearly put into this project and presentation! I see your demographic data show the usual attrition of females across time. Do you have thoughts on how to disentangle a potential impact of gender bias on opportunities to publish from the potential impact of more men being in the field longer and, therefore, simply having more time to publish?more?

    1. Thank you so much for the lovely comment Dr. Keefe. I remember discussing this topic with you when I was writing the proposal.

      You pose a very interesting and difficult question to answer. This study was focused on assessing if individuals viewed their own authorship contributions as being undervalued, and if there was an association due to gender bias. Thus, we surprisingly discovered that males (in most dimensions) numerically reported more conflicts, suggesting that males either have more opportunities to publish than females, or have an inherent higher value of their work. The disparity in the number of publications by gender is suggestive that gender-inequality exists. I think the impact of gender bias on publishing opportunities will be an interesting tend to observe over time as a shift in gender distribution occurs within the field. At this time, I’m not sure how one would be able to distinguish the potential impact of gender bias on publishing opportunities from the potential impact of more men being in the field longer. However, we did control for years of experience and despite this, males still had on average more publications than females.
      I hope I answered your question. Thank you so much for the interest!
      Please stay safe and healthy.

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