Sex Bias in Laryngology Research and Publishing

To investigate sex bias in laryngology research and publishing.

Articles published in 2019 in seven mainstream otolaryngology journals were reviewed. Original manuscripts were included. Study type (medical, speech-language pathology, basic science, or pedagogy), subject sex, ≥50% sex-matching (SM_≥50), sex-based analysis, and bibliometric data including author sex were recorded.

Of 1619 publications reviewed, 259 patient-centered original laryngology studies were included, totaling 7,130,991 subjects (3,411,741 [47.8%] male; 3,718,694 [52.1%] female; 556 [0.0%] unreported). 29 studies included subjects of a single sex and 14 did not report sex. 114 (44%) studies met SM_≥50, and 95 (37%) used sex-based analysis; no differences were found among study types or location. Sex-based analysis was used less in single-institution (33%) than database studies (62%, P = 0.01). No difference in SM_≥50 was found among single or multi-institution, or database. There were 1340 total authors (578 [43%] female). First, corresponding, and senior authors were 47%, 39%, and 35% female, respectively. Studies that had female first and/or senior authors did not differ in rates of SM_≥50 or sex-based analysis or mean enrollment of females compared to studies with male first and senior authors. The proportion of female physician first and senior authors did not differ from the proportion of female Association of American Medical Colleges otolaryngology faculty, but was non-significantly smaller than the proportion of female laryngology fellows at four academic institutions.

Laryngology research exhibits sex bias in subject enrollment and sex-based analysis. Female authorship was representative of national demographics and author sex did not influence the rate of sex bias.