Evaluation of Author Instructions for Inclusive Language Guidance in Highly Cited English Language Medical Journals

Diversity, equity, and inclusion (DEI) are at the core of publication ethics, and language around DEI has been shown to affect patient outcomes. Inclusive language is an important piece of effective communication and is one way to demonstrate and foster a welcoming, respectful, and accessible environment. Non-inclusive terminology in research may represent implicit bias, which is not typically corrected through introspection; thus, a systematic approach is needed in scientific writing. The prevalence of inclusive language guidance in leading medical journals is currently unknown.

Investigators assess the prevalence and quality of inclusive language guidelines in author instructions in highly cited English language medical journals.

A cross-sectional review of author instructions from a convenience sample of 100 highly cited medical journals was completed in January 2023.

Each journal's author instructions were reviewed for presence of inclusive language guidelines for manuscript submissions.

Guidelines that included specific examples of inclusive language were defined as "strong." Author instructions were also reviewed for the Sex and Gender Equity in Research (SAGER) checklist, and each journal's publisher and impact factor (IF) were recorded.

The 100 journals reviewed had an IF range of 3.0-202.7 with a median IF = 19.5 (IQR 11.95, 38.68), and 28 unique publishers were represented. Inclusive language guidance was provided in 23% of medical journals reviewed. Of those, 20 (86.9%) provided strong guidance. Seven journals also recommended use of the SAGER checklist.

Significant gaps still exist in ensuring use of inclusive language in medical journals.