Gender Differences in the Authorship of Gastroenterology Clinical Practice Guidelines

Women are underrepresented in gastroenterology (GI), and few studies have evaluated gender differences in the authorship of GI clinical practice guidelines. This study aimed to assess gender disparities in the authorship of GI guidelines and their cited articles over time.

We reviewed luminal GI guidelines from three major GI societies to compare authorship of current guidelines (defined as published from 2019 to 2022) to their retired guidelines (defined as the previous guideline replaced by the current guideline). Several characteristics of the author and article including gender, faculty rank, study type, and strength of recommendation supported by the cited article were collected to evaluate factors associated with female authorship.

We reviewed 13 current guidelines, 12 retired guidelines, and 4328 cited articles. There was no significant change in female authorship of guidelines from 2010 to 2022. Proportions of female first (p-value < 0.0001) and senior (p-value < 0.0001) authors of cited articles increased over time. Women were less often first authors of cited randomized control trials, systematic reviews, and meta-analyses than observational studies (35% vs. 65%, p < 0.0001). Cited articles that supported a "strong" guideline recommendation were less often first-authored (19% vs. 81%, p = 0.003) and senior-authored (10% vs. 90%, p = 0.006) by women.

Female authorship increased over time, but a gender disparity remains. Female authors less commonly authored higher level of evidence studies. Further studies are needed to assess if the proportional increase in female authorship is due to a small subset of prolific authors or representative of the number of women practicing in gastroenterology.