Gender-Based Trends in Authorship of Cardiothoracic Surgery Literature Over Two Decades

Gender disparities in academic productivity remain well described. Although women have historically been underrepresented in cardiothoracic surgery, longitudinal trends in authorship are not fully understood. We aimed to evaluate temporal patterns in women's representation as first and senior authors in major cardiothoracic surgery journals.

A bibliometric analysis of 4 cardiothoracic surgery journals, Annals of Thoracic Surgery, the Journal of Thoracic and Cardiovascular Surgery, the European Journal of Cardio-Thoracic Surgery, and Journal of Thoracic and Cardiovascular Surgery Open, was conducted of all PubMed-indexed articles published between 2002 and 2022. Author data were extracted using BioPython, and gender was assigned by first name using GenderAPI. Only assignments with ≥90% confidence were included. Linear regression assessed trends in women's first and senior authorship over time, and global patterns were visualized using R (R Core Team, 2023; The R Foundation for Statistical Computing, Vienna, Austria) using RStudio version 2024.04.2+764 (Posit Software, Boston, MA).

Of 53,034 publications, 38,091 (71.8%) had gender identified for both first and senior authors and were included in the analysis. A significant association was observed between first and senior author gender (P < 0.001), with most articles authored by men in both positions (82.0%), while only 2.8% had women as both first and senior authors. In the contemporary cohort (2020-2022), this proportion increased to 5.2%. Trends varied by journal, with projected increases in the women-to-men authorship ratio by 2030, highest in Annals of Thoracic Surgery. Globally, Northern European countries demonstrated the greatest representation of women first authors.

Although gender disparities persist, women's authorship in cardiothoracic surgery journals is increasing. Journal-specific and regional differences in representation, considered alongside imperfect workforce benchmarks, highlight areas warranting continued attention.