Gender disparities in leadership of methodological research in health science

Gender disparities in methodological studies are largely unexplored. We aimed to examine gender representation between first and last authorship positions in methodological research in health science.

We searched for methodological articles as part of a large study focused on creating a methodological study reporting checklist. We extracted the names of the first and last authors of all included studies and determined their gender using Genderize.io, classifying authors as women if the gender probability was ≥ 60%. Our primary outcome was the proportion of studies with women in leadership roles (first or last author as separate outcomes). Secondary outcomes included the proportion of studies with both or either the first or last authors as women. We examined associations between women's leadership and country income level, World Health Organization region, number of authors on the study team, and publication year.

Of the 1,375 included studies, the genders of 1,332 first authors and 1,334 last authors were determined. Among first authors, 675 (50.7%) were women, and 657 (49.3%) were men, indicating no gender difference. Among last authors, 486 (36.4%) were women, and 848 (63.6%) were men, with a statistically significant difference (χ² = 98.23, p < 0.001). Studies with women last authors had fewer listed co-authors than those with men (t = -3.63, p < 0.001; risk difference = -27.14%, 95% CI -32.50% to -21.77%). In adjusted models, women's last authorship was negatively associated with number of authors (adjusted odds ratio [aOR]=0.93, 95% CI 0.90-0.97). Publication year was associated with both women first (aOR=1.03, 95% CI 1.01-1.05) and last (aOR=1.05, 95% CI 1.02-1.07) authorship.

Our findings highlight a gender disparity in last authorship positions, with men more often in these roles. The association between women last authorship position and smaller author teams may reflect differences in collaborative structure and access to leadership opportunities in larger-scale methodological research. Addressing these disparities can help foster more inclusive research environments, especially within methodological research.