#WomenInMedicine: Progress in gender equity at Research and Practice in Thrombosis and Haemostasis

RPTH Statement on Diversity, Equity, and Inclusion

RPTH believes that diversity in all forms will advance scientific discourse. We commit to building a publishing culture of diversity, equity, and inclusion that will increase the participation of women, those from underrepresented race/ethnic groups, early career professionals, and those from all regions of the world as associate editors, editorial board members, authors, and peer reviewers.

#WomenInMedicine #WomenInScience #HeForShe #NoManels. These #s are not just social media tropes, but they bring people together on social media to build community and to reduce conscious and unconscious bias affecting women in science and medicine. Ensuing discussions empower men and women to real change.

Summarized in the box above, I reported 1 year ago the commitment of Research and Practice in Thrombosis and Haemostasis (RPTH) to promote diversity, equity, and inclusion in scientific publishing in a manner that will advance science.1 That editorial discussed our vision in the areas of editorial board and author gender, race/ethnicity, career stage, and geography. Other journals are putting forth similar visions.2 The International Society on Thrombosis and Haemostasis (ISTH) has formed a task force on diversity, equity, and inclusion to develop policies and programs for implementation across the society.

In this update, I provide data on RPTH author gender for the consideration of our readers. Examination of these data is vital to reduce both conscious and unconscious bias that disadvantages women in scientific publishing. We believe, as stated last year, that tracking data on author gender will help us improve representation of women in science and medicine. We now add information on reviewer gender, to enhance our reporting and accountability to increase the quality of peer review by providing the needed insight of women's perspectives.

Author Gender

We consider author gender in categories including all authors, first authors, senior (or corresponding) authors, and those of invited articles and noninvited articles (ie, regular submissions). RPTH author gender from July 2017 through July 2018 was examined; among 648 authors whose gender could be identified, 277 (42.7%) were women. Of 111 first authors, 50 (45.0%) were women, while of 111 last/senior authors, 42 (38.8%) were women. Of 31 senior authors of invited articles (commentaries, reviews, and others), 13 (41.9%) were women. Little published information was available at the time from other journals, but these percentages compared favorably to published data from The Lancet Haematology, where 36% of all authors and 18% of senior authors were women.3 They also compared reasonably well to the ISTH membership, which is 45% women.

For articles published in RPTH from October 2018 through July 2019, of 591 authors whose gender could be identified (1 was unknown), 255 (43.1%) were women. Of 89 senior authors, 34 (38.2%) were women. Of 89 first authors, 46 (51.7%) were women. There were 45 authors of invited articles, and 17 (37.8%) were women, while senior authors of invited articles (ie, the person invited to write) included 26 individuals, of whom 8 were women (30.8%); of 26 first authors, 10 (38.5%) were women.

Figure 1 shows longitudinal trends in these statistics. Authorship gender has remained consistent for the proportion of women overall. There was some increase in women first authors but a decline in first authorship by women for invited articles. The percentage of women senior authors of invited articles decreased by 26%, from 41.9% to 30.8% (P for difference, 0.38). While not statistically significant owing to a small sample size, this raised concern at the journal. I am shining the light on this result with our editorial team and readers so that all are aware and the editorial team can be accountable to increase this percentage. A reasonable goal is to have our authorship gender distribution for all author categories match that of the ISTH membership, at 45% women for all categories of authors.

Figure 1.

Longitudinal trend in percentage of women authors, overall and for invited articles, and by author type; Research and Practice in Thrombosis and Haemostasis, 2017‐19.

How will we achieve our goal? Like any science experiment, an understanding of the cause of inequity is required. A decline in women invited authors might be due to fewer invitations to women, that women more frequently decline invitations, or that women more frequently do not submit their invited articles. A closer look at invited articles since the journal's inception reveals that only 3 invited authors (2 men) declined our invitation and only 3 (2 men) did not complete their invited article, leading to withdrawal. Similar numbers of men and women have articles still in progress.

Since there was no gender disparity in acceptance of invitations or withdrawal of invited articles, increasing the number of invitations to women is the best first step to improving the gender diversity of invited articles. After discussion of the above results with the editorial team, we all commit to increased attention to considering invitations to women for invited articles. Although men and women did not differ in their acceptance of invitations, we will also explicitly express our desire in invitation letters to achieve gender diversity in authorship.

Peer Reviewer Gender

Participation in peer review is a key activity for scientists to engage in academic discourse and build relationships with experts in their field that may help advance their careers. To enhance the peer review process at RPTH, we tabulated gender data for the most frequent peer reviewers as of July 1, 2019. For editorial board members, among our top reviewers (who have reviewed ≥7 articles), 4 of 9 (44.4%) were women, perhaps reflecting the gender diversity of the group (45% women). However, among frequent reviewers who are not on the editorial board (those who have reviewed ≥6 articles), 4 of 19 (21.0%) were women. Of all reviewers with ≥6 invitations, 28 of 87 (32.2%) were women, and among all reviewers completing ≥6 reviews, 14 of 42 (33%) were women. Among reviewers declining invitations ≥5 times, 5 of 20 (25%) were women. The findings suggest that women tend to agree to review more frequently, but they are less likely than men to be invited. I discussed these results with the associate editor team, and they will make a greater effort to invite more women peer reviewers. We also examined the language of the reviewer invitation letter and removed gender‐biased language (the only language was attribution as “Ms., Mr.,” and the like for those not referred to as “Dr.” or “Prof.”). We added the italicized text to the following, “If you cannot review this article, we would greatly appreciate any suggestions for other potential reviewers. We are striving for inclusion of women and those of diverse race/ethnicity and geography in peer review, so please keep this in mind when suggesting other reviewers.”

Efforts by RPTH to increase gender diversity, equity, and inclusion:

• State our vision for diversity and inclusion on our website and in journal communications.

• Report data over time to remain accountable.

• Conduct regular editorial team discussions on conscious and unconscious bias.

• Confidentially collect self‐reported gender from authors, peer reviewers, and editorial board members.

• Remove any gender‐biased language from website, author instructions, and journal communications.

As in 2018, we again pledge to a culture of inclusion at RPTH, with transparency and reporting to the research community on author gender. The box lists our actions to date to improve. These actions will lead to better science. As stated 1 year ago, we call on other journals in the field to make similar pledges and share their data.

We need help from our authors to implement our vision. For example, we hope to implement a process to request information from authors, peer reviewers, and editorial board members to confidentially report gender and race/ethnicity so we have accurate information. We assigned author gender for all analyses above, so misclassification is certain; we have no information on those with nonbinary gender, and we do not know race/ethnicity.

We will continue to provide information on our progress toward gender equity and welcome your input. If you have thoughts to share, please feel invited to contact me.