Letter to the Editor Response Regarding “Research Equity in Otolaryngology–Head and Neck Surgery”

We thank Djoutsop et al for their insightful response to the commentary, “Research Equity in Otolaryngology–Head and Neck Surgery.”¹ The authors accurately summarize the Global Otolaryngology–Head and Neck Surgery (OHNS) Initiative Research Equity Guidelines and highlight components integral to fostering equitable research.

We appreciate their recently published bibliometric analysis that reviews global OHNS authorship trends during the coronavirus disease 2019 (COVID-19) pandemic, further emphasizing imbalances in capacity to perform and publish research.² This study addresses a key gap in knowledge about OHNS research trends, and we hope it will spark further analysis and action to address research inequities through equitable collaborations. In addition, we agree with the authors’ emphasis on leveraging South-South collaborations to support research, clinical capacity, and innovation. As experienced during the ongoing global COVID-19 pandemic, lessons from resource-constrained health systems are valuable in all health care settings.

The bibliometric analysis by Djoutsop et al presents valuable findings regarding global OHNS research output during the COVID-19 pandemic. Notably, there were significantly more articles from authors affiliated with North American institutions than other regions, and articles affiliated with high-income country authors had a greater median number of citations than other income groups. The authors also offer publication volume by institution and a network analysis as tools to promote new international collaborations across different networks. Finally, this article includes an excellent description of the global neurosurgery field’s success and the opportunity to similarly support global OHNS research, education, and advocacy within the broader global surgery landscape. We applaud this research and plan to use these findings to guide our own work.

We invite Dr Djoutsop, coresearchers, and readers to consider joining or partnering with the Global OHNS Initiative.³ Within the organization, over 180 members from over 40 countries (Figure 1) are striving toward a world with universal access to high-quality, safe, timely, and affordable care for those with OHNS conditions.⁴ Our ongoing work includes research to delineate the current state of global OHNS disease and care delivery. We hope these research findings shall be leveraged to make OHNS care a policy and funding priority. This will facilitate capacity building for OHNS research and care delivery, particularly in places where patients have insufficient access to OHNS care. Of note, as the Global OHNS Initiative continues to grow, we aim to develop the capacity to decrease or eliminate the financial barriers that have prevented authors from presenting research at international conferences and publishing research in indexed journals.⁵

Figure 1.

Countries represented by members of the Global OHNS Initiative.

Disclosures

Competing interests: None.

Sponsorships: None.

Funding source: None.

Rolvix Harlan Patterson, MD, MPH
Department of Head and Neck Surgery & Communication Sciences, Duke University School of Medicine, Durham, North Carolina, USA

Mary Jue Xu, MD
Department of Otolaryngology–Head and Neck Surgery, University of California, San Francisco, San Francisco, California, USA

Samuel Okerosi, MBChB, MMed
Department of Otolaryngology, Machakos Level Five Hospital, Machakos County, Kenya

Mahmood F. Bhutta, DPhil, FRCS
University Hospitals Sussex, Eastern Road, Brighton, UK
Brighton & Sussex Medical School, Falmer, Brighton, UK

Carolina Der, MD, PhD
School of Medicine, Clínica Alemana Universidad del Desarrollo, Otorhinolaryngology Department Dr. Luis Calvo Mackenna Children’s Hospital, Santiago, Chile

Blake Alkire, MD, MPH
Program in Global Surgery and Social Change, Harvard Medical School, Boston, Massachusetts, USA
Center for Global Surgery Evaluation, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA
Department of Global Health Equity, Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts, USA

Rose Njogu, MSc
SH:24 Sexual and Adolescent Reproductive Health, London, UK

Varun Vendra, MD, MA
Department of Otolaryngology–Head and Neck Surgery, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA

Sharon Ovnat Tamir, MD
Department of Otolaryngology–Head and Neck Surgery, Faculty of Health Sciences, Samson Assuta Ashdod University Hospital, Ben Gurion University, Ashdod, Israel

Johannes J. Fagan, MBChB, MMed
Division of Otolaryngology, University of Cape Town, Cape Town, South Africa