Department of Emergency Medicine, Alpert Medical School of Brown University, Providence, Rhode Island, USA
Emergency Medicine Department, Muhimbili National Hospital, Dar es Salaam, United Republic of Tanzania.
BMJ Glob Health. 2022 Jun;7(6). doi: 10.1136/bmjgh-2022-009538.
High-income country (HIC) authors are disproportionately represented in authorship bylines compared with those affiliated with low and middle-income countries (LMICs) in global health research. An assessment of authorship representation in the global emergency medicine (GEM) literature is lacking but may inform equitable academic collaborations in this relatively new field.
We conducted a bibliometric analysis of original research articles reporting studies conducted in LMICs from the annual GEM Literature Review from 2016 to 2020. Data extracted included study topic, journal, study country(s) and region, country income classification, author order, country(s) of authors' affiliations and funding sources. We compared the proportion of authors affiliated with each income bracket using Χ analysis. We conducted logistic regression to identify factors associated with first or last authorship affiliated with the study country.
There were 14 113 authors in 1751 articles. Nearly half (45.5%) of the articles reported work conducted in lower middle-income countries (MICs), 23.6% in upper MICs, 22.5% in low-income countries (LICs). Authors affiliated with HICs were most represented (40.7%); 26.4% were affiliated with lower MICs, 17.4% with upper MICs, 10.3% with LICs and 5.1% with mixed affiliations. Among single-country studies, those without any local authors (8.7%) were most common among those conducted in LICs (14.4%). Only 31.0% of first authors and 21.3% of last authors were affiliated with LIC study countries. Studies in upper MICs (adjusted OR (aOR) 3.6, 95% CI 2.46 to 5.26) and those funded by the study country (aOR 2.94, 95% CI 2.05 to 4.20) had greater odds of having a local first author.
There were significant disparities in authorship representation. Authors affiliated with HICs more commonly occupied the most prominent authorship positions. Recognising and addressing power imbalances in international, collaborative emergency medicine (EM) research is warranted. Innovative methods are needed to increase funding opportunities and other support for EM researchers in LMICs, particularly in LICs.
与低收入和中等收入国家（LMICs）相比，高收入国家（HICs）的作者在全球健康研究的作者署名中所占比例过高。目前缺乏对全球急诊医学（GEM）文献中作者代表性的评估，但这可能为该相对较新领域的公平学术合作提供信息。
我们对 2016 年至 2020 年每年的 GEM 文献综述中报告的在 LMICs 进行的原始研究文章进行了文献计量分析。提取的数据包括研究主题、期刊、研究国家和地区、国家收入分类、作者顺序、作者所属机构的国家和资金来源。我们使用Χ检验比较了每个收入阶层的作者比例。我们进行逻辑回归以确定与研究国家的第一或最后作者从属相关的因素。
在 1751 篇文章中有 14113 位作者。近一半（45.5%）的文章报告了中下等收入国家（MICs）开展的工作，23.6%的文章报告了中上收入国家（MICs）的工作，22.5%的文章报告了低收入国家（LICs）的工作。HIC 国家的作者代表最多（40.7%）；26.4%隶属于中下收入国家，17.4%隶属于中上收入国家，10.3%隶属于低收入国家，5.1%隶属于混合收入国家。在单国研究中，那些没有任何本地作者（8.7%）的研究最常见于低收入国家（LICs）（14.4%）。只有 31.0%的第一作者和 21.3%的最后作者隶属于 LIC 研究国家。中上收入国家（调整后的比值比（aOR）3.6，95%CI 2.46 至 5.26）和由研究国家资助的研究（aOR 2.94，95%CI 2.05 至 4.20）更有可能拥有本地第一作者。
作者代表性存在显著差异。HIC 附属作者更常占据最突出的作者地位。认识到并解决国际合作急诊医学（EM）研究中的权力不平衡问题是必要的。需要创新方法来增加中低收入国家（尤其在低收入国家）EM 研究人员的资金机会和其他支持。
