Abstract Details

The need for promoting diversity and equitable representation in academic neurology is being increasingly recognized. Cochrane systematic reviews are perceived worldwide to be amongst the highest quality of evidence available, thereby globally impacting policy and practice. However, the current state of authorship diversity in neurology-related Cochrane reviews is unknown.

This study sought to determine the country-wise and gender-wise authorship representation, and worldwide collaboration patterns, in the authorship of Cochrane reviews of stroke.

We searched the Cochrane Library on 1st September 2021 using ‘topic: stroke’, and included published reviews, unpublished review protocols, and withdrawn publications. We extracted authors’ details and searched online to determine their gender, attempting to capture at least one webpage demonstrating it. Authors whose gender could not be ascertained were excluded from gender-based analyses. A second author cross-verified the extracted data.

We included 209 publications, having 950 co-authors cumulatively. Only 1.3% of all authors came from low and lower-middle income countries (LMICs), with 0% representation from Africa. The top-five represented nations in authorship were the United Kingdom (33.3%), China (16.7%), Australia (8.2%), Netherlands (8.2%), and Italy (6.7%). The United States (US) and Canada had only 3% of all authors each. Of the 777 authors whose genders could be ascertained, women constituted 48.5% of all authors, 50.6% of first authors, and 50.3% of corresponding authors.

Authors from high-income countries continue to be the biggest contributors to the highest-quality evidence in stroke, with poor representation from LMICs. US and Canada, despite significant contribution to global neurology and stroke literature, find relatively much lower representation here. However, women are well-represented both as contributors and senior authors. Active capacity-building efforts are needed for advancing authorship diversity at the highest levels of evidence in neurology.