Articles published in clinical research journals are less likely to list female authors first in the byline, reasons of which have yet to be made clear, according to a cross-sectional analysis published in JAMA.

In this study, investigators performed a cross-sectional analysis of original research articles published in 10 different journals that featured co-first authors of different genders. Placement of the female author’s name first in the byline comprised the dependent variable, whereas journal genre, year of publication, last author gender, total number of authors, and geographic location of corresponding authors comprised the independent variables.

A total of 3706 multiple authors were listed in the 10 journals as equal contributors. After exclusion of co-first authors of the same gender as well as articles featuring ≥1 co-first author of unknown gender, investigators evaluated 862 articles with co-first authors of different genders.

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Overall, the proportion of female authors listed in the byline first was not statistically significant from the proportion of males listed first (0.50; 95% CI, 0.46-0.53; P =.92). When this analysis was restricted to articles published in clinical journals only, however, the proportion of females listed first was significantly lower (0.37; 95% CI, 0.30-0.45; P <.001). In addition, articles published in a clinical research journal featured an inverse relationship with female first authorship compared with articles published in a basic science journal (adjusted risk ratio, 0.69; 95% CI, 0.56-0.85; P <.001). Investigators also observed an association between a female last author with a female co-first author printed first in the byline (adjusted risk ratio, 1.18; 95% CI, 1.00-1.39; P =.04).

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The findings from this study are limited in generalizability to other journals, considering investigators included only 10 high-impact factor journals in this analysis. Also, unmeasured factors, such as differences in author specialty or seniority, could have provided greater insight into the observed differences between clinical and basic science journals.

Investigators of this study call for further investigation into the factors that influence “byline position among co-first authors and what professional consequences, if any, result from differences in byline position of equally contributing co-first authors.”


Aakhus E, Mitra N, Lautenbach E, Joffe S. Gender and byline placement of co-first authors in clinical and basic science journals with high impact factors. JAMA. 2018;319(6):610-611.