{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T07:43:20Z","timestamp":1777448600503,"version":"3.51.4"},"reference-count":16,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2025,8,5]],"date-time":"2025-08-05T00:00:00Z","timestamp":1754352000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The American Surgeon\u2122"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Clinical practice guidelines (CPGs) shape surgical care and outcomes, but concerns persist regarding the diversity and expertise of their authors. Whether U.S. surgical society guidelines reflect inclusive and expert-driven authorship remains unknown.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a cross-sectional analysis of 213 CPGs published by 11 national U.S. surgical societies between 2015 and 2024. We assessed author gender, race\/ethnicity, and prior publication history using validated name-based algorithms and PubMed queries. Authors were classified as underrepresented in medicine (URiM) if identified as Black and Hispanic\/Latino. Trends over time were analyzed using the Jonckheere-Terpstra test.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 2185 authors, 557 (25.5%) were women and 111 (5.1%) were URiM. Over half of guidelines (52.1%) had no URiM authors, and 21.6% had no female authors. Female representation increased over time (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.02), while URiM representation remained unchanged (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.32). Representation varied widely across societies. Among first and corresponding authors, 45% had fewer than 5 topic-specific publications. Additionally, 486 (14.7%) of all authors had no prior guideline authorship experience.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>CPGs published by U.S. surgical societies from 2015 to 2024 demonstrated persistent gaps in gender and racial\/ethnic diversity, as well as inconsistent subject-matter expertise among authors. These findings raise concerns about the representativeness and rigor of current guideline development practices. Surgical societies should consider reforms to authorship selection processes to promote more inclusive and expert-driven guidance reflective of the populations they serve.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/00031348251367049","type":"journal-article","created":{"date-parts":[[2025,8,6]],"date-time":"2025-08-06T05:35:52Z","timestamp":1754458552000},"page":"369-375","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Diversity and Expertise Among Authors of U.S. Surgical Society Clinical Guidelines"],"prefix":"10.1177","volume":"92","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8480-0181","authenticated-orcid":false,"given":"Alexander","family":"Berg","sequence":"first","affiliation":[{"name":"Department of Cardiothoracic Surgery, Stanford University School of Medicine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kaustav","family":"Chattopadhyay","sequence":"additional","affiliation":[{"name":"Robert Wood Johnson Medical School"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-7255-9862","authenticated-orcid":false,"given":"Youvin","family":"Chung","sequence":"additional","affiliation":[{"name":"Perelman School of Medicine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kayen","family":"Tang","sequence":"additional","affiliation":[{"name":"University of Washington School of Medicine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4590-4268","authenticated-orcid":false,"given":"Nam Yong","family":"Cho","sequence":"additional","affiliation":[{"name":"University of California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lakshika","family":"Tennakoon","sequence":"additional","affiliation":[{"name":"Stanford University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David A.","family":"Spain","sequence":"additional","affiliation":[{"name":"Stanford University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeff","family":"Choi","sequence":"additional","affiliation":[{"name":"Stanford University"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,8,5]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2021.15319"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)32268-2"},{"issue":"4","key":"e_1_3_3_4_2","first-page":"536","article-title":"Gender differences in north American and international otolaryngology clinical practice guideline authorship: a 17-Year analysis","volume":"169","author":"Graham ME","year":"2023","unstructured":"Graham ME, McGuirt FL, Neal D, et al. Gender differences in north American and international otolaryngology clinical practice guideline authorship: a 17-Year analysis. Otolaryngol Head Neck Surg. 2023;169(4):536-543.","journal-title":"Otolaryngol Head Neck Surg"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.p1035"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(21)02759-8"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.191537811"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2023.7174"},{"issue":"10","key":"e_1_3_3_9_2","first-page":"1678","article-title":"Gender differences in authorship of the American college of cardiology\/American heart association guidelines over the last 15 years","volume":"122","author":"Sardar MR","year":"2018","unstructured":"Sardar MR, Badri M, Uchino K, et al. Gender differences in authorship of the American college of cardiology\/American heart association guidelines over the last 15 years. Am J Cardiol. 2018;122(10):1678-1682.","journal-title":"Am J Cardiol"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.5858\/arpa.2022-0351-OA"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000207576"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2023.4777"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.2200841119"},{"key":"e_1_3_3_14_2","first-page":"111","article-title":"The gender gap in surgical literature: are we making progress?","volume":"280","author":"Shah MM","year":"2024","unstructured":"Shah MM, Ajay PS, Sahoo S, Kothari D. The gender gap in surgical literature: are we making progress? J Surg Res. 2024;280:111-119.","journal-title":"J Surg Res"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12893-017-0211-4"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.121.024249"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2022.10.052"}],"container-title":["The American Surgeon\u2122"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00031348251367049","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/00031348251367049","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00031348251367049","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T12:38:20Z","timestamp":1777379900000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/00031348251367049"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,5]]},"references-count":16,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,2]]}},"alternative-id":["10.1177\/00031348251367049"],"URL":"https:\/\/doi.org\/10.1177\/00031348251367049","relation":{},"ISSN":["0003-1348","1555-9823"],"issn-type":[{"value":"0003-1348","type":"print"},{"value":"1555-9823","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,5]]}}}