Geographic Representation of Authorship in Ophthalmic Research from Low- and Middle-Income Countries

Low- and middle-income countries (LMICs) are underrepresented in ophthalmic research, despite carrying the highest burden of visual impairment. To assess the representation of local authors in global ophthalmic research, this cross-sectional, bibliometric analysis measured the proportion of LMIC-affiliated authorship in LMIC-based ophthalmic research. We sampled original, primary research conducted in LMICs and published in 1 of 7 high-impact ophthalmic journals between 2017 and 2021. For each article, we extracted the number and name of country study site(s), country affiliation(s) of first and last author, proportion of LMIC-affiliated authors, funding sources, and study design. Of the 1,333 studies exclusively conducted in LMICs, 89.4% of first authors and 80.6% of last authors were exclusively LMIC-affiliated. Representation of LMIC-affiliated first authors were lower in studies based in low-income countries (25.0%) or in sub-Saharan Africa (26.5%), published in journals with higher impact factors (68.0% in Ophthalmology), funded by high-income countries (HICs) (41.4%), or conducted in both LMICs and HICs (27.1%). The United States, United Kingdom, and Australia had the 3rd, 6th, and 8th largest shares of last authors. There were only 12 single-country studies conducted in low-income countries, namely Ethiopia, the Gambia, Guinea, Liberia, the Niger, and Sierra Leone. Of these countries, only three held first authorship and one held last authorship. Although LMIC-based ophthalmic research has demonstrated higher local authorship representation compared to other fields, underrepresentation can be exacerbated by country income level, journal “prestige,” and degree of HIC involvement. These discrepancies highlight the need for more equitable data ownership in global ophthalmic research.

尽管中低收入国家（Low- and middle-income countries, LMICs）承担着全球最为沉重的视力损害疾病负担，但这类国家在眼科研究中的参与度却严重不足。为评估本土作者在全球眼科研究中的参与占比，本横断面文献计量分析针对以中低收入国家为研究场景的眼科研究，测算其中隶属于LMIC机构的作者的署名占比。本研究筛选了2017至2021年间发表于7种高影响力眼科期刊之一、且在LMICs境内开展的原创性一手研究作为样本。针对每篇纳入样本的论文，本研究提取了以下信息：研究地点所在国家的数量与名称、第一作者与通讯作者的所属国家机构、LMIC附属作者的占比、资金来源以及研究设计类型。在仅于LMICs境内开展的1333项研究中，89.4%的第一作者与80.6%的通讯作者均完全隶属于LMIC机构。在以下场景的研究中，LMIC附属第一作者的占比更低：研究场景为低收入国家（占比25.0%）或撒哈拉以南非洲地区（占比26.5%）、发表于高影响因子期刊（如《眼科学》（Ophthalmology）的占比为68.0%）、由高收入国家（High-income countries, HICs）提供资金支持（占比41.4%），或是同时在LMICs与HICs境内开展（占比27.1%）。美国、英国与澳大利亚的机构所属通讯作者占比分别位列全球第三、第六与第八位。仅开展过12项以单一低收入国家为研究场景的研究，涉及埃塞俄比亚、冈比亚、几内亚、利比里亚、尼日尔与塞拉利昂。在上述国家中，仅有3个国家的作者担任了第一作者，仅1个国家的作者担任了通讯作者。尽管相较于其他研究领域，以LMICs为场景的眼科研究已实现更高的本土作者参与占比，但国家收入层级、期刊"prestige"以及高收入国家的参与程度仍会进一步加剧参与不足的问题。上述研究差异凸显出，全球眼科研究亟需建立更为公平的数据权属机制。