Disparities in Surgical Research Output Between Hospital Systems and National Healthcare Research Institutions: A Systematic Review of Global Trends
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All Authors
Ahmad,Suhaib J. S.
Khalil,Miriam
Khalid,Ali Waleed
Khamise,Ameer
Rawaf,David
Ahmed,Ahmed R.
Lala,Anil
Gelber,Edgar
Whiteley,Graham
Agarwal,Anurag
LTHT Author
Khalil, Miriam
LTHT Department
Abdominal Medicine & Surgery
John Goligher Colorectal Unit
Drs Rotation
John Goligher Colorectal Unit
Drs Rotation
Non Medic
Publication Date
2025
Item Type
Article
Language
Subject
Subject Headings
Abstract
This systematic review examined global disparities in surgical research output between hospital systems and national healthcare institutions. A bibliometric analysis of the 50 most cited surgical articles in Web of Science was performed following PRISMA. High-income countries, particularly North America and Western Europe, dominated output, while Sub-Saharan Africa, South Asia, and parts of the Middle East were underrepresented. Male first authors accounted for 88% of articles; female authorship showed comparable citation performance. Higher co-authorship correlated with greater citations but lower evidence levels. Equitable funding, open access, and investment in low-resource settings are essential to foster inclusive, context-relevant innovation. KEY TAKE-AWAYS: High-impact surgical research remains concentrated in university-affiliated centers in high-income countries, with no articles originating from national healthcare research institutions or low- and middle-income settings. Despite comparable citation performance, women are underrepresented as first authors (12%), highlighting persistent gender imbalances in surgical academia. Collaborative, multi-author studies and consensus-based methodological guidelines achieve the highest citation densities, underscoring the value of broad research networks and standardized frameworks.
Journal
Journal of Hospital Librarianship