Gender- and Sex-equitable Submission Guidelines in Emergency Medicine Journals Are Associated with Enhanced Publication Metrics

Introduction: Gender and sex equity-promoting (GSEP) clinical research is essential to improving diversity and inclusivity in medicine. In this study we aimed to compare journal impact metrics in emergency medicine (EM) between journals that integrated gender- and sex-based considerations and those that did not. Methods: We searched the 2023 Journal Citations Report (Clarivate Analytics) for EM journals. Submission guidelines of each EM journal were examined according to the SAGER (Sex and Gender Equity in Research) guidelines and stratified as conforming or non-conforming depending on whether at least one SAGER criterion was met. Our primary outcome measure was the journal impact factor. Secondary outcome measures included other citation and influence metrics: total citations; 5-year journal impact factor; journal citation indicator; article influence score, normalized Eigenfactor score; citable items; total articles; and immediacy index. Results: Based on our classification system informed by the SAGER criteria, most journals (66%, 31/47) were classified as non-compliant. The EM journals that conformed to the sex and gender equity guidelines were rated higher than non-conforming journals across all studied journal metrics. We found that conforming journals had a significantly higher median difference (MD) than non-conforming EM journals in total citations (MD 1,586; GSEP: 3,599 vs non-GSEP: 901); 2023 2-year journal impact factor (MD 0.8; 2.3 vs 1.4); 5-year journal impact factor (MD 0.7; 2.5 vs 1.9); article influence score (MD 0.26; 0.76 vs 0.47); normalized Eigenfactor score (MD 0.79; 1.06 vs 0.26); citable items (MD 37; 103 vs 56), and total articles (MD 41; 87 vs 42). All differences were statistically significant (P < 0.05). Conclusion: Using criteria informed by the Sex and Gender Equity in Research guidelines, most EM journals (66%) were classified as non-conforming to these guidelines. This indicates a significant gap in the integration of gender- and sex-based considerations in EM research publication practices.