The responsiveness of surgical research to Ma<overline>ori in Aotearoa, New Zealand-a scoping review

Background Ma<overline>ori, the Indigenous people of Aotearoa, New Zealand (NZ), experience significant inequities in access to surgery and postoperative outcomes. This scoping review aimed to present a synopsis of the extent and nature of research concerning Ma<overline>ori in surgery in NZ and evaluated the responsiveness of this evidence base to Ma<overline>ori using two Indigenous frameworks. Methods Utilising a Kaupapa Ma<overline>ori methodological stance, a scoping review of all studies related to Ma<overline>ori and surgical care in NZ (2000-2024) was performed. The studies underwent thorough evaluation using the CONSIDER and MA<overline>ORI frameworks to assess responsiveness to Indigenous Ma<overline>ori. Findings A total of 254 studies were included, most being quantitative (N = 230, 91%) and most categorised under General Surgery (N = 139, 55%). Ma<overline>ori responsiveness assessments of each study highlighted significant shortcomings, with 96% of studies (N = 243/254) rated as low quality as per the adapted CONSIDER framework and 68% (N =172/254) rated as low quality in accordance with the MA<overline>ORI framework. More than half of all studies (55%) did not report Ma<overline>ori leadership, governance, and co-authorship. Studies that utilised Kaupapa Ma<overline>ori research were more likely to be considered high-quality. Interpretation This study shows that the current surgical evidence base is not responsive to Ma<overline>ori. It calls for a review of research practices and encourages monitoring of the surgical evidence base for all Indigenous peoples. Funding This study was supported by a Health Research Council of New Zealand Health Delivery Research Activation Grant (21/860) and Ma<overline>ori Health Knowledge Translation Grant (25/234). The funders had no role in the study design, conception, data collection, analysis, interpretation, or report writing. They also had no role in submitting our study for publication. Copyright (c) 2025 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).