Low Rates of Reporting Race, Ethnicity, and Socioeconomic Status in Studies Published in Top Orthopaedic Journals

Abstract

Background:Although there have been calls for the routine reporting of patient demographics associated with health disparities, including race, ethnicity, and socioeconomic status (SES), in published research, the extent to which these variables are reported in orthopaedic journals remains unclear.Methods:We identified and examined all research articles with human cohorts published in 2019 in the 2 highest-ranked U.S. general orthopaedics journals, Clinical Orthopaedics and Related Research and The Journal of Bone & Joint Surgery. Excluded from analysis were studies with no U.S.-based institution and those that did not report any demographic data. Articles were reviewed to determine study type; reporting of race, ethnicity, and any of 3 SES variables (i.e., income, education, and health-care insurance); and the inclusion of these demographics in multivariable analyses.Results:A total of 156 articles met the inclusion criteria. Of these, 56 (35.9%) reported patient race and 24 (15.4%) reported patient ethnicity. Income was reported in 13 (8.3%) of the articles, education in 23 (14.7%), and health insurance in 18 (11.5%). Of the 97 papers that reported results of multivariable analyses, 30 (30.9%) included race in the analysis and 21 (21.6%) reported significance associated with race. Income, education, and health insurance were included in multivariable analyses in 7 (7.2%), 11 (11.3%), and 10 (10.3%) of the articles, respectively.Conclusions:Race, ethnicity, and SES were infrequently reported and analyzed within articles published in 2 of the top orthopaedic journals. This problem may be remedied if orthopaedic journals impose standards for the reporting and analysis of patient demographics in studies with human cohorts.Clinical Relevance:Failure to report key demographics makes it difficult for practitioners to determine whether study results apply to their patient populations. In addition, when orthopaedic interventions are evaluated without accounting for potential disparities by demographics, clinicians may incorrectly assume that the overall benefits and risks reported in studies apply equally to all patients.

Reporting of Participants' Sex, Race, Ethnicity, and Socioeconomic Status in Pituitary Surgery Literature

“…Several studies have shown that SDOH, including sex, race, ethnicity, education level, and income, are independent predictors of surgical management and outcomes. [5][6][7][8] Many of the studies included in this scoping review used postoperative complications, such as incidence of cerebrospinal fluid leaks and diabetes insipidus, and hospitalization metrics, such as readmission rates, as the primary outcome measures (►Supplementary Table S1, available in the online version). Goljo et al found that the likelihood of postoperative complications was higher in Black and Hispanic patients compared with White patients.…”

“…5 Studies in ophthalmology and orthopedics reviewed their field's literature from top journals over a 1-year period and also found that sociodemographics were routinely underreported. 6,7 Studies evaluating reporting of sociodemographics has not been performed in the pituitary surgery literature. Research has demonstrated disparities in complication rates in pituitary surgery based on race, ethnicity, socioeconomic status (SES), insurance status, and hospital factors.…”

Socioeconomic Status and Race Are Rarely Reported in Randomized Controlled Trials for Achilles Tendon Pathology in the Top 10 Orthopaedic Journals: A Systematic Review

“… 29 , 40 , 44 , 45 , 64 However, the rate of reporting of these metrics is low in top orthopaedic journals. 22 Within foot and ankle orthopaedics, one previous systematic review organized SES and race reporting for RCTs encompassing all foot and ankle surgery. 64 Although this review found evidence demonstrating consistent underreporting of SEC and race within foot and ankle surgery, it was limited to only a 6-year time frame (2016-2021) and only described studies within 4 specific journals.…”

Demographic and Socioeconomic Patient Data Are Rarely Included in Randomized Controlled Trials for Femoral Acetabular Impingement and Hip Arthroscopy: A Systematic Review

“…Yet, studies also have shown that these variables have been drastically under-reported in randomized controlled trials (RCTs) across many medical and surgical specialties, 6 , 7 , 8 including orthopaedic RCTs. 9 , 10 , 11 …”