The Reporting of Race and Ethnicity in Surgery Literature

Abstract

nequities affecting underserved racial and ethnic groups continue to be identified across the spectrum of medical research. [1][2][3][4] From the disproportionate number of Black and Hispanic persons who have been hospitalized or died because of COVID-19 in 2020 [5][6][7][8] to discrimination against Asian American persons 9 and the comparatively poor perioperative outcomes even among low-risk racial and ethnic minority patients, 10,11 attentiveness to race and ethnicity has illuminated inequities and disparities throughout our health care systems. Recognition of health disparities through research has led to recent significant victories, such as the Henrietta Lacks Enhancing Cancer Research Act of 2019, 12 which became public law in January 2021, requiring officials to examine barriers to government-funded clinical trials for traditionally underrepresented groups. Unfortunately, race and ethnicity continue to be infrequently reported in the medical literature to describe study participants, and when race is described, the quality of the reporting is variable. [1][2][3][4][13][14][15][16] In 1978 (updated in 2019), the International Committee of Medical Journal Editors (ICMJE) developed recommendations for uniformity in manuscript submissions and promoting increased frequency and quality reporting of race. Current recommendations are that "[a]uthors should define how they determined race or ethnicity and justify their relevance," 17 and that a study "should aim for inclusion of representative populations into all study types and at a minimum provide descriptive data for these and other relevant demographic variables." [17][18][19] Despite these recommendations, studies examining the reporting of race continue to show infrequent use of race to desc ribe study partic ipants in sc ientific publications. [13][14][15][16] A 2020 article by Moore 14 revealed that in the ophthalmology literature, most articles (88%) reported baseline demographic information on study participants; however, only 43% of articles included data on race and ethnicity, and an even smaller fraction described how the information was determined. IMPORTANCEThe reporting of race provides transparency to the representativeness of data and helps inform health care disparities. The International Committee of Medical Journal Editors (ICMJE) developed recommendations to promote quality reporting of race; however, the frequency of reporting continues to be low among most medical journals.OBJECTIVE To assess the frequency as well as quality of race reporting among publications from high-ranking broad-focused surgical research journals. DESIGN, SETTING, AND PARTICIPANTSA literature review and bibliometric analysis was performed examining all human-based primary research articles

Reporting of data on participant ethnicity and socioeconomic status in high-impact medical journals: a targeted literature review

“…19 However, whether or not the journal states they follow guidance or not, this has no impact on the relevance of these data and the importance of reporting them. Additionally, Maduka et al 20 found no difference between journals stating they follow ICMJE recommendations, and those that do not, in the frequency of reporting race and ethnicity in a sample of surgical research publications in 2019.…”

A Systematic Review on Participant Diversity in Clinical Trials—Have We Made Progress for the Management of Obesity and Its Metabolic Sequelae in Diet, Drug, and Surgical Trials

“…During the final review of articles that met inclusion criteria, not all studies reported demographics for their participants, and for those that did, the selection of reporting categories such as "other" were not clearly defined. This is a pervasive issue despite guidelines by the International Committee of Medical Journal Editors and NIH, which defines the standards for the classification of federal data on race and ethnicity [51][52][53][54][55][56]. The editors of the Journal of the American Medical Association recently published "Updated Guidance on the Reporting of Race and Ethnicity in Medical and Science Journals" in response to ongoing issues with reporting, with specific recommendations on the correct use of terms such as sex and gender, and that authors should "define how they determined race or ethnicity and justify their relevance."…”

Reductionist methodology and the ambiguity of the categories of race and ethnicity in biomedical research: an exploratory study of recent evidence

“…The use of ethnoracial categories in medical and health sciences has been the subject of numerous studies that have focused on three main groups of questions: how researchers report on ethnoracial categories in their publications (Ma et al 2007;Zhang and Finkelstein 2019;Maduka et al 2021), on explanations/hypotheses for the use of ethnoracial categories in certain studies (Lee 2009;Sankar et al 2007;Friedman and Lee 2013;Duello et al 2021), and on how scientists conceptualise these categories (Lin and Kelsey, 2000;Huddart et al 2019;Popejoy et al 2020;Popejoy 2021). In the majority of such studies, researchers have adopted two methods to answer the above questions: broadly understood systematic reviews of the literature (e.g., content analysis) of published articles etc., or interviews and surveys carried out in a given community (e.g., geneticists).…”