Race and Ethnicity Reporting in Randomized Controlled Trials Published in Upper-Extremity Journals

Stephanie Delma; Katelyn Langford; Jessica L Baylor; Yagiz Ozdag; Daniel S Hayes; Joel C Klena; Louis C Grandizio

doi:10.1016/j.jhsa.2022.11.019

Race and Ethnicity Reporting in Randomized Controlled Trials Published in Upper-Extremity Journals

J Hand Surg Am. 2023 Apr;48(4):340-347. doi: 10.1016/j.jhsa.2022.11.019. Epub 2023 Jan 17.

Authors

Stephanie Delma¹, Katelyn Langford¹, Jessica L Baylor¹, Yagiz Ozdag¹, Daniel S Hayes¹, Joel C Klena¹, Louis C Grandizio²

Affiliations

¹ Department of Orthopaedic Surgery, Geisinger Commonwealth School of Medicine, Geisinger Musculoskeletal Institute, Danville, PA.
² Department of Orthopaedic Surgery, Geisinger Commonwealth School of Medicine, Geisinger Musculoskeletal Institute, Danville, PA. Electronic address: chris.grandizio@gmail.com.

PMID: 36658049
DOI: 10.1016/j.jhsa.2022.11.019

Abstract

Purpose: Hand surgery remains one of the least racially and ethnically diverse subspecialties in all of medicine, and minority patients demonstrate overall worse health care outcomes compared with White patients. Our purpose was to determine the frequency of race and ethnicity reporting in randomized controlled trials (RCTs) published in journals with an upper-extremity (UE) focus.

Methods: A systematic review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines by searching EMBASE and MEDLINE for RCTs contained in peer-reviewed journals with an UE focus. All articles from 2000 to 2021 were included. Information such as article sample size, center type, funding, and location was recorded. We assessed each article to determine whether demographic information, including race and ethnicity, was reported for study participants.

Results: A total of 481 RCTs in 9 UE journals were included. For UE RCTs, 96% of studies reported age, 90% reported sex, and 5% reported either race or ethnicity. Demographic information about economic status, insurance status, mental health, educational level, and marital status were each reported in <10% of RCTs. Racial representation was highest for White participants (80%) and lowest among American Indian participants. Of studies conducted within the United States, all racial groups except for White patients were underrepresented compared with census data.

Conclusions: Demographic data related to race and ethnicity for patients involved in UE RCTs are infrequently reported. When reported, the racial demographics of UE RCT patients do not match the demographics of the patients in United States. Black patients remain underrepresented in RCTs.

Clinical relevance: Academic journals mandating the reporting of demographic data related to race may aid in improved reporting and allow for subsequent aggregation within systematic reviews to assess outcomes for racial minorities.

Keywords: Demographics; diversity; ethnicity; hand surgery; race.

Publication types

Systematic Review

MeSH terms

Ethnicity*
Extremities
Humans
Minority Groups
Periodicals as Topic*
Randomized Controlled Trials as Topic
United States