School of Medicine, Louisiana State University Health Sciences Center, New Orleans, Louisiana.
Department of Orthopaedic Surgery, Louisiana State University Health Sciences Center, New Orleans, Louisiana.
J Bone Joint Surg Am. 2022 Jul 20;104(14):1244-1249. doi: 10.2106/JBJS.21.01159. Epub 2022 Apr 14.
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.
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.
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.
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.
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.
尽管人们呼吁在已发表的研究中常规报告与健康差异相关的患者人口统计学信息，包括种族、民族和社会经济地位（SES），但在矫形外科期刊中这些变量的报告程度尚不清楚。
我们确定并检查了 2019 年在美国排名最高的 2 种普通矫形外科杂志《临床矫形与相关研究》和《骨与关节外科杂志》上发表的所有具有人类队列的研究文章。未纳入分析的是没有美国机构的研究和没有报告任何人口统计学数据的研究。对文章进行了回顾，以确定研究类型；报告种族、民族以及 3 个 SES 变量（即收入、教育和医疗保险）中的任何一个；以及这些人口统计学数据是否纳入多变量分析。
共有 156 篇文章符合纳入标准。其中，56 篇（35.9%）报告了患者的种族，24 篇（15.4%）报告了患者的民族。13 篇文章（8.3%）报告了收入，23 篇（14.7%）报告了教育程度，18 篇（11.5%）报告了医疗保险情况。在报告多变量分析结果的 97 篇论文中，30 篇（30.9%）在分析中纳入了种族，21 篇（21.6%）报告了与种族相关的显著性。在文章中，分别有 7 篇（7.2%）、11 篇（11.3%）和 10 篇（10.3%）将收入、教育和医疗保险纳入多变量分析。
在 2 种顶级矫形外科杂志上发表的文章中，种族、民族和 SES 很少被报告和分析。如果矫形外科杂志对具有人类队列的研究中患者人口统计学信息的报告和分析制定标准，这个问题可能会得到纠正。
未能报告关键人口统计学信息使得从业者难以确定研究结果是否适用于他们的患者群体。此外，当对矫形干预措施进行评估而不考虑人口统计学因素造成的潜在差异时，临床医生可能会错误地认为研究报告的总体益处和风险同样适用于所有患者。
