Department of Orthopaedic Surgery, Geisinger Commonwealth School of Medicine, Geisinger Musculoskeletal Institute, Danville, PA.
Department of Orthopaedic Surgery, Geisinger Commonwealth School of Medicine, Geisinger Musculoskeletal Institute, Danville, PA.
J Hand Surg Am. 2023 Apr;48(4):340-347. doi: 10.1016/j.jhsa.2022.11.019. Epub 2023 Jan 17.
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.
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.
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.
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.
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.
手外科仍然是医学所有专科中种族和民族多样性最差的专科之一，与白人患者相比，少数族裔患者的整体医疗保健结果更差。我们的目的是确定在以上肢为重点的期刊上发表的随机对照试验（RCT）中报告种族和民族的频率。
按照系统评价和荟萃分析的首选报告项目指南，通过在以上肢为重点的同行评审期刊中搜索 RCT，进行系统评价。纳入 2000 年至 2021 年发表的所有文章。记录了文章样本量、中心类型、资金和地点等信息。我们评估了每篇文章，以确定是否报告了研究参与者的人口统计学信息，包括种族和民族。
共纳入 9 种以上肢为重点的期刊中的 481 项 RCT。对于上肢 RCT，96%的研究报告了年龄，90%报告了性别，5%报告了种族或民族。关于经济状况、保险状况、心理健康、教育水平和婚姻状况的人口统计学信息，在<10%的 RCT 中报告。白人参与者的代表性最高（80%），而美洲印第安参与者的代表性最低。在美国进行的研究中，与人口普查数据相比，除白人患者外，所有种族群体的代表性都不足。
涉及上肢 RCT 患者的种族和民族相关人口统计学数据很少报告。当报告时，上肢 RCT 患者的种族人口统计学特征与美国患者的人口统计学特征不匹配。黑人和西班牙裔患者在 RCT 中仍然代表性不足。
要求报告与种族相关的人口统计学数据的学术期刊可能有助于改善报告，并允许在随后的系统评价中汇总，以评估少数民族的结果。
