The current issue of JBJS features an editorial and paper on a topic of discussion in the orthopaedic community: the reporting of race and ethnicity in scientific research.
Dr. Kanu Okike, JBJS Deputy Editor for Health Disparities, and Editor-in-Chief Dr. Marc Swiontkowski offer this perspective:
“Although race and ethnicity are social constructs without biologic meaning, they provide important context for understanding scientific research. Differences in outcomes on the basis of race and ethnicity, as well as of socioeconomic status, have been widely documented in medicine generally and in orthopaedic surgery specifically.1 To know whether the findings of a particular study are generalizable, we need to understand the characteristics of the population that was studied. Because Asian, Black, and Hispanic patients are known to be underrepresented in orthopaedic research,2 documentation of participant race and ethnicity is also important for tracking (and encouraging) progress. The same can be said of analyzing outcomes on the basis of race and ethnicity: if we stop shining a light on the differences in access and outcomes that exist in orthopaedic surgery, these disparities will continue to plague our field.”
The editors discuss the study by Crnkovic et al. in the current issue of JBJS. And they provide an update on guidance regarding the topic.
In the study, Crnkovic et al. assessed articles published in 2019 in JBJS and Clinical Orthopaedics and Related Research. They found that 36% of the published studies reported patient race, 15% reported patient ethnicity, and 23% reported at least 1 variable related to socioeconomic status. Among the studies with a multivariable analysis, 31% included race as a factor in that analysis.
2021 Updated Guidance
The American Medical Association (AMA) Manual of Style Committee has since published an Updated Guidance on the Reporting of Race and Ethnicity in Medical and Science Journals.
“As JBJS works to finalize its policy on the reporting of race and ethnicity data, this AMA Guidance will serve as a central reference,” say Drs. Okike and Swiontkowski.
The Guidance recommends that “aggregate, deidentified information (e.g., age, sex, race and ethnicity, and socioeconomic indicators) should be reported for research reports along with all prespecified outcomes.”
In addition, “the reporting of race and ethnicity should not be considered in isolation and should be accompanied by reporting of other sociodemographic factors and social determinants, including concerns about racism, disparities, and inequities, and the intersectionality of race and ethnicity with these other factors.”
JBJS Deputy Editor for Health Disparities
- Pandya NK, Wustrack R, Metz L, Ward D. Current Concepts in Orthopaedic Care Disparities. J Am Acad Orthop Surg. 2018 Dec 1;26(23):823-32.
- Cwalina TB, Jella TK, Manyak GA, Kuo A, Kamath AF. Is Our Science Representative? A Systematic Review of Racial and Ethnic Diversity in Orthopaedic Clinical Trials from 2000 to 2020. Clin Orthop Relat Res. 2022 May 1;480(5):848-58.