A new editorial by Dr. Kanu Okike, JBJS Deputy Editor for Health Disparities, and Dr. Marc Swiontkowski, JBJS Editor-in-Chief, appears in the February 15, 2023 issue of JBJS:
The editorial follows the September 2022 decision by the JBJS Editorial Board to adopt the provisions of the “Updated Guidance on the Reporting of Race and Ethnicity in Medical and Science Journals” published by the American Medical Association (AMA) Manual of Style Committee in 20211.
“It is vital for orthopaedic research communities to get this reporting aspect correct. We have published a lot of work documenting racial disparities in access to high-quality musculoskeletal care, and we must now develop interventions to address the issues,” says Dr. Swiontkowski.
As stated in the editorial, a key provision of the AMA Guidance “is that1 ‘aggregate, deidentified demographic information (eg, age, sex, race and ethnicity, and socioeconomic indicators) should be reported for research reports along with all prespecified outcomes.’ Authors submitting manuscripts for consideration of publication in JBJS are urged to describe the population of individuals included in the study on the basis of their race and ethnicity, in addition to the other demographic variables listed above.”
Starting January 1, 2024, the inclusion of participant race and ethnicity information will become a formal requirement of clinical research article submissions to JBJS and JBJS Open Access.
Drs. Okike and Swiontkowski outline a number of reasons why the accurate reporting of participants’ racial and ethnic characteristics, along with other demographic variables, is important in scientific publications. “Perhaps most importantly,” they say, it “allows for the continued examination of health-care disparities,” which have been widely documented in orthopaedic surgery.
They note that the AMA Guidance does not make recommendations regarding the analysis of outcomes on the basis of race and ethnicity. “Likewise, JBJS will not require authors to conduct post hoc analyses of outcomes by participant race or ethnicity.” They add that this is consistent with the preferred research practice of prespecifying primary and secondary outcomes prior to initiating a clinical trial.
A table detailing best practices in the reporting of race and ethnicity is included with the editorial.
A related editorial was published in JBJS in July 2022.
- Flanagin A, Frey T, Christiansen SL; AMA Manual of Style Committee. Updated guidance on the reporting of race and ethnicity in medical and science journals. JAMA. 2021 Aug 17;326(7):621-7.