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The Reporting of Race and Ethnicity in Surgery Literature

Educational objective
To determine how often race and ethnicity are reported for human study participants in surgical literature and the extent to which authors follow the International Committee of Medical Journal Editors' recommendations for high-quality reporting.
1 Credit CME
Key Points

Question  How often are race and ethnicity reported for human study participants in surgical literature, and when race is reported, do authors follow the International Committee of Medical Journal Editors (ICMJE) recommendations for quality reporting?

Findings  In this study of 2485 articles published in 2019, the reporting of race and ethnicity was low at a mean (SD) of 32.5% (12.0) overall. There was no significant difference in the frequency of race and ethnicity reporting in publications from journals that state they follow ICMJE recommendations compared with those that do not explicitly claim adherence, but journals following ICMJE recommendations were more likely to follow the guidelines for quality reporting.

Meaning  Increased frequency and improved standardization of race and ethnicity reporting is needed among publications from surgical journals.


Importance  The reporting of race provides transparency to the representativeness of data and helps inform health care disparities. The International Committee of Medical Journal Editors (ICMJE) developed recommendations to promote quality reporting of race; however, the frequency of reporting continues to be low among most medical journals.

Objective  To assess the frequency as well as quality of race reporting among publications from high-ranking broad-focused surgical research journals.

Design, Setting, and Participants  A literature review and bibliometric analysis was performed examining all human-based primary research articles published in 2019 from 7 surgical journals: JAMA Surgery, Journal of the American College of Surgeons, Annals of Surgery, Surgery, American Journal of Surgery, Journal of Surgical Research, and Journal of Surgical Education. The 5 journals that stated they follow the ICMJE recommendations were analyzed against the 2 journals that did not explicitly claim adherence.

Main Outcomes and Measures  Measured study outcomes included race reporting frequency and use of the ICMJE recommendations for quality reporting of race.

Results  A total of 2485 publications were included in the study. The mean (SD) frequency of reporting of race and ethnicity in publications of ICMJE vs non-ICMJE journals was 32.8% (8.4) and 32.0% (20.9), respectively (P = .72). Adherence to ICMJE recommendations for reporting race was more frequent in ICMJE journals than non-ICMJE journals (mean [SD] of 73.1% [17.8] vs 37.0% [10.2]; P < .001).

Conclusions and Relevance  The frequency of race and ethnicity reporting among surgical journals is low. A journal’s statement of adherence to ICMJE recommendations did not affect the frequency of race and ethnicity reporting; however, there was an increase in the use of ICMJE quality metrics. These findings suggest the need for increased and more standardized reporting of racial and ethnic demographic data among surgical journals.

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Article Information

Accepted for Publication: May 27, 2021.

Published Online: August 18, 2021. doi:10.1001/jamasurg.2021.3752

Corresponding Author: Gurjit Sandhu, PhD, Department of Surgery, Michigan Medicine, 1500 E Medical Center Dr, SPC 5346, Ann Arbor, MI 48109 (

Author Contributions: Drs Maduka and G. Sandhu had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

Study concept and design: Maduka, Broderick, White, Ballouz, Chen, G. Sandhu.

Acquisition, analysis, or interpretation of data: Maduka, Broderick, White, Ballouz, H. Sandhu, Kwakye, G. Sandhu.

Drafting of the manuscript: Maduka, Broderick, White, Ballouz, G. Sandhu.

Critical revision of the manuscript for important intellectual content: All authors.

Statistical analysis: Maduka, White, Ballouz, H. Sandhu.

Obtained funding: Maduka.

Administrative, technical, or material support: Maduka, H. Sandhu, Chen.

Study supervision: Kwakye, G. Sandhu.

Conflict of Interest Disclosures: None reported.

Funding/Support: Dr Maduka receives funding from the Yale Cancer Center Advanced Physician Scientist Training Program (grant T32 CA233414 from the National Institute of Environmental Health Sciences).

Role of the Funder/Sponsor: The funder had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

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