The Reporting of Race and Ethnicity in Surgery Literature | Medical Journals and Publishing | JN Learning | AMA Ed Hub [Skip to Content]
[Skip to Content Landing]

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.

Abstract

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.

Sign in to take quiz and track your certificates

Buy This Activity

JN Learning™ is the home for CME and MOC from the JAMA Network. Search by specialty or US state and earn AMA PRA Category 1 CME Credit™ from articles, audio, Clinical Challenges and more. Learn more about CME/MOC

CME Disclosure Statement: Unless noted, all individuals in control of content reported no relevant financial relationships. If applicable, all relevant financial relationships have been mitigated.

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 (gurjit@med.umich.edu).

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.

References
1.
Burchard  EG , Ziv  E , Coyle  N ,  et al.  The importance of race and ethnic background in biomedical research and clinical practice.   N Engl J Med. 2003;348(12):1170-1175. doi:10.1056/NEJMsb025007PubMedGoogle ScholarCrossref
2.
Cooper  RS , Nadkarni  GN , Ogedegbe  G .  Race, ancestry, and reporting in medical journals.   JAMA. 2018;320(15):1531-1532. doi:10.1001/jama.2018.10960PubMedGoogle ScholarCrossref
3.
Haider  AH , Scott  VK , Rehman  KA ,  et al.  Racial disparities in surgical care and outcomes in the United States: a comprehensive review of patient, provider, and systemic factors.   J Am Coll Surg. 2013;216(3):482-492.e12.PubMedGoogle ScholarCrossref
4.
Rosenbaum  K , Grigorian  A , Yeates  E ,  et al.  A national analysis of pediatric firearm violence and the effects of race and insurance status on risk of mortality.   Am J Surg. 2021;S0002-9610(20)30827-8.PubMedGoogle Scholar
5.
Karaca-Mandic  P , Georgiou  A , Sen  S .  Assessment of COVID-19 hospitalizations by race/ethnicity in 12 states.   JAMA Intern Med. 2021;181(1):131-134. doi:10.1001/jamainternmed.2020.3857PubMedGoogle ScholarCrossref
6.
Gold  JAW , Rossen  LM , Ahmad  FB ,  et al.  Race, ethnicity, and age trends in persons who died from COVID-19—United States, May-August 2020.   MMWR Morb Mortal Wkly Rep. 2020;69(42):1517-1521. doi:10.15585/mmwr.mm6942e1PubMedGoogle ScholarCrossref
7.
Collier  KT , Rothstein  DH .  COVID 19: surgery & the question of race.   Am J Surg. 2020;220(4):845-846. doi:10.1016/j.amjsurg.2020.05.026PubMedGoogle ScholarCrossref
8.
Borno  HT , Zhang  S , Gomez  S .  COVID-19 disparities: an urgent call for race reporting and representation in clinical research.   Contemp Clin Trials Commun. 2020;19:100630. doi:10.1016/j.conctc.2020.100630PubMedGoogle Scholar
9.
Chen  HA , Trinh  J , Yang  GP .  Anti-Asian sentiment in the United States—COVID-19 and history.   Am J Surg. 2020;220(3):556-557. doi:10.1016/j.amjsurg.2020.05.020PubMedGoogle ScholarCrossref
10.
Nafiu  OO , Mpody  C , Kim  SS , Uffman  JC , Tobias  JD .  Race, postoperative complications, and death in apparently healthy children.   Pediatrics. 2020;146(2):e20194113. doi:10.1542/peds.2019-4113PubMedGoogle Scholar
11.
Maduka  RC , Gibson  CE , Chiu  AS ,  et al.  Racial disparities in surgical outcomes for benign thyroid disease.   Am J Surg. 2020;220(5):1219-1224. doi:10.1016/j.amjsurg.2020.06.054PubMedGoogle ScholarCrossref
12.
Henrietta Lacks Enhancing Cancer Research Act of 2019, HR 1966, 116th Cong (2019-2020). Accessed January 25, 2021. https://www.congress.gov/bill/116th-congress/house-bill/1966
13.
Bokor-Billmann  T , Langan  EA , Billmann  F .  The reporting of race and/or ethnicity in the medical literature: a retrospective bibliometric analysis confirmed room for improvement.   J Clin Epidemiol. 2020;119:1-6. doi:10.1016/j.jclinepi.2019.11.005PubMedGoogle ScholarCrossref
14.
Moore  DB .  Reporting of race and ethnicity in the ophthalmology literature in 2019.   JAMA Ophthalmol. 2020;138(8):903-906. doi:10.1001/jamaophthalmol.2020.2107PubMedGoogle ScholarCrossref
15.
Susarla  HK , Dentino  KM , Kalenderian  E , Ramoni  RB .  The reporting of race and ethnicity information in the dental public health literature.   J Public Health Dent. 2014;74(1):21-27. doi:10.1111/j.1752-7325.2012.00358.xPubMedGoogle ScholarCrossref
16.
Chao  GF , Emlaw  J , Chiu  AS ,  et al.  Asian American Pacific Islander representation in outcomes research: NSQIP scoping review.   J Am Coll Surg. 2021;232(5):682-689.e5. doi:10.1016/j.jamcollsurg.2021.01.015PubMedGoogle ScholarCrossref
17.
Iverson  C , Christiansen  S , Flanagin  A ,  et al; International Committee of Medical Journal Editors. Recommendations for the conduct, reporting, editing, and publication of scholarly work in medical journals. Accessed October 25, 2020. http://www.icmje.org/icmje-recommendations.pdf
18.
International Committee of Medical Journal Editors. Journals stating they follow the ICMJE recommendations. Accessed October 25, 2020. http://www.icmje.org/journals-following-the-icmje-recommendations/
19.
American Medical Association.  AMA Manual of Style: A Guide for Authors and Editors. 10th ed. Oxford University Press; 2007.
20.
Perez  NP , Baez  YA , Stapleton  SM ,  et al.  Racially conscious cancer screening guidelines: a path towards culturally competent science.   Ann Surg. Published online May 19, 2020. doi:10.1097/SLA.0000000000003983PubMedGoogle Scholar
21.
Amirikia  KC , Mills  P , Bush  J , Newman  LA .  Higher population-based incidence rates of triple-negative breast cancer among young African-American women: implications for breast cancer screening recommendations.   Cancer. 2011;117(12):2747-2753. doi:10.1002/cncr.25862PubMedGoogle ScholarCrossref
22.
Stapleton  SM , Oseni  TO , Bababekov  YJ , Hung  YC , Chang  DC .  Race/ethnicity and age distribution of breast cancer diagnosis in the United States.   JAMA Surg. 2018;153(6):594-595. doi:10.1001/jamasurg.2018.0035PubMedGoogle ScholarCrossref
23.
Wu  YL , Cheng  Y , Zhou  X ,  et al.  Dacomitinib versus gefitinib as first-line treatment for patients with EGFR-mutation-positive non-small-cell lung cancer (ARCHER 1050): a randomised, open-label, phase 3 trial.   Lancet Oncol. 2017;18(11):1454-1466. doi:10.1016/S1470-2045(17)30608-3PubMedGoogle ScholarCrossref
24.
Mok  TSK , Cheng  Y , Zhou  X ,  et al.  Safety and efficacy of dacomitinib for EGFR+ NSCLC in the subgroup of Asian patients from ARCHER 1050.   Ann Oncol. 2019;30(suppl 9):ix160–ix161. doi:10.1093/annonc/mdz437.006Google ScholarCrossref
25.
Midha  A , Dearden  S , McCormack  R .  EGFR mutation incidence in non-small-cell lung cancer of adenocarcinoma histology: a systematic review and global map by ethnicity (mutMapII).   Am J Cancer Res. 2015;5(9):2892-2911.PubMedGoogle Scholar
26.
Ma  IW , Khan  NA , Kang  A , Zalunardo  N , Palepu  A .  Systematic review identified suboptimal reporting and use of race/ethnicity in general medical journals.   J Clin Epidemiol. 2007;60(6):572-578. doi:10.1016/j.jclinepi.2006.11.009PubMedGoogle ScholarCrossref
27.
Shanawani  H , Dame  L , Schwartz  DA , Cook-Deegan  R .  Non-reporting and inconsistent reporting of race and ethnicity in articles that claim associations among genotype, outcome, and race or ethnicity.   J Med Ethics. 2006;32(12):724-728. doi:10.1136/jme.2005.014456PubMedGoogle ScholarCrossref
28.
Gravlee  CC , Sweet  E .  Race, ethnicity, and racism in medical anthropology, 1977-2002.   Med Anthropol Q. 2008;22(1):27-51. doi:10.1111/j.1548-1387.2008.00002.xPubMedGoogle ScholarCrossref
29.
Corbie-Smith  G , St George  DM , Moody-Ayers  S , Ransohoff  DF .  Adequacy of reporting race/ethnicity in clinical trials in areas of health disparities.   J Clin Epidemiol. 2003;56(5):416-420. doi:10.1016/S0895-4356(03)00031-3PubMedGoogle ScholarCrossref
30.
Kanakamedala  P , Haga  SB .  Characterization of clinical study populations by race and ethnicity in biomedical literature.   Ethn Dis. 2012;22(1):96-101.PubMedGoogle Scholar
31.
Drevdahl  D , Taylor  JY , Phillips  DA .  Race and ethnicity as variables in nursing research, 1952-2000.   Nurs Res. 2001;50(5):305-313. doi:10.1097/00006199-200109000-00009PubMedGoogle ScholarCrossref
32.
Brahan  D , Bauchner  H .  Changes in reporting of race/ethnicity, socioeconomic status, gender, and age over 10 years.   Pediatrics. 2005;115(2):e163-e166. doi:10.1542/peds.2004-1437PubMedGoogle ScholarCrossref
33.
Bamshad  M , Wooding  S , Salisbury  BA , Stephens  JC .  Deconstructing the relationship between genetics and race.   Nat Rev Genet. 2004;5(8):598-609. doi:10.1038/nrg1401PubMedGoogle ScholarCrossref
34.
Kibbe  MR , Freischlag  J .  Call to action to all surgery journal editors for diversity in the editorial and peer review process.   JAMA Surg. 2020;155(11):1015-1016. doi:10.1001/jamasurg.2020.4549PubMedGoogle ScholarCrossref
If you are not a JN Learning subscriber, you can either:
Subscribe to JN Learning for one year
Buy this activity
jn-learning_Modal_Multimedia_LoginSubscribe_Purchase
Close
If you are not a JN Learning subscriber, you can either:
Subscribe to JN Learning for one year
Buy this activity
jn-learning_Modal_Multimedia_LoginSubscribe_Purchase
Close
With a personal account, you can:
  • Access free activities and track your credits
  • Personalize content alerts
  • Customize your interests
  • Fully personalize your learning experience
Education Center Collection Sign In Modal Right
Close

Name Your Search

Save Search
Close
With a personal account, you can:
  • Track your credits
  • Personalize content alerts
  • Customize your interests
  • Fully personalize your learning experience
jn-learning_Modal_SaveSearch_NoAccess_Purchase
Close

Lookup An Activity

or

Close

My Saved Searches

You currently have no searches saved.

Close

My Saved Courses

You currently have no courses saved.

Close
With a personal account, you can:
  • Access free activities and track your credits
  • Personalize content alerts
  • Customize your interests
  • Fully personalize your learning experience
Education Center Collection Sign In Modal Right
Close