Trends and Rates of Reporting of Race, Ethnicity, and Social Determinants of Health in Spine Surgery Randomized Clinical Trials: A Systematic Review.

IF 1.6 4区医学 Q3 CLINICAL NEUROLOGY

Clinical Spine Surgery Pub Date : 2024-09-03 DOI:10.1097/BSD.0000000000001675

Eric Solomon, Mihir Gupta, Rachel Su, Nolan Reinhart, Valentina Battistoni, Aditya Mittal, Rachel S Bronheim, Juan Silva-Aponte, Miguel Cartagena Reyes, Devan Hawkins, Aditya Joshi, Khaled M Kebaish, Hamid Hassanzadeh

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引用次数: 0

Abstract

Study design: A systematic review.

Objective: We characterized the rates of sociodemographic data and social determinants of health (SDOH) reported in spinal surgery randomized control trials (RCTs) and the association between these RCTs' characteristics and their rates of reporting on race, ethnicity, and SDOH variables.

Summary of background data: Although numerous institutions maintain guidelines and recommendations regarding the inclusion and reporting of sociodemographic and SDOH variables in RCTs, the proportion of studies that ultimately report such information is unclear, particularly in spine surgery.

Materials and methods: We searched the MEDLINE, PubMed, and Embase databases for published results from spinal surgery RCTs from January 2002 through December 2022, and screened studies according to prespecified inclusion criteria regarding analysis and reporting of sociodemographic and SDOH variables.

Results: We analyzed 421 studies. Ninety-six studies (22.8%) reported race, ethnicity, or SDOH covariates. On multivariate analysis, study size [rate ratio (RR)=1.18; 95% CI, 1.06-1.32], public/institutional funding (RR=2.28; 95% CI, 1.29-4.04), and private funding (RR=3.27; 95% CI, 1.87-5.74) were significantly associated with reporting race, ethnicity, or SDOH variables. Study size (RR=1.26; 95% CI, 1.07-1.48) and North American region (RR=21.84; CI, 5.04-94.64) were associated with a higher probability of reporting race and/or ethnicity. Finally, study size (RR=1.27; 95% CI, 1.10-1.46), public/institutional funding (RR=2.68; 95% CI, 1.33-5.39), focus on rehabilitation/therapy intervention (RR=2.70; 95% CI, 1.40-5.21), and nonblinded study groups (RR=2.70; 95% CI, 1.40-5.21) were associated with significantly higher probability of reporting employment status.

Conclusion: Rates of reporting race, ethnicity, and SDOH variables were lower in the spinal surgery RCTs in our study than in RCTs in other medical disciplines. These reporting rates did not increase over a 20-year period. Trial characteristics significantly associated with higher rates of reporting were larger study size, North American region, private or public funding, and a focus on behavioral/rehabilitation interventions.

Level of evidence: Level III.

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脊柱外科随机临床试验中种族、民族和健康社会决定因素的趋势和报告率：系统回顾

研究设计系统综述：我们对脊柱外科随机对照试验（RCT）中报告的社会人口学数据和健康的社会决定因素（SDOH）的比例以及这些 RCT 的特征与其报告种族、民族和 SDOH 变量的比例之间的关联进行了描述：尽管许多机构都有关于在 RCT 中纳入和报告社会人口学和 SDOH 变量的指南和建议，但最终报告此类信息的研究比例尚不明确，尤其是在脊柱外科领域：我们在 MEDLINE、PubMed 和 Embase 数据库中检索了 2002 年 1 月至 2022 年 12 月期间发表的脊柱手术 RCT 结果，并根据有关社会人口学和 SDOH 变量分析与报告的预设纳入标准对研究进行了筛选：我们分析了 421 项研究。96项研究（22.8%）报告了种族、民族或SDOH协变量。在多变量分析中，研究规模[比率比（RR）=1.18；95% CI，1.06-1.32]、公共/机构资助（RR=2.28；95% CI，1.29-4.04）和私人资助（RR=3.27；95% CI，1.87-5.74）与报告种族、民族或 SDOH 变量显著相关。研究规模（RR=1.26；95% CI，1.07-1.48）和北美地区（RR=21.84；CI，5.04-94.64）与报告种族和/或民族的概率较高有关。最后，研究规模（RR=1.27；95% CI，1.10-1.46）、公共/机构资助（RR=2.68；95% CI，1.33-5.39）、康复/治疗干预重点（RR=2.70；95% CI，1.40-5.21）和非盲法研究组（RR=2.70；95% CI，1.40-5.21）与报告就业状况的概率显著较高有关：结论：在我们的研究中，脊柱外科 RCT 报告种族、民族和 SDOH 变量的比率低于其他医学学科的 RCT。这些报告率在 20 年间没有增加。与较高报告率明显相关的试验特征包括：研究规模较大、位于北美地区、私人或公共资助以及侧重于行为/康复干预：证据等级：三级。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Spine Surgery Medicine-Surgery

CiteScore

3.00

自引率

5.30%

发文量

236

期刊介绍： Clinical Spine Surgery is the ideal journal for the busy practicing spine surgeon or trainee, as it is the only journal necessary to keep up to date with new clinical research and surgical techniques. Readers get to watch leaders in the field debate controversial topics in a new controversies section, and gain access to evidence-based reviews of important pathologies in the systematic reviews section. The journal features a surgical technique complete with a video, and a tips and tricks section that allows surgeons to review the important steps prior to a complex procedure. Clinical Spine Surgery provides readers with primary research studies, specifically level 1, 2 and 3 studies, ensuring that articles that may actually change a surgeon’s practice will be read and published. Each issue includes a brief article that will help a surgeon better understand the business of healthcare, as well as an article that will help a surgeon understand how to interpret increasingly complex research methodology. Clinical Spine Surgery is your single source for up-to-date, evidence-based recommendations for spine care.