Do the Skin Colors Depicted in Orthopedic Literature Reflect the Population?

IF 1.2 4区医学 Q3 ORTHOPEDICS

Orthopedics Pub Date : 2025-07-01 Epub Date: 2025-07-03 DOI:10.3928/01477447-20250610-01

Dre'Marcus Ferrell, Walter Klyce, Raymond W Liu

{"title":"Do the Skin Colors Depicted in Orthopedic Literature Reflect the Population?","authors":"Dre'Marcus Ferrell, Walter Klyce, Raymond W Liu","doi":"10.3928/01477447-20250610-01","DOIUrl":null,"url":null,"abstract":"Background: Depictions of skin color in medical journals have been observed to misrepresent the population in other fields but have not been studied in orthopedics. We assessed whether the spectrum of skin color depicted in orthopedic literature appropriately reflects the population and whether that representation has changed over time.Materials and methods: We examined images of human patients published in four journals: Journal of Bone and Joint Surgery (JBJS), Clinical Orthopaedics and Related Research (CORR), Journal of the American Academy of Orthopaedic Surgeons (JAAOS), and The American Journal of Sports Medicine (AJSM) in 2010 and 2020. Fitzpatrick skin phototypes were used to categorize images as \"lighter skin tone\" (types I-III) or \"darker skin tone\" (types IV-VI), with the latter attributed to Black, Asian, Native American, and multiracial individuals. We compared published skin tones to 2020 United States census data (38% of the population being Fitzpatrick types IV-VI) using chi-square analysis.Results: Of 649 eligible images, 13% depicted Fitzpatrick skin types IV-VI. There was no significant change from 2010 to 2020 (11% vs 16%, P=0.07) in depictions of Fitzpatrick types IV and above. Darker skin tones were underrepresented compared to the US population (13% vs 38%, P<0.001). In US-based articles representation increased from 11% to 18% (P=0.045), but no change was observed in non-US articles (12% vs 12%, P=0.9).Conclusion: While there has been a mild improvement over time in the diversity of skin colors represented, the depiction of darker skin types in orthopedic literature still falls well short of that seen in the general population. [Orthopedics. 2025;48(4):197-202.].","PeriodicalId":19631,"journal":{"name":"Orthopedics","volume":" ","pages":"197-202"},"PeriodicalIF":1.2000,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Orthopedics","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3928/01477447-20250610-01","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/7/3 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"ORTHOPEDICS","Score":null,"Total":0}

引用次数: 0

Abstract

Background: Depictions of skin color in medical journals have been observed to misrepresent the population in other fields but have not been studied in orthopedics. We assessed whether the spectrum of skin color depicted in orthopedic literature appropriately reflects the population and whether that representation has changed over time.

Materials and methods: We examined images of human patients published in four journals: Journal of Bone and Joint Surgery (JBJS), Clinical Orthopaedics and Related Research (CORR), Journal of the American Academy of Orthopaedic Surgeons (JAAOS), and The American Journal of Sports Medicine (AJSM) in 2010 and 2020. Fitzpatrick skin phototypes were used to categorize images as "lighter skin tone" (types I-III) or "darker skin tone" (types IV-VI), with the latter attributed to Black, Asian, Native American, and multiracial individuals. We compared published skin tones to 2020 United States census data (38% of the population being Fitzpatrick types IV-VI) using chi-square analysis.

Results: Of 649 eligible images, 13% depicted Fitzpatrick skin types IV-VI. There was no significant change from 2010 to 2020 (11% vs 16%, P=0.07) in depictions of Fitzpatrick types IV and above. Darker skin tones were underrepresented compared to the US population (13% vs 38%, P<0.001). In US-based articles representation increased from 11% to 18% (P=0.045), but no change was observed in non-US articles (12% vs 12%, P=0.9).

Conclusion: While there has been a mild improvement over time in the diversity of skin colors represented, the depiction of darker skin types in orthopedic literature still falls well short of that seen in the general population. [Orthopedics. 2025;48(4):197-202.].

查看原文本刊更多论文

骨科文献中描述的肤色是否反映了人口？

背景：在医学期刊上对肤色的描述在其他领域被观察到是对人群的歪曲，但在骨科领域尚未进行研究。我们评估了骨科文献中描述的肤色谱是否恰当地反映了人群，以及这种表现是否随着时间的推移而发生了变化。材料和方法：我们研究了2010年和2020年发表在《骨与关节外科杂志》（JBJS）、《临床骨科与相关研究》（CORR）、《美国骨科学会杂志》（JAAOS）和《美国运动医学杂志》（AJSM）四种期刊上的人类患者图像。菲茨帕特里克皮肤照片类型用于将图像分类为“浅色肤色”（I-III型）或“深色肤色”（IV-VI型），后者归因于黑人、亚洲人、美洲原住民和多种族个体。我们使用卡方分析将公布的肤色与2020年美国人口普查数据（38%的人口为菲茨帕特里克IV-VI型）进行了比较。结果：在649张符合条件的图像中，13%描绘的是IV-VI型Fitzpatrick皮肤。从2010年到2020年，Fitzpatrick IV型及以上的描述没有显著变化（11% vs 16%， P=0.07）。与美国人群相比，肤色较深的人群代表性不足（13%对38%，PP=0.045），但在非美国人群中没有观察到变化（12%对12%，P=0.9）。结论：虽然随着时间的推移，所代表的肤色多样性有了轻微的改善，但骨科文献中对深色皮肤类型的描述仍然远远低于一般人群。[矫形手术。202 x; 4 x (x): xx-xx。]。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Orthopedics 医学-整形外科

CiteScore

2.20

自引率

0.00%

发文量

160

审稿时长

3 months

期刊介绍： For over 40 years, Orthopedics, a bimonthly peer-reviewed journal, has been the preferred choice of orthopedic surgeons for clinically relevant information on all aspects of adult and pediatric orthopedic surgery and treatment. Edited by Robert D''Ambrosia, MD, Chairman of the Department of Orthopedics at the University of Colorado, Denver, and former President of the American Academy of Orthopaedic Surgeons, as well as an Editorial Board of over 100 international orthopedists, Orthopedics is the source to turn to for guidance in your practice. The journal offers access to current articles, as well as several years of archived content. Highlights also include Blue Ribbon articles published full text in print and online, as well as Tips & Techniques posted with every issue.