Unmasking healthcare disparities: the underreporting of gender, race, and ethnicity data in high-impact factor minimally invasive surgery journals.

IF 3.3 2区 医学 Q2 SURGERY
Amber Chen-Goodspeed, Victoria Ende, Xiaoyue Ma, Shahenda Khedr, Stephen Merola, Steven Chao
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引用次数: 0

Abstract

Background: Diverse representation in clinical research is essential for equitable healthcare. Despite mandates from organizations like the NIH and ICMJE, race and gender remain underreported in surgical research, raising concerns about the generalizability of findings. This study examines demographic reporting trends in minimally invasive surgery (MIS) and advanced endoscopy publications before and after the onset of the COVID-19 pandemic.

Methods: A systematic review of Surgical Endoscopy, Journal of Robotic Surgery, and Surgical Innovation was conducted, analyzing articles published between January 1, 2018, and December 31, 2023. 472 studies were included. For each study, study type, journal, date, geographic origin, and reported demographic data were recorded. Reporting rates across time periods (pre- vs. post-March 2020), region of origin, study design, and journal were analyzed via Chi-square, Fisher's exact tests, and Cochran-Armitage trend tests.

Results: Of the 472 studies, 61.2% were randomized controlled trials, with geographic representation from Asia (37.7%), Europe (34.8%), and North America (22.3%). Only 21 North American studies (20 U.S., 1 Canada) reported race; no studies from Asia or Europe did so. Among U.S. studies, race reporting did not differ significantly pre- vs. post-COVID (22.2% vs. 21.8%; p = 0.25), nor did gender reporting (p = 0.07). Regional differences in U.S. race reporting were significant (p = 0.003), with the Midwest having the lowest rate. Post-2020, gender reporting was significantly higher in Asia (94.9%) compared to Europe (84.7%) and North America (80.9%) (p = 0.005).

Conclusions: Demographics remain underreported in MIS and advanced endoscopy research, particularly outside North America. Despite increased attention to health equity during the COVID-19 pandemic, reporting practices have not significantly improved. Broader adoption of standardized demographic reporting is needed to ensure evidence-based surgical care for all populations.

揭露医疗保健差异:高影响因子微创外科期刊中性别、种族和民族数据的少报
背景:临床研究中的多样化代表对公平医疗至关重要。尽管有NIH和ICMJE等组织的授权,但在外科研究中,种族和性别仍然被低估,这引起了人们对研究结果的普遍性的担忧。本研究调查了2019冠状病毒病大流行前后微创手术(MIS)和高级内窥镜出版物的人口统计报告趋势。方法:对2018年1月1日至2023年12月31日发表的《外科内窥镜》、《机器人外科杂志》和《外科创新》杂志的文章进行系统综述。纳入了472项研究。对于每项研究,记录了研究类型、期刊、日期、地理来源和报告的人口统计数据。通过卡方检验、Fisher精确检验和Cochran-Armitage趋势检验,分析了不同时间段(2020年3月前后)、原产地区、研究设计和期刊的报告率。结果:在472项研究中,61.2%为随机对照试验,地理分布来自亚洲(37.7%)、欧洲(34.8%)和北美(22.3%)。只有21项北美研究(20项美国研究,1项加拿大研究)报告了种族;亚洲和欧洲的研究没有这样做。在美国的研究中,种族报告在感染前和感染后没有显著差异(22.2%对21.8%,p = 0.25),性别报告也没有显著差异(p = 0.07)。美国种族报告的地区差异是显著的(p = 0.003),中西部的比率最低。2020年后,亚洲的性别报告比例(94.9%)明显高于欧洲(84.7%)和北美(80.9%)(p = 0.005)。结论:在MIS和高级内窥镜研究中,特别是在北美以外的地区,人口统计数据仍然被低估。尽管在2019冠状病毒病大流行期间,人们更加关注卫生公平,但报告做法并未得到显著改善。需要更广泛地采用标准化的人口统计报告,以确保所有人群的循证外科护理。
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
CiteScore
6.10
自引率
12.90%
发文量
890
审稿时长
6 months
期刊介绍: Uniquely positioned at the interface between various medical and surgical disciplines, Surgical Endoscopy serves as a focal point for the international surgical community to exchange information on practice, theory, and research. Topics covered in the journal include: -Surgical aspects of: Interventional endoscopy, Ultrasound, Other techniques in the fields of gastroenterology, obstetrics, gynecology, and urology, -Gastroenterologic surgery -Thoracic surgery -Traumatic surgery -Orthopedic surgery -Pediatric surgery
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