Evidence map›Paper›PMID 38979600›Full record

ReviewAnnals of surgery2024

Statistical Methods to Examine Racial and Ethnic Disparities in the Surgical Literature: A Review and Recommendations for Improvement.

Alex H S Harris, Hyrum Eddington, Vaibhavi B Shah, Michael Shwartz, Deborah Gurewich, Amy K Rosen, Badí Quinteros, Britni Wilcher, Kenneth J Nieser, Gabrielle Jones and 2 more

Abstract readReview
In one paragraph

Review in Annals of surgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Alex H S HarrisHSR&D Center for Innovation to Implementation, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA.
Hyrum EddingtonStanford-Surgery Policy Improvement Research and Education Center (S-SPIRE), Department of Surgery, Stanford University School of Medicine, Palo Alto, CA.
Vaibhavi B ShahStanford-Surgery Policy Improvement Research and Education Center (S-SPIRE), Department of Surgery, Stanford University School of Medicine, Palo Alto, CA.
Michael ShwartzHSR&D Center for Healthcare Organization, Implementation and Research (CHOIR), VA Boston Healthcare System, Boston MA.
Deborah GurewichHSR&D Center for Healthcare Organization, Implementation and Research (CHOIR), VA Boston Healthcare System, Boston MA.
Amy K RosenHSR&D Center for Healthcare Organization, Implementation and Research (CHOIR), VA Boston Healthcare System, Boston MA.
Badí QuinterosStanford-Surgery Policy Improvement Research and Education Center (S-SPIRE), Department of Surgery, Stanford University School of Medicine, Palo Alto, CA.
Britni WilcherHSR&D Center for Innovation to Implementation, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA.
Kenneth J NieserHSR&D Center for Innovation to Implementation, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA.
Gabrielle JonesHSR&D Center for Innovation to Implementation, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA.
Julie Tsu-Yu WuHSR&D Center for Innovation to Implementation, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA.
Arden M MorrisStanford-Surgery Policy Improvement Research and Education Center (S-SPIRE), Department of Surgery, Stanford University School of Medicine, Palo Alto, CA.

Funding

HSR&D Senior Research Career Scientist AwardIK6HX002839 · VA · VA BOSTON HEALTH CARE SYSTEM · PI AMY K ROSEN · 2020 to 2026
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HSRD VA IK6 HX002839HSRD VA IK6 HX002840HSRD VA IK6 HX003906
6 · The paper itself

Abstract

objectiveTo characterize the quality of statistical methods for studies of racial and ethnic disparities in the surgical-relevant literature during 2021-2022.

backgroundHundreds of scientific papers are published each year describing racial and ethnic disparities in surgical access, quality, and outcomes. The content and design quality of this literature have never been systematically reviewed.

methodsWe searched for 2021 to 2022 studies focused on describing racial and/or ethnic disparities in surgical or perioperative access, process quality, or outcomes. Identified studies were characterized in terms of 3 methodological criteria: (1) adjustment for variables related to both race/ethnicity and outcomes, including social determinants of health (SDOH), (2) accounting for clustering of patients within hospitals or other subunits ("providers"), and (3) distinguishing within-provider and between-provider effects.

resultsWe identified 224 papers describing racial and/or ethnic differences. Of the 38 single-institution studies, 24 (63.2%) adjusted for at least one SDOH variable. Of the 186 multisite studies, 113 (60.8%) adjusted for at least one SDOH variable, and 43 (23.1%) accounted for the clustering of patients within providers using appropriate statistical methods. Only 10 (5.4%) of multi-institution studies made efforts to examine how much of the overall disparities were driven by within versus between-provider effects.

conclusionsMost recently published papers on racial and ethnic disparities in the surgical literature do not meet these important statistical design criteria and, therefore, may risk inaccuracy in the estimation of group differences in surgical access, quality, and outcomes. The most potent leverage points for these improvements are changes to journal publication guidelines and policies.

Indexed as

Healthcare DisparitiesEthnicityHumansQuality ImprovementRacial GroupsSocial Determinants of HealthSurgical Procedures, Operative

Identifiers

PMID38979600
PMCPMC13053048

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.