The responsiveness of surgical research to Māori in Aotearoa, New Zealand-a scoping review.

Background: Māori, the Indigenous people of Aotearoa, New Zealand (NZ), experience significant inequities in access to surgery and postoperative outcomes. This scoping review aimed to present a synopsis of the extent and nature of research concerning Māori in surgery in NZ and evaluated the responsiveness of this evidence base to Māori using two Indigenous frameworks. Methods: Utilising a Kaupapa Māori methodological stance, a scoping review of all studies related to Māori and surgical care in NZ (2000-2024) was performed. The studies underwent thorough evaluation using the CONSIDER and MĀORI frameworks to assess responsiveness to Indigenous Māori. Findings: A total of 254 studies were included, most being quantitative (N = 230, 91%) and most categorised under General Surgery (N = 139, 55%). Māori responsiveness assessments of each study highlighted significant shortcomings, with 96% of studies (N = 243/254) rated as low quality as per the adapted CONSIDER framework and 68% (N = 172/254) rated as low quality in accordance with the MĀORI framework. More than half of all studies (55%) did not report Māori leadership, governance, and co-authorship. Studies that utilised Kaupapa Māori research were more likely to be considered high-quality. Interpretation: This study shows that the current surgical evidence base is not responsive to Māori. It calls for a review of research practices and encourages monitoring of the surgical evidence base for all Indigenous peoples. Funding: This study was supported by a Health Research Council of New Zealand Health Delivery Research Activation Grant (21/860) and Māori Health Knowledge Translation Grant (25/234). The funders had no role in the study design, conception, data collection, analysis, interpretation, or report writing. They also had no role in submitting our study for publication.