technical paper
Comparison of Reporting Race and Ethnicity in Medical Journals Before and After Implementation of Reporting Guidance, 2019-2022 | VIDEO
keywords:
quality of reporting
reporting guidelines
diversity and inclusion
Objective Previous research found limited progress in
reporting race and socioeconomic status in research
published in medical journals from 2015 to 2019. 1 This study
compared race and ethnicity reporting in 3 JAMA Network
medical journals before and after implementation of Updated
Guidance on Reporting Race and Ethnicity in Medical and
Science Journals in August 2021. 2
Design All major research articles published in JAMA,
JAMA Internal Medicine, and JAMA Pediatrics in the first 3
months of 2019 and 2022 and the 3 months immediately
before guidance implementation (May-July 2021) were
included. Articles were reviewed independently by 2
reviewers for the following: study included human
participants; race and ethnicity, age, sex and gender, and
measures of socioeconomic status reported; where race and
ethnicity was reported (abstract, methods, results, tables);
number and order of racial and ethnic categories reported; if
the category “other” was included and if that was defined;
and if the article indicated how race and ethnicity were
determined. Comparisons between years were calculated with
χ² for 2-sided P values, odds ratios (ORs), and Wald test 95%
CIs using R version 4.2.0.
Results Of 258 research articles published during the study
periods, 249 (96.5%) included human participants and were
included in this analysis. In 2019, 49 of 86 articles (57.0%)
reported race and ethnicity of study participants compared
with 42 of 77 (54.5%) in 2021 and 58 of 86 (67.4%) in 2022
(Table 4). Compared with articles reporting race and
ethnicity, higher proportions of articles reported participants’
age and sex or gender and a lower proportion reported
socioeconomic status measures in all years. There were no
significant differences in article location of reporting race and
ethnicity or the proportion of articles that reported racial and
ethnic categories. Of articles that included “other” as a
collective racial and ethnic category, the proportion that
defined specific categories included in “other” was 26.7% in
2019, 70.4% in 2021, and 84.8% in 2022, with a significant
difference observed before guidance implementation in 2021
vs 2019 (OR, 6.53; 95% CI, 2.05-20.76; P < .001). A
significant difference after reporting guidance
implementation was observed for articles listing categories in
alphabetical order (92.6% in 2022 vs 16.7% in 2021 OR
73.75; 95% CI, 20.15-269.99; P < .001) and articles
indicating how race and ethnicity were determined (74.1% in
2022 vs 50.0% in 2021 OR, 2.87; 95% CI, 1.23-6.66; P =
.01).
Conclusions In this analysis, higher proportions of articles
reported how race and ethnicity were determined and listed
categories in alphabetical order in 2022 following the
implementation of reporting guidance. Some improvement
was noted before 2021 and may have been associated with
internal guidance shared in October 2020 and publication of
an early draft of the guidance in February 2021. 3 Overall, race
and ethnicity were still underreported compared with age,
sex, and gender.
References
1. Alegria M, Sud S, Steinberg BE, Gai N, Siddiqui A.
Reporting of participant race, sex, and socioeconomic
status in randomized clinical trials in general medical
journals, 2015 vs 2019. JAMA Netw Open.
2021;4(5):e2111516. doi:10.1001/
jamanetworkopen.2021.11516
2. Flanagin A, Frey T, Christiansen SL; AMA Manual of Style
Committee. Updated guidance on the reporting of race and
ethnicity in medical and
science journals. JAMA. 2021;326(7):621-627.
doi:10.1001/jama.2021.13304
3. Flanagin A, Frey T, Christiansen SL, Bauchner H. The
reporting of race and ethnicity in medical and science
journals: comments invited. JAMA. 2021;325(11):1049-
1052.
doi:10.1001/jama.2021.2104
1 JAMA Network, Chicago, IL, USA, annette.flanagin@jamanetwork.
org; 2 Berry Consultants LLC, Austin, TX, USA; 3 Harbor-UCLA
Medical Center, Torrance, CA, USA; 4 David Geffen School of
Medicine at UCLA, Los Angeles, CA, USA
Conflict of Interest Disclosures Stacy L. Christiansen is
chair and Annette Flanagin and Tracy Frey are members of
the AMA Manual of Style committee. Annette Flanagin is
executive director of the Peer Review Congress but was not
involved in the review or decision for this abstract.