Low Rates of Reporting and Analyzing Race and Ethnicity in Hand Surgery Randomized Controlled Trials: A Systematic Review

Purpose: Sociodemographic factors have been shown to influence musculoskeletal health. However, little is known regarding the frequency of reporting and analysis of certain sociodemographic variables (e.g., age, sex, height, weight, body mass index (BMI), race, and ethnicity) in randomized clinical trials (RCTs) pertaining to hand surgery. The purpose of this study was to assess the rate of reporting and analysis of these variables in RCTs published in the Journal of Hand Surgery (JHS). Methods: A systematic review was conducted of RCTs published in JHS between 2015 and 2021. For each study, we determined whether the following sociodemographic variables were reported and/or analyzed: age, sex, height, weight, BMI, race, and ethnicity. Frequencies were reported by year and as a cumulative total. Studies were evaluated using the Cochrane risk-of-bias tool. Results: A total of 45 RCTs met inclusion criteria, with about half (53.3%) originating from the United States. Age (97.8%) and sex (91.1%) were the most frequently reported sociodemographic variables, followed by race (17.8%), BMI (11.1%), and ethnicity (8.9%). Age (17.8%) was the most frequently analyzed variable, followed by sex (13.3%), and race (4.4%); the remaining variables were not analyzed in any study. Conclusions: While age and sex are reported at a high rate, only about 1 in 4 RCTs published in JHS report either race or ethnicity. All sociodemographic variables were infrequently included as part of statistical analysis. The significance of these findings should be recognized and used to interpret and enhance the methodology of future RCTs.