Issue analysis: Race and ethnicity in case reports part II

To analyze patient data in The Ochsner Journal, we examined the case reports and case series of the journal’s 14 volumes.

Here’s what we found:

  • Of 561 articles, 21.4% were case reports and series.
  • Of 151 patients in the case reports and series,
    • 82.1% had no race or ethnicity data reported.
    • 8.6% were reported as white/Caucasian.
    • 6.6% were reported as black/African American.
    • 0.7% were reported as Hispanic.
    • 0.7% were reported as Asian.
    • 0.7% were reported as Middle Eastern.
    • 0.7% were reported as “Spanish speaking.”
    • 48.3% were reported as male.
    • 51.7% were reported as female.
  • Cases that included race or ethnicity provided no information about how the data were collected.
  • Patients were more often reported as Caucasian than white (8 vs 5 instances) and African American than black (9 vs 1 instances).
  • The youngest patient was 1 day old; the oldest was 87 years.
  • Mean patient age was 48.47 years; median patient age was 52 years.

Unaeze and Bigby conducted an in-depth analysis of the Journal of the American Academy of Dermatology‘s case reports from 2004. Race was not mentioned in 59% of cases but included in 41%. No mention was made of how race/ethnicity of the patient was determined in 74% of cases. The authors concluded their report with this advice, “Journal editors may find it helpful to address the reporting of race/ethnicity in instructions to authors of case reports and small case series.”

The Ochsner Journal does not advise authors about the reporting of race and ethnicity. As evidenced by the diverse nomenclature above, the editorial staff adheres to the American Medical Association (AMA) Manual of Style instructions to “follow author usage” of race and ethnicity terms.

The AMA Manual of Style also references author instructions from the Journal of the American Medical Association that state, “If race and/or ethnicity is reported, indicate in the Methods section who classified individuals as to race/ethnicity, the classifications, and whether the options were defined by the investigator or the participant. Explain why race and/or ethnicity was assessed in the study.”

The Ochsner Journal editorial board will periodically address the need for developing a policy about the reporting of patient race and ethnicity and encourages other medical journals to investigate their authors’ reporting habits.

Research disclosures: Given the nonmedical background of the researcher, we were unable to assess whether reported race or ethnicity was potentially relevant to the particular case or whether there was an evidence-based reason for inclusion. Total article count did not include editorials, From the Editor’s Desk, academic updates, Ochsner profiles, book reviews, Research Night/Research Day abstracts, and historical accounts.

For a discussion of collecting and reporting patient race and ethnicity, see “Issue analysis: Race and ethnicity in case reports part I.”

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