Asian American Pacific Islander Representation in Outcomes Research: NSQIP Scoping Review

• Published in: Journal of the American College of Surgeons Vol. 232; no. 5; pp. 682 - 689.e5
• Main Authors: Chao, Grace F., Emlaw, Jonel, Chiu, Alexander S., Yang, Jie, Thumma, Jyothi, Brackett, Alexandria, Pei, Kevin Y.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.05.2021
• Subjects: Asian American Native Hawaiian and Pacific Islander - statistics & numerical data; Health Services Research - standards; Health Services Research - statistics & numerical data; Healthcare Disparities - statistics & numerical data; Humans; Patient Acceptance of Health Care - statistics & numerical data; Patient Selection; Specialties, Surgical - organization & administration; Specialties, Surgical - standards; Specialties, Surgical - statistics & numerical data; Treatment Outcome
• ISSN: 1072-7515; 1879-1190
• DOI: 10.1016/j.jamcollsurg.2021.01.015

If Asian American and Pacific Islanders (AAPIs) are not recognized within patients in health services research, we miss an opportunity to ensure health equity in patient outcomes. However, it is unknown what the rates are of AAPIs inclusion in surgical outcomes research. Through a scoping review, we used Covidence to search MEDLINE, EMBASE, PsycINFO, Web of Science, Scopus, and CINAHL for studies published in 2008-2018 using NSQIP data. NSQIP was chosen because of its national scope, widespread use in research, and coding inclusive of AAPI patients. We examined the proportion of studies representing AAPI patients in the demographic characteristics and Methods, Results, or Discussion section. We then performed multivariable logistic regression to examine associations between study characteristics and AAPI inclusion. In 1,264 studies included for review, 62% included race. Overall, only 22% (n = 278) of studies included AAPI patients. Of studies that included race, 35% represented AAPI patients in some component of the study. We found no association between sample size or publication year and inclusion. Studies were significantly more likely to represent AAPI patients when there was a higher AAPI population in the region of the first author's institution (lowest vs highest tercile; p < 0.001). Studies with a focus on disparities were more likely to include AAPI patients (p = 0.001). Our study is the first to examine AAPI representation in surgical outcomes research. We found < 75% of studies examine race, despite availability within NSQIP. Little more than one-third of studies including race reported on AAPI patients as a separate group. To provide the best care, we must include AAPI patients in our research. [Display omitted]