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Workman's compensation as exclusion criteria in rotator cuff repair literature – are we inadvertently excluding race?

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Title: Workman's compensation as exclusion criteria in rotator cuff repair literature – are we inadvertently excluding race?
Authors: Lee, Donghoon1 (AUTHOR), Destine, Henson1 (AUTHOR), Perez, Andres1 (AUTHOR), Detweiler, Maxwell C1 (AUTHOR), Corsi, Douglas R1 (AUTHOR), Lencer, Adam J1 (AUTHOR), Gibbs, Brian S1 (AUTHOR), Freedman, Kevin B1 (AUTHOR), Tjoumakaris, Fotios P1 (AUTHOR) Fotios.Tjoumakaris@rothmanortho.com
Source: Physician & Sportsmedicine. Aug2024, Vol. 52 Issue 4, p355-359. 5p.
Subject Terms: *Hispanic Americans, *Demographic characteristics, Workers' compensation, Rotator cuff, Race
Geographic Terms: United States
Abstract: Despite an equal willingness to participate in clinical trials, there is evidence that several minority populations are systematically under-represented in studies. One potential cause and frequently used exclusionary criterion in orthopedic trials is patients with active workman's compensation (WC) insurance claims. The purpose of this study is to determine demographic differences in patients undergoing arthroscopic rotator cuff repair with commercial and government insurance vs workers compensation claims. This was a retrospective review of patients who underwent primary arthroscopic rotator cuff repair at a single institution in the northeastern United States from 2018 to 2019. Patients undergoing revision cases were excluded. Chart review was used to extract demographic data such as age, gender, insurance, and reported race. A total of 4553 patient records were reviewed and included. There were 742 WC patients and 3811 non-WC patients. Two hundred and forty-four patients did not report their race. Overall, WC patients differed from non-WC with respect to race (P < 0.001). One hundred and eleven (15.0%) of WC and 293 (7.7%) non-WC patients reported being 'Black' or 'African American' (P = 0.002). This compares to 368 (49.6%) WC and 2788 (73.2%) non-WC patients who reported 'White' (P < 0.001). About 16.8% of WC patients were identified as 'Hispanic or Latino,' compared to 5.2% of non-WC (P < 0.001). African American and Hispanic/Latino patients are over-represented in workman's compensation patient populations relative to non-workman's compensation. Conversely, white patients are over-represented in non-WC patient populations, which serve as the basis for the majority of clinical study populations. Excluding workman's compensation patients from clinical trials may lead to an underrepresentation of African American and Hispanic/Latino patient populations in orthopedic clinical trials. In doing so, the generalizability of the results of rotator cuff repair clinical outcomes research to all races and ethnicities may be compromised. [ABSTRACT FROM AUTHOR]
Copyright of Physician & Sportsmedicine is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Education Research Complete
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  Data: Workman&#39;s compensation as exclusion criteria in rotator cuff repair literature – are we inadvertently excluding race?
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  Data: &lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Lee%2C+Donghoon%22&quot;&gt;Lee, Donghoon&lt;/searchLink&gt;&lt;relatesTo&gt;1&lt;/relatesTo&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Destine%2C+Henson%22&quot;&gt;Destine, Henson&lt;/searchLink&gt;&lt;relatesTo&gt;1&lt;/relatesTo&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Perez%2C+Andres%22&quot;&gt;Perez, Andres&lt;/searchLink&gt;&lt;relatesTo&gt;1&lt;/relatesTo&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Detweiler%2C+Maxwell+C%22&quot;&gt;Detweiler, Maxwell C&lt;/searchLink&gt;&lt;relatesTo&gt;1&lt;/relatesTo&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Corsi%2C+Douglas+R%22&quot;&gt;Corsi, Douglas R&lt;/searchLink&gt;&lt;relatesTo&gt;1&lt;/relatesTo&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Lencer%2C+Adam+J%22&quot;&gt;Lencer, Adam J&lt;/searchLink&gt;&lt;relatesTo&gt;1&lt;/relatesTo&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Gibbs%2C+Brian+S%22&quot;&gt;Gibbs, Brian S&lt;/searchLink&gt;&lt;relatesTo&gt;1&lt;/relatesTo&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Freedman%2C+Kevin+B%22&quot;&gt;Freedman, Kevin B&lt;/searchLink&gt;&lt;relatesTo&gt;1&lt;/relatesTo&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Tjoumakaris%2C+Fotios+P%22&quot;&gt;Tjoumakaris, Fotios P&lt;/searchLink&gt;&lt;relatesTo&gt;1&lt;/relatesTo&gt; (AUTHOR)&lt;i&gt; Fotios.Tjoumakaris@rothmanortho.com&lt;/i&gt;
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  Data: &lt;searchLink fieldCode=&quot;JN&quot; term=&quot;%22Physician+%26+Sportsmedicine%22&quot;&gt;Physician &amp; Sportsmedicine&lt;/searchLink&gt;. Aug2024, Vol. 52 Issue 4, p355-359. 5p.
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  Data: *&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Hispanic+Americans%22&quot;&gt;Hispanic Americans&lt;/searchLink&gt;&lt;br /&gt;*&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Demographic+characteristics%22&quot;&gt;Demographic characteristics&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Workers&#39;+compensation%22&quot;&gt;Workers&#39; compensation&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Rotator+cuff%22&quot;&gt;Rotator cuff&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Race%22&quot;&gt;Race&lt;/searchLink&gt;
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  Data: &lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22United+States%22&quot;&gt;United States&lt;/searchLink&gt;
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Despite an equal willingness to participate in clinical trials, there is evidence that several minority populations are systematically under-represented in studies. One potential cause and frequently used exclusionary criterion in orthopedic trials is patients with active workman&#39;s compensation (WC) insurance claims. The purpose of this study is to determine demographic differences in patients undergoing arthroscopic rotator cuff repair with commercial and government insurance vs workers compensation claims. This was a retrospective review of patients who underwent primary arthroscopic rotator cuff repair at a single institution in the northeastern United States from 2018 to 2019. Patients undergoing revision cases were excluded. Chart review was used to extract demographic data such as age, gender, insurance, and reported race. A total of 4553 patient records were reviewed and included. There were 742 WC patients and 3811 non-WC patients. Two hundred and forty-four patients did not report their race. Overall, WC patients differed from non-WC with respect to race (P &lt; 0.001). One hundred and eleven (15.0%) of WC and 293 (7.7%) non-WC patients reported being &#39;Black&#39; or &#39;African American&#39; (P = 0.002). This compares to 368 (49.6%) WC and 2788 (73.2%) non-WC patients who reported &#39;White&#39; (P &lt; 0.001). About 16.8% of WC patients were identified as &#39;Hispanic or Latino,&#39; compared to 5.2% of non-WC (P &lt; 0.001). African American and Hispanic/Latino patients are over-represented in workman&#39;s compensation patient populations relative to non-workman&#39;s compensation. Conversely, white patients are over-represented in non-WC patient populations, which serve as the basis for the majority of clinical study populations. Excluding workman&#39;s compensation patients from clinical trials may lead to an underrepresentation of African American and Hispanic/Latino patient populations in orthopedic clinical trials. In doing so, the generalizability of the results of rotator cuff repair clinical outcomes research to all races and ethnicities may be compromised. [ABSTRACT FROM AUTHOR]
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  Data: &lt;i&gt;Copyright of Physician &amp; Sportsmedicine is the property of Taylor &amp; Francis Ltd and its content may not be copied or emailed to multiple sites without the copyright holder&#39;s express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.&lt;/i&gt; (Copyright applies to all Abstracts.)
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      – Type: doi
        Value: 10.1080/00913847.2023.2267556
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        Text: English
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      – SubjectFull: Hispanic Americans
        Type: general
      – SubjectFull: Demographic characteristics
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      – SubjectFull: Workers' compensation
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      – SubjectFull: Rotator cuff
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      – SubjectFull: Race
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      – SubjectFull: United States
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      – TitleFull: Workman's compensation as exclusion criteria in rotator cuff repair literature – are we inadvertently excluding race?
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              Text: Aug2024
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