Background:

Patients’ race and/or ethnicity are increasingly being associated with differential surgical access and outcomes in cardiac surgery. However, poor diversity in study populations and conflicting research methodology and findings have made it difficult to derive evidence-based conclusions that can inform surgical care. Using a fictional patient example, this review identifies areas of concern in research engagement, methodology, and analyses as well as potential steps to improve race and ethnicity considerations in cardiac surgical research.

Methods:

A narrative literature review was performed using the PubMed/MEDLINE and Google Scholar databases with a combination of cardiac surgery, race, ethnicity, and disparities keywords.

Results:

Less than half of the published cardiac surgery randomized control trials (RCTs) report research participants’ race and/or ethnicity. Racial and/or ethnic minorities make up less than 20% of most study populations and are significantly underrepresented relative to their proportions of the general population. Further, research participants’ race and/or ethnicity are variably categorized based on ancestry, geographical regions, cultural similarities, or minority status. There is growing consideration of analyzing interrelated and confounding variables, such as socioeconomic status, geographical location, or hospital quality, to better elucidate racial and/or ethnic disparities; however, intersectionality considerations remain limited in cardiac surgery research.

Conclusions:

Racial and/or ethnic disparities are increasingly being reported in research engagement, cardiac pathologies, and surgical outcomes. To promote equitable surgical care, tangible efforts are needed to recruit racially and/or ethnically minoritized patients to research studies, be transparent and consistent in their groupings, and elucidate the impact of their intersectional social identities.