Lack of Demographic Information in Total Hip Arthroplasty/Total Knee Arthroplasty Randomized Controlled Trial Publications.

BACKGROUND: The impact of social determinants of health (SDOH) has been documented in orthopaedic literature. However, there is a lack of data on the inclusion of these variables in orthopaedic studies. Our aim was to investigate how many total hip arthroplasties and total knee arthroplasties randomized controlled trials report SDOH variables such as race, ethnicity, insurance, income, and education within the manuscript. METHODS: A systematic review was conducted on a PubMed search for randomized controlled trials published from 2017 to 2019 in the Journal of Bone and Joint Surgery, Journal of Arthroplasty, Clinical Orthopaedics and Related Research, and Osteoarthritis and Cartilage. Data collected included publication year, type of surgery, and the inclusion of race, ethnicity, insurance, income, and education. RESULTS: Of the 72 manuscripts included in the study, 5.6% of the manuscripts mentioned race, 4.2% included race within the demographic table, and 1.4% included ethnicity in the demographic table. Overall, only 5 studies discussed any one of the variables studied and none included any SDOH variables in their multivariable regressions. There were no statistically significant differences on inclusion across journal year (P value = .78), journal name (P value = 1.00), or surgery type (P value = .555). CONCLUSION: Our findings identify a major shortcoming in the inclusion of SDOH variables in total knee arthroplasty/total hip arthroplasty publications. Their exclusion may be indirectly perpetuating disparities if research that does not use representative patient samples is used in creating health policies and national standards. LEVEL OF EVIDENCE: Level V.

Graduate students in public health predict their actual usage of different library services and resources quite accurately.

BACKGROUND: Public health students need to use different resources to those used by other health science students. OBJECTIVES: To compare how users expect to interact with library resources and services with how they reported actual interactions and expected future usage, to inform library planning. METHODS: During first semester orientation, a paper questionnaire was administered to graduate students (n = 25), followed by an end of semester questionnaire in a mandatory public health course. Differences (orientation vs. actual and actual vs. predicted future) were analysed using chi-square tests. RESULTS: Most graduate students utilized library resources as frequently as they anticipated at the semester's start. Regarding which library resources they would use, respondents' predictions during orientation were accurate. Respondent confidence in their abilities to use the library resources rose by the semester's end, and the group's expectations of using electronic books in the future semester increased significantly. DISCUSSION: Graduate students had realistic expectations when predicting their library resource usage and difficulties and most expected to value the quiet space as much as they did. CONCLUSION: Such tracking of group expectations, experience and predicted usage helps library managers' plan where support is required.