Abstract A86: Specialty comparison of disparities-related research over forty years
Authors: Ahmed Awad , Deville Curtiland 
Published: October 2015

Introduction: Research on health disparities in racial/ethnic minorities and the medically underserved is integral to the future of healthcare both globally and in the United States. This research is essential to understand and improve inequities in medicine, and to guarantee the delivery of first-class health care. While much research has investigated diversity in the medical field from the perspective of faculty, residents and medical students, little has been devoted to examining how much research is allotted to disparities in health-care with respect to racial/ethnic minorities and the medically underserved. To our knowledge, no investigation has compared specialties with regard disparity-related research. The purpose of this study was to compare allocation of research dedicated to the underserved across different specialties and time-periods.

Methods: A PubMed data search for keywords of interest and control keywords was implemented for three time periods, 1969-1983, 1984-1998, and 1999-2013. Keywords of interest were, “racial,” “disparities,” “socioeconomic,” and “ethnic.” The keywords used as controls were, “diagnosis,” and “cell.” This was done for three journals from each of the major medical specialties: Internal Medicine (NEJM, Lancet, JAMA), Surgery (Annals of Surgery, British Journal of Surgery, Endoscopy), Pediatrics (Pediatrics, Archives of Pediatrics and Adolescent Medicine, Journal of Pediatrics), Obstetrics and Gynecology (Obstetrics and Gynecology, American Journal of Obstetrics and Gynecology, BJOG), in addition to journals from Oncology (CA-A Cancer Journal for Clinicians, JCO, JNCI) and Radiation Oncology (IJROBP, Radiotherapy and Oncology, Radiation Research). Journals were selected on the basis of relevance to a field, and Thomas Reuters ranking. All journals used in this analysis were established before 1985. For each search, the number of returned search results in addition to the total number of articles for that period was recorded to yield a percentage. Search entries utilized keywords exclusively, using Boolean operator filtering, to prevent overlap between search results. Statistical analysis was centered at time period 1969-1983 so as to determine whether changes occurred over time. Linear models were fitted between the specialties and the proportion of returned search results. Control keyword search results were included in the model for standardization. Additionally, the total for all three time periods was combined to generate a total disparity-related research percentage for each specialty.

Results: All six specialties examined in this study experienced statistically significant increases in relevant search results over the time periods examined (p&lt;0.05). Radiation Oncology and Surgery were observed to have the greatest changes over time showing changes statistically different than those observed in the other subspecialties. However, these were also the specialties with the smallest proportion of returned keywords in total over the three time periods examined: Radiation Oncology 0.23%, Surgery 0.29%, Internal Medicine 1.06%, Oncology 1.25%, Obstetrics and Gynecology 1.69%, Pediatrics 3.53%.

Conclusion: Our study demonstrates that these 6 medical specialties are making great strides in the struggle to address and understand the unique disease processes and socioeconomic problems endemic to underserved populations. However, the distribution of research dedicated to this population is not equally distributed among medical specialties despite some advances. Greater attention and future research dedicated to this end should be made available-particularly to scientists and researchers in fields where such investigations are insufficient. Future studies should examine the root causes for the differences in the amount of disparity-related research among specialties.

Citation Format: Awad Ahmed, Curtiland Deville. Specialty comparison of disparities-related research over forty years. [abstract]. In: Proceedings of the Seventh AACR Conference on The Science of Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; Nov 9-12, 2014; San Antonio, TX. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2015;24(10 Suppl):Abstract nr A86.