Background/Purpose: Race and ethnicity are increasingly evaluated in rheumatology research due to their influence on health outcomes, yet there remains heterogeneity in their interpretation and use. The objectives of this study were to (1) identify how race and ethnicity have been conceptualized, to (2) comparatively evaluate  methods used to ascertain race and ethnicity, and (3) methods of race and ethnicity categorization in clinical research.

Methods: An umbrella review was conducted compliant with Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). We searched MEDLINE, Embase, CINAHL, SCOPUS and Sociological Abstracts from January 2002 to October 2023 using search terms related to: (1) race and ethnicity, (2) conceptualization, (3) genetics, and (4) clinical research. Relevant English language review articles published in peer-reviewed journals were selected for inclusion by two independent reviewers. Titles and abstracts were reviewed for potentially relevant articles, then full text articles for final inclusion. References of selected articles and grey literature were reviewed. Data on the construct of race and ethnicity, methods of ascertainment and categorization were abstracted using a standardized form.

Results: The search generated 9853 articles, with 183 articles selected for full-text review. A total of 11 review articles were selected for inclusion. Race and ethnicity have been conceptualized as biologic entities, with a more recent shift as socially constructed concepts. There is conflated understanding of how these concepts relate and differ from ancestry. We identified 5 methods for the ascertainment of race: self-report, social assignment, name-based ethnic classification, geocoding, and genetic analysis (Table 1). We identified 17 systems of categorization, with racial categories ranging from 3 to 15 (Table 2). Systems of race and ethnicity categorization vary within and across geographic regions, reflecting population context.

Conclusion: The constructs of race and ethnicity are evolving, ranging from a biologic to socio-political construct. There are several methods of ascertainment and categorization of race and ethnicity, with varying risk of misclassification bias. This synthesis of methods can be used to inform the conduct of clinical research in rheumatic diseases.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/evaluation-of-methods-for-ascertainment-and-categorization-of-race-and-ethnicity-for-clinical-research-an-umbrella-review/