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临床试验中纳入少数群体:代表性不足和数据报告不充分的问题。

The inclusion of minority groups in clinical trials: problems of under representation and under reporting of data.

作者信息

Rochon Paula A, Mashari Azad, Cohen Ariel, Misra Anjali, Laxer Dara, Streiner David L, Clark Jocalyn P, Dergal Julie M, Gold Jennifer

机构信息

Kunin-Lunenfeld Applied Research Unit, Baycrest Centre for Geriatric Care, 3560 Bathurst St., Toronto, ON M6A 2E1, Canada.

出版信息

Account Res. 2004 Jul-Dec;11(3-4):215-23. doi: 10.1080/08989620490891412.

Abstract

OBJECTIVE

To evaluate the representation of minority groups in randomized control trials (RCTs), and the frequency with which this information is reported.

STUDY DESIGN

Reviewers collected data on the racial/ethnic composition of study samples from all RCTs published in six leading medical journals in 1999.

RESULTS

Of the 280 RCTs, most (204, 71.3%) provided no information on the race/ethnicity of participants. Of the 89 U.S.-based RCTs, 50 (56.1%) reported their minority distribution. Relative to other trials, those funded by the National Institute of Health (NIH) (n = 52) were more likely to report race/ethnicity data (55.8% vs. 23.7%; x2 = 20.9, p <_0.001) and to include nonwhite participants (13.5 % vs. 12.5%; x2=22.7, p<_0.001).

CONCLUSION

Minority groups are currently under-represented in clinical trials. Information on the race and ethnicity of clinical trial participants is currently underreported in six leading medical journals. Reporting of minority group information was significantly better only in NIH funded trials, which also were more likely to include nonwhite participants. This suggests that mandatory reporting policies may have a positive effect on both reporting and representation.

摘要

目的

评估少数群体在随机对照试验(RCT)中的代表性,以及该信息的报告频率。

研究设计

评审人员收集了1999年在六种主要医学期刊上发表的所有RCT中研究样本的种族/民族构成数据。

结果

在280项RCT中,大多数(204项,71.3%)未提供参与者种族/民族的信息。在89项美国的RCT中,50项(56.1%)报告了其少数群体分布情况。与其他试验相比,由美国国立卫生研究院(NIH)资助的试验(n = 52)更有可能报告种族/民族数据(55.8%对23.7%;x2 = 20.9,p <_0.001)并纳入非白人参与者(13.5%对12.5%;x2 = 22.7,p <_0.001)。

结论

少数群体目前在临床试验中的代表性不足。关于临床试验参与者种族和民族的信息目前在六种主要医学期刊上报告不足。仅在NIH资助的试验中,少数群体信息的报告情况明显更好,这些试验也更有可能纳入非白人参与者。这表明强制报告政策可能对报告和代表性都有积极影响。

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