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少数民族群体参与癌症临床研究试验,以评估对卫生部研究治理框架原则的遵守情况:来自英格兰一家医院信托的国家数据来源和出现的一般问题。

Recruitment of minority ethnic groups into clinical cancer research trials to assess adherence to the principles of the Department of Health Research Governance Framework: national sources of data and general issues arising from a study in one hospital trust in England.

机构信息

Department of Epidemiology and Public Health, Health Care Evaluation Group, UCL, London, England.

出版信息

J Med Ethics. 2010 Jun;36(6):358-62. doi: 10.1136/jme.2009.033845. Epub 2010 May 3.

Abstract

BACKGROUND

This article describes the issues encountered when designing a study to evaluate recruitment of minority ethnic groups into clinical cancer research in order to monitor adherence to the principles for good practice set out in the Department of Health, Research Governance Framework, England.

METHODS

(i) A review of routine data sources to determine whether their usefulness as a source of data on prevalence of cancer in the population by ethnic category. (ii) A local case study at one hospital trust to ascertain whether the ethnicity of cancer trial participants was representative of admitted cancer patients.

RESULTS

(i) The lack of a comparator population makes it problematic to assess recruitment levels by ethnic group in clinical research. (ii) The odds of being in a trial were 30% lower for a member of a minority ethnic group compared to a white cancer patient after adjusting for disease, age and gender, OR 0.70 (0.53 to 0.94). These results differed for each ethnic group; Asian patients did not appear under-represented while Black and Chinese did so. However, there are important caveats to the findings based on the limited recording of ethnicity.

CONCLUSIONS

The lack of available data on the ethnicity of participants in clinical research and the prevalence of cancer in the population according to ethnicity makes it difficult to design a study to monitor representation of minority ethnic groups. This information is necessary to assess adherence to the Research Governance Framework principle that research evidence reflects the diversity of the population.

摘要

背景

本文描述了在设计一项评估少数民族参与癌症临床研究的研究时所遇到的问题,以便监测英国卫生部研究治理框架中规定的良好实践原则的遵守情况。

方法

(i)回顾常规数据源,以确定其是否可作为按族裔类别划分的人群癌症患病率数据来源。(ii)在一家医院信托进行局部案例研究,以确定癌症试验参与者的种族是否代表入院癌症患者。

结果

(i)缺乏对照组人群,因此难以按族裔群体评估临床研究中的招募水平。(ii)调整疾病、年龄和性别后,少数民族群体成员参与试验的可能性比白人癌症患者低 30%,OR 0.70(0.53 至 0.94)。这些结果因每个族裔群体而异;亚裔患者似乎没有代表性不足,而黑人和华裔患者则存在代表性不足。然而,基于对族裔的有限记录,调查结果存在重要的限制。

结论

缺乏关于临床研究参与者种族和按族裔划分的人群癌症患病率的可用数据,使得难以设计一项监测少数民族群体代表性的研究。为了评估研究证据是否反映人群的多样性,这是遵守研究治理框架原则所必需的信息。

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