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血液学临床试验中整合多样性、公平性和包容性的路线图:美国血液学会倡议。

The roadmap to integrate diversity, equity, and inclusion in hematology clinical trials: an American Society of Hematology initiative.

作者信息

Kuaban Alice, Croker Alysha K, Keefer Jeffrey, Valentino Leonard A, Bierer Barbara E, Boateng Stephen, DiMichele Donna, Fogarty Patrick, Gibson C Michael, Hood Anna M, Hubbard Lloryn, Isgrò Antonella, Knobe Karin, Lake Leslie, Martin Iman, Reid Michel, Roberts Jonathan C, Tomlinson Wendy, Tunji-Ajayi Lanre, Van Spall Harriette G C, Voltz-Girolt Caroline, Wheeler Allison P, Mast Alan E, Seremetis Stephanie

机构信息

Scientific Affairs Department, American Society of Hematology, Washington, DC.

Health Canada, Ottawa, ON, Canada.

出版信息

Blood Adv. 2025 Feb 25;9(4):687-695. doi: 10.1182/bloodadvances.2024013945.

Abstract

Clinical trial design for classical hematologic diseases is difficult because samples sizes are often small and not representative of the disease population. The American Society of Hematology initiated a roadmap project to identify barriers and make progress to integrate diversity, equity, and inclusion into trial design and conduct. Focus groups of international experts from across the clinical trial ecosystem were conducted. Eight issues identified include (1) harmonization of demographic terminology; (2) engagement of lived experience experts across the entire study timeline; (3) awareness of how implicit biases impede patient enrollment; (4) the need for institutional review boards to uphold the justice principle of clinical trial enrollment; (5) broadening of eligibility criteria; (6) decentralized trial design; (7) improving access to clinical trial information; and (8) increased community physician involvement. By addressing these issues, the hematology community can promote accessible and inclusive trials that will further inform research, clinical decision-making, and care for patients.

摘要

经典血液学疾病的临床试验设计颇具难度,因为样本量往往较小,且不能代表疾病总体情况。美国血液学会启动了一个路线图项目,以识别障碍,并在将多样性、公平性和包容性纳入试验设计与实施方面取得进展。来自临床试验生态系统各个领域的国际专家焦点小组参与其中。确定的八个问题包括:(1)人口统计学术语的统一;(2)在整个研究过程中让有实际经验的专家参与进来;(3)认识到隐性偏见如何阻碍患者入组;(4)机构审查委员会需要坚持临床试验入组的公正原则;(5)放宽入选标准;(6)分散式试验设计;(7)改善临床试验信息的获取;以及(8)增加社区医生的参与。通过解决这些问题,血液学界可以推动开展可及且包容的试验,这将进一步为研究、临床决策以及患者护理提供信息。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/da5e/11869854/52b8c6cbedb8/BLOODA_ADV-2024-013945-ga1.jpg

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