Schumacher Leah M, Chibueze Joseph, Knudsen Francesca M, Rajpal Astha, Kalala Siddhartha, Power Ksenia, Silver Julie K, Burton-Murray Helen
Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia, Pennsylvania, USA.
Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania, USA.
Obesity (Silver Spring). 2025 May;33(5):915-926. doi: 10.1002/oby.24273. Epub 2025 Apr 11.
Federal policies mandate the inclusion of historically marginalized groups in clinical trials and sociodemographic reporting on ClinicalTrials.gov. This study used ClinicalTrials.gov to comprehensively assess sociodemographic reporting and representation in obesity-related trials.
Age, race and ethnicity, and sex data were extracted for interventional studies completed in the United States with results from January 1, 2012, to October 13, 2023. We assessed the frequency of sociodemographic reporting and sample representation (equitable, over, or under), as determined by comparing the percentage of trial participants with each characteristic to US Census data and obesity-specific estimates.
The search yielded 847 study records, 449 of which were eligible. Most studies (>99%) reported sex; older age (33%), race (75%), and ethnicity (57%) were less commonly reported, although race and ethnicity reporting increased over time (p values <0.001). The following three patterns emerged for representation: 1) individuals identifying as Black/African American were slightly overrepresented relative to the comparators; 2) representation of older adults and other racial and ethnic identities was more mixed and differed by trial type; and 3) female participants were overrepresented.
Progress has been made in reporting and representation, although gaps remain. Given obesity-related health disparities and reasons for inclusion beyond population-based representation (e.g., subgroup analyses), continued efforts are needed to enhance reporting and representation.
联邦政策要求在临床试验以及ClinicalTrials.gov上的社会人口统计学报告中纳入历史上被边缘化的群体。本研究利用ClinicalTrials.gov全面评估肥胖相关试验中的社会人口统计学报告及代表性情况。
提取2012年1月1日至2023年10月13日在美国完成的干预性研究的年龄、种族和族裔以及性别数据。我们通过将具有各特征的试验参与者百分比与美国人口普查数据及肥胖症特定估计值进行比较,评估社会人口统计学报告的频率和样本代表性(公平、过度或不足)。
检索得到847条研究记录,其中449条符合条件。大多数研究(>99%)报告了性别;年龄较大者(33%)、种族(75%)和族裔(57%)的报告较少见,不过种族和族裔报告随时间增加(p值<0.001)。出现了以下三种代表性模式:1)自我认定为黑人/非裔美国人的个体相对于比较对象略超比例;2)老年人以及其他种族和族裔身份的代表性更为复杂,且因试验类型而异;3)女性参与者超比例。
尽管仍存在差距,但在报告和代表性方面已取得进展。鉴于与肥胖相关的健康差异以及除基于人群的代表性之外的纳入原因(例如亚组分析),仍需继续努力加强报告和代表性。