Major Josh, Mahnken Kurt, Ghebrehiwet Merhawit, Clark Payton, Autaubo Josh, Wilson Andrew, Checketts Jake, Ford Alicia, Vassar Matt
From the Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK (Mr. Major, Mr. Mahnken, Ms. Ghebrehiwet, Ms. Clark, Mr. Autaubo, Mr. Wilson, Dr. Ford, and Dr. Vassar); the Department of Orthopaedic Surgery, Oklahoma State University Medical Center, Tulsa, OK (Mr./Dr. Checketts); and the Department of Psychiatry and Behavioral Sciences, Oklahoma State University Center for Health Sciences, Tulsa, OK (Dr. Ford and Dr. Vassar).
J Am Acad Orthop Surg Glob Res Rev. 2025 Apr 29;9(5). doi: 10.5435/JAAOSGlobal-D-24-00242. eCollection 2025 May 1.
To investigate the recruitment and retention strategies in clinical trials evaluating hip fractures, with a focus on underrepresented populations.
The prevalence and burden of hip fractures necessitate diverse and representative clinical trials to improve management outcomes. Underrepresented populations often face barriers to participation, affecting the generalizability of trial results.
We conducted a cross-sectional analysis of clinical trials on hip fractures published between 2018 and 2023. We searched Embase and MEDLINE, screening and extracting data in a masked duplicate manner. For statistical analysis, Stata 18 SE (StataCorp LLC) was used to determine frequencies of recruitment and retention strategies.
We screened 624 studies, with 72 meeting our inclusion criteria. Trials were conducted in the United States (12/72, 16.7%), non-United States (53/72, 73.6%), or both (7/72, 9.7%). Only one trial (1.4%) mentioned specific recruitment strategies, and three (4.2%) reported measures to minimize participant dropout. Overall, the mention of strategies for diverse participation was scarce.
There is a notable lack of recruitment and retention strategies directed at promoting diverse participation in hip fracture trials. This study highlights the need for improved inclusiveness and equity in future clinical trials to enhance the generalizability of their findings and better serve all populations affected by hip fractures.
调查评估髋部骨折的临床试验中的招募和保留策略，重点关注代表性不足的人群。
髋部骨折的患病率和负担使得需要开展多样化且具有代表性的临床试验，以改善治疗结果。代表性不足的人群在参与试验时往往面临障碍，这影响了试验结果的普遍性。
我们对2018年至2023年期间发表的关于髋部骨折的临床试验进行了横断面分析。我们检索了Embase和MEDLINE，以双盲重复的方式筛选和提取数据。为进行统计分析，使用Stata 18 SE（StataCorp有限责任公司）来确定招募和保留策略的频率。
我们筛选了624项研究，其中72项符合我们的纳入标准。试验在美国（12/72，16.7%）、美国以外地区（53/72，73.6%）或两个地区均开展（7/72，9.7%）。只有一项试验（1.4%）提到了具体的招募策略，三项试验（4.2%）报告了将参与者退出率降至最低的措施。总体而言，针对多样化参与的策略提及较少。
在促进髋部骨折试验多样化参与方面，明显缺乏招募和保留策略。本研究强调，未来的临床试验需要提高包容性和公平性，以增强研究结果的普遍性，并更好地服务于所有受髋部骨折影响的人群。
