Representation of Hispanic Patients in Clinical Trials for Respiratory Failure: A Systematic Review
OBJECTIVES:. Hispanic individuals comprise one-fifth of the U.S. population and Hispanic patients with acute hypoxemic respiratory failure (AHRF) experience higher odds of death compared with non-Hispanic White patients. Representation of Hispanic patients in clinical trials for respiratory failure...
Saved in:
| Main Authors: | , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer
2025-01-01
|
| Series: | Critical Care Explorations |
| Online Access: | http://journals.lww.com/10.1097/CCE.0000000000001193 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832589737050767360 |
|---|---|
| author | Emily A. Harlan, MD, MA, MSc Kaitlin Malley, BS Grecia Quiroga, MD Eman Mubarak, MD Pema Lama, BS Amanda Schutz, PhD Adolfo Cuevas, PhD Catherine L. Hough, MD MSc Theodore J. Iwashyna, MD PhD Mari Armstrong-Hough, PhD Thomas S. Valley, MD, MSc |
| author_facet | Emily A. Harlan, MD, MA, MSc Kaitlin Malley, BS Grecia Quiroga, MD Eman Mubarak, MD Pema Lama, BS Amanda Schutz, PhD Adolfo Cuevas, PhD Catherine L. Hough, MD MSc Theodore J. Iwashyna, MD PhD Mari Armstrong-Hough, PhD Thomas S. Valley, MD, MSc |
| author_sort | Emily A. Harlan, MD, MA, MSc |
| collection | DOAJ |
| description | OBJECTIVES:. Hispanic individuals comprise one-fifth of the U.S. population and Hispanic patients with acute hypoxemic respiratory failure (AHRF) experience higher odds of death compared with non-Hispanic White patients. Representation of Hispanic patients in clinical trials for respiratory failure is critical to address this inequity. We conducted a systematic review to examine the inclusion of Hispanic patients in randomized controlled trials for AHRF and assessed language as a potential barrier to enrollment.
DATA SOURCES:. National Library of Medicine PubMed, Elsevier Embase, and Cochrane Central Register of Controlled Trials databases through January 2024.
STUDY SELECTION:. Randomized controlled trials assessing AHRF interventions enrolling U.S. patients receiving mechanical ventilation, noninvasive mechanical ventilation, or high-flow nasal cannula were included. The systematic review was registered prospectively through PROSPERO (CRD42023437828).
DATA EXTRACTION:. Two authors independently screened studies and extracted data for each included study.
DATA SYNTHESIS:. Ninety-four trials published from 1975 to 2023 were included; 33.0% (n = 31) of studies reported ethnicity, and 11.2% of participants in studies reporting race or ethnicity (1,320/11,780) were identified as Hispanic. The proportion of Hispanic-identified participants was significantly lower than the U.S. Hispanic population from 1996 to 2019 (p < 0.01). Starting in 2020, the proportion of Hispanic-identified participants was significantly higher than the U.S. population (27.8% vs. 19.1%; p < 0.01). Two studies (4.9%) reporting race or ethnicity excluded non-English speaking participants; the remainder did not specify language requirements for enrollment.
CONCLUSIONS:. Hispanic-identified individuals were underrepresented in trials for AHRF until 2020 when Hispanic patient representation increased during COVID-19. Exclusion of participants who do not speak English may represent a barrier to trial enrollment. |
| format | Article |
| id | doaj-art-ea50f5f21b16421dbc2097300b74551d |
| institution | Kabale University |
| issn | 2639-8028 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | Critical Care Explorations |
| spelling | doaj-art-ea50f5f21b16421dbc2097300b74551d2025-01-24T09:19:27ZengWolters KluwerCritical Care Explorations2639-80282025-01-0171e119310.1097/CCE.0000000000001193202501000-00006Representation of Hispanic Patients in Clinical Trials for Respiratory Failure: A Systematic ReviewEmily A. Harlan, MD, MA, MSc0Kaitlin Malley, BS1Grecia Quiroga, MD2Eman Mubarak, MD3Pema Lama, BS4Amanda Schutz, PhD5Adolfo Cuevas, PhD6Catherine L. Hough, MD MSc7Theodore J. Iwashyna, MD PhD8Mari Armstrong-Hough, PhD9Thomas S. Valley, MD, MSc101 Division of Pulmonary and Critical Care Medicine, University of Michigan, Ann Arbor, MI.5 University of Michigan Medical School, Ann Arbor, MI.5 University of Michigan Medical School, Ann Arbor, MI.6 Department of Internal Medicine, Yale University, New Haven, CT.1 Division of Pulmonary and Critical Care Medicine, University of Michigan, Ann Arbor, MI.1 Division of Pulmonary and Critical Care Medicine, University of Michigan, Ann Arbor, MI.7 Department of Social and Behavioral Sciences, Center for Anti-Racism, Social Justice, and Public Health, New York University School of Global Public Health, New York, NY.8 Department of Medicine, Oregon Health & Science University, Portland, OR.9 Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Johns Hopkins School of Medicine, Baltimore, MD.10 Department of Epidemiology and Department of Social and Behavioral Sciences, New York University School of Global Public Health, New York, NY.1 Division of Pulmonary and Critical Care Medicine, University of Michigan, Ann Arbor, MI.OBJECTIVES:. Hispanic individuals comprise one-fifth of the U.S. population and Hispanic patients with acute hypoxemic respiratory failure (AHRF) experience higher odds of death compared with non-Hispanic White patients. Representation of Hispanic patients in clinical trials for respiratory failure is critical to address this inequity. We conducted a systematic review to examine the inclusion of Hispanic patients in randomized controlled trials for AHRF and assessed language as a potential barrier to enrollment. DATA SOURCES:. National Library of Medicine PubMed, Elsevier Embase, and Cochrane Central Register of Controlled Trials databases through January 2024. STUDY SELECTION:. Randomized controlled trials assessing AHRF interventions enrolling U.S. patients receiving mechanical ventilation, noninvasive mechanical ventilation, or high-flow nasal cannula were included. The systematic review was registered prospectively through PROSPERO (CRD42023437828). DATA EXTRACTION:. Two authors independently screened studies and extracted data for each included study. DATA SYNTHESIS:. Ninety-four trials published from 1975 to 2023 were included; 33.0% (n = 31) of studies reported ethnicity, and 11.2% of participants in studies reporting race or ethnicity (1,320/11,780) were identified as Hispanic. The proportion of Hispanic-identified participants was significantly lower than the U.S. Hispanic population from 1996 to 2019 (p < 0.01). Starting in 2020, the proportion of Hispanic-identified participants was significantly higher than the U.S. population (27.8% vs. 19.1%; p < 0.01). Two studies (4.9%) reporting race or ethnicity excluded non-English speaking participants; the remainder did not specify language requirements for enrollment. CONCLUSIONS:. Hispanic-identified individuals were underrepresented in trials for AHRF until 2020 when Hispanic patient representation increased during COVID-19. Exclusion of participants who do not speak English may represent a barrier to trial enrollment.http://journals.lww.com/10.1097/CCE.0000000000001193 |
| spellingShingle | Emily A. Harlan, MD, MA, MSc Kaitlin Malley, BS Grecia Quiroga, MD Eman Mubarak, MD Pema Lama, BS Amanda Schutz, PhD Adolfo Cuevas, PhD Catherine L. Hough, MD MSc Theodore J. Iwashyna, MD PhD Mari Armstrong-Hough, PhD Thomas S. Valley, MD, MSc Representation of Hispanic Patients in Clinical Trials for Respiratory Failure: A Systematic Review Critical Care Explorations |
| title | Representation of Hispanic Patients in Clinical Trials for Respiratory Failure: A Systematic Review |
| title_full | Representation of Hispanic Patients in Clinical Trials for Respiratory Failure: A Systematic Review |
| title_fullStr | Representation of Hispanic Patients in Clinical Trials for Respiratory Failure: A Systematic Review |
| title_full_unstemmed | Representation of Hispanic Patients in Clinical Trials for Respiratory Failure: A Systematic Review |
| title_short | Representation of Hispanic Patients in Clinical Trials for Respiratory Failure: A Systematic Review |
| title_sort | representation of hispanic patients in clinical trials for respiratory failure a systematic review |
| url | http://journals.lww.com/10.1097/CCE.0000000000001193 |
| work_keys_str_mv | AT emilyaharlanmdmamsc representationofhispanicpatientsinclinicaltrialsforrespiratoryfailureasystematicreview AT kaitlinmalleybs representationofhispanicpatientsinclinicaltrialsforrespiratoryfailureasystematicreview AT greciaquirogamd representationofhispanicpatientsinclinicaltrialsforrespiratoryfailureasystematicreview AT emanmubarakmd representationofhispanicpatientsinclinicaltrialsforrespiratoryfailureasystematicreview AT pemalamabs representationofhispanicpatientsinclinicaltrialsforrespiratoryfailureasystematicreview AT amandaschutzphd representationofhispanicpatientsinclinicaltrialsforrespiratoryfailureasystematicreview AT adolfocuevasphd representationofhispanicpatientsinclinicaltrialsforrespiratoryfailureasystematicreview AT catherinelhoughmdmsc representationofhispanicpatientsinclinicaltrialsforrespiratoryfailureasystematicreview AT theodorejiwashynamdphd representationofhispanicpatientsinclinicaltrialsforrespiratoryfailureasystematicreview AT mariarmstronghoughphd representationofhispanicpatientsinclinicaltrialsforrespiratoryfailureasystematicreview AT thomassvalleymdmsc representationofhispanicpatientsinclinicaltrialsforrespiratoryfailureasystematicreview |