Black representation in critical care randomized controlled trials: a meta-epidemiological study.

Autor: Tchouambou Youmbi C; McMaster Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada.; Temerty Faculty of Medicine, University of Toronto, Toronto, Canada., Gilman TJ; McMaster Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada., Ndzana Siani IC; Department of Kinesiology, McMaster University, Hamilton, ON, Canada., Olaye IE; Department of Kinesiology, McMaster University, Hamilton, ON, Canada., Popoola AF; McMaster Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada., Yahya SA; McMaster Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada., Kyeremanteng K; Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada., Gandotra S; Division of Pulmonary, Allergy, and Critical Care Medicine, University of Alabama Birmingham, Birmingham, AL, USA., Casey JD; Department of Medicine, Vanderbilt University, Nashville, TN, USA.; Pragmatic Critical Care Research Group, Vanderbilt University, Nashville, TN, USA., Semler MW; Department of Medicine, Vanderbilt University, Nashville, TN, USA.; Pragmatic Critical Care Research Group, Vanderbilt University, Nashville, TN, USA., Mbuagbaw L; Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada., Khalifa A; Department of Medicine (Critical Care), Juravinski Hospital, McMaster University, Hamilton, ON, Canada., Rochwerg B; Department of Medicine (Critical Care), Juravinski Hospital, McMaster University, Hamilton, ON, Canada. rochwerg@mcmaster.ca.
Jazyk: angličtina
Zdroj: Canadian journal of anaesthesia = Journal canadien d'anesthesie [Can J Anaesth] 2023 Jun; Vol. 70 (6), pp. 1064-1074. Date of Electronic Publication: 2023 May 12.
DOI: 10.1007/s12630-023-02462-x
Abstrakt: Purpose: The under-representation of Black people within critical care research limits the generalizability of randomized controlled trials (RCTs). This meta-epidemiologic study investigated the proportionate representation of Black people enrolled at USA and Canadian study sites from high impact critical care RCTs.
Source: We searched for critical care RCTs published in general medicine and intensive care unit (ICU) journals between 1 January 2016 and 31 December 2020. We included RCTs that enrolled critically ill adults at USA or Canadian sites and provided race-based demographic data by study site. We compared study-based racial demographics with site-level city-based demographics and pooled representation of Black people across studies, cities, and centres using a random effects model. We used meta-regression to explore the impact of the following variables on Black representation in critical care RCTs: country, drug intervention, consent model, number of centres, funding, study site city, and year of publication.
Principal Findings: We included 21 eligible RCTs. Of these, 17 enrolled at only USA sites, two at only Canadian sites, and two at both USA and Canadian sites. Black people were under-represented in critical care RCTs by 6% compared with population-based city demographics (95% confidence interval, 1 to 11). Using meta-regression, after controlling for pertinent variables, the country of the study site was the only significant source of heterogeneity (P = 0.02).
Conclusion: Black people are under-represented in critical care RCTs compared with site-level city-based demographics. Interventions are required to ensure adequate Black representation in critical care RCTs at both USA and Canadian study sites. Further research is needed to investigate the factors contributing to Black under-representation in critical care RCTs.
(© 2023. Canadian Anesthesiologists' Society.)
Databáze: MEDLINE
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