Background For extreme hereditary hemorrhagic telangiectasia (HHT) disease, treatments such as intravenous bevacizumab are often utilized. However, whether its efficacy is similar across diverse races and ethnicities is unclear. Methods In this systematic review, we performed a search for English-language articles identified through PubMed, Embase, and Scopus databases whose research occurred in the United States (US). Search terms related to HHT, epistaxis, and intravenous bevacizumab. We searched specifically for the intervention of intravenous bevacizumab because the term serves as a suitable surrogate to convey a patient who has both a diagnosis of HHT and established care. We focused on number of patients recruited in intravenous bevacizumab trials who were identified by race or ethnicity. Results Our search identified 79 studies, of which four were conducted in the US. These four were selected for our systematic review. In these studies, 58 total patients were evaluated (ranging from 5 to 34 participants), whereby, information on age and gender were included. However, none of the US-based studies shared race or ethnicity data. Conclusion Inability to find studies regarding intravenous bevacizumab use in patients with HHT in which race and ethnicity are reported limits our ability to understand the therapy’s efficacy in specific populations. Without emphasis on race and ethnicity in such trials, showing the potential of HHT-related diversity in individuals with this disease may reaffirm implicit bias around HHT diagnosis and treatment. Future work on HHT should emphasize sociodemographic data collection and reporting in an effort to understand this disease in diverse populations.
Written in response to what he recognizes as the problematic philosophical underpinnings of “orthodox research ethics,” Alex John London’s For the Common Good reimagines what is called for in any effort to create a better system of oversight and regulation in biomedical research. London weaves a common thread — justice — through this historical and critical account of the practice of research ethics and its organization of stakeholders, institutions and regulations. By introducing the idea of “a common good” London reframes the narrative and responsibilities of the research ethics field to demonstrate that scientific research and regard for the rights and welfare of individuals are not mutually exclusive. This impressive monograph encourages its readers to push past the limitations of traditional research ethics to consider the context in which the discipline is embedded. That is, rather than settling for analysis at the level of researchers and research participants alone, London encourages us to expand our inquiry to encompass a wider array of stakeholders who co-labor in the social undertaking of biomedical knowledge production. London accomplishes the difficult task of upstream analysis — turning his attention to the conditions and assumptions which create ethical dilemmas rather than applying a retrospective ethical salve to injuries near-guaranteed by a broken system. As opposed to the limited domain of orthodox research ethics (researchers, participants, and the institutional bodies which regulate interaction between the two) London also considers the role and contributions of affected communities, pharmaceutical firms, philanthropic organizations, and journal editors among others.
that experience distrust from historic experiences. This survey aims to characterize practice patterns of a network of Black vascular surgeons.Methods: A cross-sectional survey was conducted via a questionnaire sent to all members of Black vascular surgeons that convened monthly with organic growth during the pandemic. The survey included 20 questions with variables quantified included the surgeon's demographics, experience, scope of practice, treated patient demographics, and society membership.Results: Fifty-nine percent of the 44 ABVS group members completed the survey. Males compromised 81% of the responding vascular surgeons, The Table summarizes the surgeons' demographic. Sixty-two percent of the respondents are involved in academic practice. Less than 25% percent of the total medical staff was Black for 77% in respondent's current work practice. Patients treated by the respondent had insurance coverage of: Medicare 41%, Medicaid 19%, private 29%, and no insurance 11%. Race demographic of the patients treated and summary type of procedures performed are summarized in Figs 1 and 2. Forty-three percent have a current active membership in Society of Vascular Surgery, and 24% have regional society membership.Conclusions: This survey describes a minority vascular surgeon subgroup that has not heretofore been characterized. Racial and ethnic demographic data are essential to develop benchmark goals of racial representation that mirrors our society at large. Future efforts should be aimed at documenting more precisely the demographic makeup of vascular surgeons. These data should drive efforts to increase diversitydirected programs at a pipeline level. Such diversity represents an opportunity to increase minority patient enrollment in vascular care research trials.
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