Representation of South Asian people in randomised clinical trials: analysis of trials' data

Abstract

ment in 23/26-88% (71% to 96%)-of cases. The discharge destinations recommended by the geriatrician were to a rehabilitation ward (eight patients), home with extra support (seven), nursing home (three), NHS continuing care (two), medicine for the elderly ward (one), hospice (one), and medical ward (one). CommentThe study confirmed the reliability and validity of the instrument for the objective evaluation of the appropriateness of surgical bed occupancy in a colorectal unit. A Canadian report on the American appropriateness evaluation protocol showed a poor validity against a panel of experts ( =0.25).2 A European version of the protocol has been suggested but has not been validated in a substantial study. 3 The validity of our instrument needs to be retested in other settings with a larger study population. Whether the instrument can be used as a tool for clinical decision making or audit needs to be confirmed in future studies.We thank R J C Steele and M Lavelle-Jones for assisting us with conducting this study.

The under-representation of minority ethnic groups in UK medical research

“…Mason et al (2003) reported under-representation of 'South Asian' patients in six RCTs covering a range of conditions. Jolly et al (2005) also found that 'South Asian' patients were more likely to be excluded for recruitment into an RCT for cardiac rehabilitation, but that ethnic differences in rates of participation were not evident among patients deemed eligible.…”

“…It has been argued that the inclusion in medical research of people from Black, Asian and Minority Ethnic (BAME) groups is necessary to avoid unwarranted inequalities and can help guard against an unrepresentative healthcare evidence-base (Mason et al 2003). There is, nevertheless, evidence to suggest that people from BAME groups are under-represented in various UK medical research contexts (Mason et al 2003;Jolly et al 2005;Ranganathan and Bhopal 2006;Godden et al 2010).…”

“…It has been argued that the inclusion in medical research of people from Black, Asian and Minority Ethnic (BAME) groups is necessary to avoid unwarranted inequalities and can help guard against an unrepresentative healthcare evidence-base (Mason et al 2003). There is, nevertheless, evidence to suggest that people from BAME groups are under-represented in various UK medical research contexts (Mason et al 2003;Jolly et al 2005;Ranganathan and Bhopal 2006;Godden et al 2010). These existing studies, however, do not provide insights into participation in medical research among the general population and give relatively little attention to factors that cut across ethnic groups like socio-economic status, education or engagement with science, or to the role these may have in explaining or mediating any purported ethnic differences in participation.…”

The Birmingham Rehabilitation Uptake Maximisation Study (BRUM). Home-based compared with hospital-based cardiac rehabilitation in a multi-ethnic population: cost-effectiveness and patient adherence

“…153,154 Given concerns about the lower uptake of CR in people from ethnic minority groups, we wanted to explore whether the provision of a home-based programme might improve uptake and adherence in this group. There have been concerns about the underrepresentation of people from ethnic minority groups in clinical trials 153,155 and trials of cardiac patients in particular, 156 but few trials of CR have even reported the ethnicity of their participants. Exclusion of ethnic minorities from clinical trials undermines the UK Government's NHS plan for tackling inequalities and its core principle of providing culturally appropriate and accessible care for different groups and individuals.…”

Different Distribution of Cardiovascular Risk Factors According to Ethnicity: A Study in a High Risk Population

“…Although several international studies have shown that both prevention through life style changes and improved treatment regimes play an important role in reducing cardiovascular diseases and related cardiovascular risk factors [7][8][9][10], the question rises whether ethnic specific interventions are more appropriate, since most studies have been conducted in white populations [11,12] and the effectiveness of general interventions is disappointing in ethnic minority groups [13,14]. An important step in investigating whether interventions tailored to various ethnic minority groups are necessary to efficiently reduce cardiovascular risk, is the assessment and comparison of the cardiovascular risk profile of high-risk people from different ethnic backgrounds.…”