Literature DB >> 19395144

Is the enrollment of racial and ethnic minorities in research in the emergency setting equitable?

Jeremy Sugarman1, Colleen Sitlani, Dug Andrusiek, Tom Aufderheide, Eileen M Bulger, Daniel P Davis, David B Hoyt, Ahamed Idris, Jeffrey D Kerby, Judy Powell, Terri Schmidt, Arthur S Slutsky, George Sopko, Shannon Stephens, Carolyn Williams, Graham Nichol.   

Abstract

BACKGROUND: Concerns have been raised about the enrollment of racial and ethnic minorities in research in the emergency setting when it is not possible to obtain informed consent. However, there is a paucity of data related to the validity of such claims.
METHODS: Retrospective comparison of registry enrollment (4/1/2006-3/31/2007) and trial enrollment (4/1/2007-3/31/2008) from three sites in the Resuscitation Outcomes Consortium. Subjects compared met the following criteria: (1) shock, defined by blunt or penetrating force to the body with either systolic blood pressure (SBP) < or =70 mmHg or SBP 71-90 mmHg and heart rate > or =108 beats/min and/or (2) traumatic brain injury (TBI), defined by blunt force to the head with out-of-hospital Glasgow Coma Score < or =8.
RESULTS: Overall, compared to a registry there were no differences in the percent of racial or ethnic groups enrolled in the clinical trial [odds ratio (OR) for Blacks versus Whites: 0.87, 95% confidence interval (CI) 0.65-1.16, p=.34; OR for Hispanics versus Whites 1.04; 95% CI 0.72-1.49, p=.85]. However, Blacks were less likely than Whites to be enrolled in the TBI cohort [OR 0.58 (0.34-0.97), p=.04].
CONCLUSIONS: Despite some discordance in subgroups, there was no overall difference in the racial and ethnic distribution of subjects enrolled in a multi-center clinical trial of severe trauma compared to a registry accounting for study entry criteria. These findings help address justice concerns about enrollment of racial and ethnic minorities in trauma research performed using an exception from informed consent under emergency circumstances.

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Year:  2009        PMID: 19395144      PMCID: PMC2692408          DOI: 10.1016/j.resuscitation.2009.03.015

Source DB:  PubMed          Journal:  Resuscitation        ISSN: 0300-9572            Impact factor:   5.262


  21 in total

1.  Accidental communities: race, emergency medicine, and the problem of polyheme.

Authors:  Karla F C Holloway
Journal:  Am J Bioeth       Date:  2006 May-Jun       Impact factor: 11.229

Review 2.  Racial disparities in acute outcomes of life-threatening injury.

Authors:  Elizabeth G NeSmith
Journal:  J Nurs Scholarsh       Date:  2006       Impact factor: 3.176

3.  Epidemiology of trauma deaths in an urban level-1 trauma center predominantly among African Americans--implications for prevention.

Authors:  Jerome Lyn-Sue; Suryanarayana Siram; Daniel Williams; Haile Mezghebe
Journal:  J Natl Med Assoc       Date:  2006-12       Impact factor: 1.798

4.  A descriptive analysis of Emergency Medical Service Systems participating in the Resuscitation Outcomes Consortium (ROC) network.

Authors:  Daniel P Davis; Lisa A Garberson; Douglas L Andrusiek; David Hostler; Mohamud Daya; Ronald Pirrallo; Alan Craig; Shannon Stephens; Jonathan Larsen; Alexander F Drum; Raymond Fowler
Journal:  Prehosp Emerg Care       Date:  2007 Oct-Dec       Impact factor: 3.077

5.  Traumatic brain injury and functional outcomes: does minority status matter?

Authors:  Juan Carlos Arango-Lasprilla; Mitchell Rosenthal; John Deluca; Eugene Komaroff; Mark Sherer; David Cifu; Robin Hanks
Journal:  Brain Inj       Date:  2007-06       Impact factor: 2.311

6.  Attitudes and beliefs of African Americans toward participation in medical research.

Authors:  G Corbie-Smith; S B Thomas; M V Williams; S Moody-Ayers
Journal:  J Gen Intern Med       Date:  1999-09       Impact factor: 5.128

7.  Epidemiology of severe trauma among status Aboriginal Canadians: a population-based study.

Authors:  Shahzeer Karmali; Kevin Laupland; A Robert Harrop; Christi Findlay; Andrew W Kirkpatrick; Brent Winston; John Kortbeek; Lindsay Crowshoe; Morad Hameed
Journal:  CMAJ       Date:  2005-04-12       Impact factor: 8.262

Review 8.  Consent in resuscitation trials: benefit or harm for patients and society?

Authors:  Graham Nichol; Judy Powell; Lois van Ottingham; Ron Maier; Tom Rea; Jim Christenson; Al Hallstrom
Journal:  Resuscitation       Date:  2006-09       Impact factor: 5.262

9.  Who refuses enrollment in cardiac clinical trials?

Authors:  Mimi Sen Biswas; L Kristin Newby; Lori A Bastian; Eric D Peterson; Jeremy Sugarman
Journal:  Clin Trials       Date:  2007       Impact factor: 2.486

Review 10.  Are racial and ethnic minorities less willing to participate in health research?

Authors:  David Wendler; Raynard Kington; Jennifer Madans; Gretchen Van Wye; Heidi Christ-Schmidt; Laura A Pratt; Otis W Brawley; Cary P Gross; Ezekiel Emanuel
Journal:  PLoS Med       Date:  2005-12-06       Impact factor: 11.069

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  6 in total

1.  Enrollment of racially/ethnically diverse participants in traumatic brain injury trials: effect of availability of exception from informed consent.

Authors:  Jose-Miguel Yamal; Claudia S Robertson; M Laura Rubin; Julia S Benoit; H Julia Hannay; Barbara C Tilley
Journal:  Clin Trials       Date:  2014-04       Impact factor: 2.486

Review 2.  Healthcare disparities in critical illness.

Authors:  Graciela J Soto; Greg S Martin; Michelle Ng Gong
Journal:  Crit Care Med       Date:  2013-12       Impact factor: 7.598

3.  Exploring the inclusion of under-served groups in trials methodology research: an example from ethnic minority populations' views on deferred consent.

Authors:  Timia Raven-Gregg; Victoria Shepherd
Journal:  Trials       Date:  2021-09-03       Impact factor: 2.728

4.  Recruitment of black subjects for a natural history study of intracerebral hemorrhage.

Authors:  Dorothy F Edwards; Ravi Menon; Ali Fokar; Christopher Gibbons; Jeffrey Wing; Brisa Sanchez; Chelsea S Kidwell
Journal:  J Health Care Poor Underserved       Date:  2013-02

5.  Consulting communities when patients cannot consent: a multicenter study of community consultation for research in emergency settings.

Authors:  Neal W Dickert; Victoria A Mah; Michelle H Biros; Deneil M Harney; Robert Silbergleit; Jeremy Sugarman; Emir Veledar; Kevin P Weinfurt; David W Wright; Rebecca D Pentz
Journal:  Crit Care Med       Date:  2014-02       Impact factor: 7.598

6.  Gender Disparities Among Adult Recipients of Bystander Cardiopulmonary Resuscitation in the Public.

Authors:  Audrey L Blewer; Shaun K McGovern; Robert H Schmicker; Susanne May; Laurie J Morrison; Tom P Aufderheide; Mohamud Daya; Ahamed H Idris; Clifton W Callaway; Peter J Kudenchuk; Gary M Vilke; Benjamin S Abella
Journal:  Circ Cardiovasc Qual Outcomes       Date:  2018-08
  6 in total

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