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A Systematic Review of Patient Race, Ethnicity, Socioeconomic Status, and Educational Attainment in Prostate Cancer Treatment Randomised Trials—Is the Evidence Base Applicable to the General Patient Population?
CONTEXT: Prostate cancer (PC) disproportionately affects men of Black race, and lower educational and socioeconomic status. Guidelines are based on randomised controlled trials (RCTs); however, the representation of different races, educations, and socioeconomic backgrounds in these trials is unclea...
Autores principales: | , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10403690/ https://www.ncbi.nlm.nih.gov/pubmed/37545851 http://dx.doi.org/10.1016/j.euros.2023.05.015 |
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author | Patki, Siddhant Aquilina, Julian Thorne, Rebecca Aristidou, Isaac Rodrigues, Filipe Brogueira Warren, Hannah Bex, Axel Kasivisvanathan, Veeru Moore, Caroline Gurusamy, Kurinchi Emberton, Mark Best, Lawrence M.J. Tran, Maxine G.B. |
author_facet | Patki, Siddhant Aquilina, Julian Thorne, Rebecca Aristidou, Isaac Rodrigues, Filipe Brogueira Warren, Hannah Bex, Axel Kasivisvanathan, Veeru Moore, Caroline Gurusamy, Kurinchi Emberton, Mark Best, Lawrence M.J. Tran, Maxine G.B. |
author_sort | Patki, Siddhant |
collection | PubMed |
description | CONTEXT: Prostate cancer (PC) disproportionately affects men of Black race, and lower educational and socioeconomic status. Guidelines are based on randomised controlled trials (RCTs); however, the representation of different races, educations, and socioeconomic backgrounds in these trials is unclear. OBJECTIVE: To assess reporting of equality, diversity, and inclusion characteristics (Equality, Diversity and Inclusion [EDI]) and differences in treatment effects between different races, and educational or socioeconomic status. EVIDENCE ACQUISITION: We conducted a systematic review of CENTRAL, MEDLINE, and Embase in April 2020 examining RCTs investigating treatments for PC. Outcomes collected were race/ethnicity, educational attainment, and socioeconomic status. RCTs investigating PC treatment in any population or setting were included. Data extraction of characteristics was performed independently by pairs of reviewers and checked by a senior author. The Cochrane risk of bias tool assessed the quality of included papers. EVIDENCE SYNTHESIS: A total of 265 trials were included, and 138 of these were available as full-text articles. Fifty-four trials including 19 039 participants reported any EDI data. All 54 trials reported race, 11 reported ethnicity, three reported educational attainment, and one reported socioeconomic status. Patients of White race were the majority of the recruited population (82.6%), while the minority prevalence was as follows: Black 9.8% and Asian 5.7%. Three studies reported mortality outcomes depending on the participant’s race. All three studies investigated different treatments, so a meta-analysis was not performed. No studies reported outcomes stratified by the educational or socioeconomic status of participants. CONCLUSIONS: There is poor reporting of patient race, ethnicity, socioeconomic background, and educational attainment in RCTs for PC treatments between 2010 and 2020. Addressing this for future studies will help explain differences in the incidence of and mortality from PC and improve the generalisability of results. PATIENT SUMMARY: In this study, we reviewed prostate cancer treatment trials to see whether these reported race, education, and socioeconomic backgrounds of their patient populations. We conclude that reporting of these characteristics is poor. This needs to be improved in future to improve outcomes for patients with prostate cancer of all ethnical, racial, and socioeconomic groups. |
format | Online Article Text |
id | pubmed-10403690 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-104036902023-08-06 A Systematic Review of Patient Race, Ethnicity, Socioeconomic Status, and Educational Attainment in Prostate Cancer Treatment Randomised Trials—Is the Evidence Base Applicable to the General Patient Population? Patki, Siddhant Aquilina, Julian Thorne, Rebecca Aristidou, Isaac Rodrigues, Filipe Brogueira Warren, Hannah Bex, Axel Kasivisvanathan, Veeru Moore, Caroline Gurusamy, Kurinchi Emberton, Mark Best, Lawrence M.J. Tran, Maxine G.B. Eur Urol Open Sci Prostate Cancer CONTEXT: Prostate cancer (PC) disproportionately affects men of Black race, and lower educational and socioeconomic status. Guidelines are based on randomised controlled trials (RCTs); however, the representation of different races, educations, and socioeconomic backgrounds in these trials is unclear. OBJECTIVE: To assess reporting of equality, diversity, and inclusion characteristics (Equality, Diversity and Inclusion [EDI]) and differences in treatment effects between different races, and educational or socioeconomic status. EVIDENCE ACQUISITION: We conducted a systematic review of CENTRAL, MEDLINE, and Embase in April 2020 examining RCTs investigating treatments for PC. Outcomes collected were race/ethnicity, educational attainment, and socioeconomic status. RCTs investigating PC treatment in any population or setting were included. Data extraction of characteristics was performed independently by pairs of reviewers and checked by a senior author. The Cochrane risk of bias tool assessed the quality of included papers. EVIDENCE SYNTHESIS: A total of 265 trials were included, and 138 of these were available as full-text articles. Fifty-four trials including 19 039 participants reported any EDI data. All 54 trials reported race, 11 reported ethnicity, three reported educational attainment, and one reported socioeconomic status. Patients of White race were the majority of the recruited population (82.6%), while the minority prevalence was as follows: Black 9.8% and Asian 5.7%. Three studies reported mortality outcomes depending on the participant’s race. All three studies investigated different treatments, so a meta-analysis was not performed. No studies reported outcomes stratified by the educational or socioeconomic status of participants. CONCLUSIONS: There is poor reporting of patient race, ethnicity, socioeconomic background, and educational attainment in RCTs for PC treatments between 2010 and 2020. Addressing this for future studies will help explain differences in the incidence of and mortality from PC and improve the generalisability of results. PATIENT SUMMARY: In this study, we reviewed prostate cancer treatment trials to see whether these reported race, education, and socioeconomic backgrounds of their patient populations. We conclude that reporting of these characteristics is poor. This needs to be improved in future to improve outcomes for patients with prostate cancer of all ethnical, racial, and socioeconomic groups. Elsevier 2023-06-18 /pmc/articles/PMC10403690/ /pubmed/37545851 http://dx.doi.org/10.1016/j.euros.2023.05.015 Text en © 2023 The Author(s) https://creativecommons.org/licenses/by/4.0/This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Prostate Cancer Patki, Siddhant Aquilina, Julian Thorne, Rebecca Aristidou, Isaac Rodrigues, Filipe Brogueira Warren, Hannah Bex, Axel Kasivisvanathan, Veeru Moore, Caroline Gurusamy, Kurinchi Emberton, Mark Best, Lawrence M.J. Tran, Maxine G.B. A Systematic Review of Patient Race, Ethnicity, Socioeconomic Status, and Educational Attainment in Prostate Cancer Treatment Randomised Trials—Is the Evidence Base Applicable to the General Patient Population? |
title | A Systematic Review of Patient Race, Ethnicity, Socioeconomic Status, and Educational Attainment in Prostate Cancer Treatment Randomised Trials—Is the Evidence Base Applicable to the General Patient Population? |
title_full | A Systematic Review of Patient Race, Ethnicity, Socioeconomic Status, and Educational Attainment in Prostate Cancer Treatment Randomised Trials—Is the Evidence Base Applicable to the General Patient Population? |
title_fullStr | A Systematic Review of Patient Race, Ethnicity, Socioeconomic Status, and Educational Attainment in Prostate Cancer Treatment Randomised Trials—Is the Evidence Base Applicable to the General Patient Population? |
title_full_unstemmed | A Systematic Review of Patient Race, Ethnicity, Socioeconomic Status, and Educational Attainment in Prostate Cancer Treatment Randomised Trials—Is the Evidence Base Applicable to the General Patient Population? |
title_short | A Systematic Review of Patient Race, Ethnicity, Socioeconomic Status, and Educational Attainment in Prostate Cancer Treatment Randomised Trials—Is the Evidence Base Applicable to the General Patient Population? |
title_sort | systematic review of patient race, ethnicity, socioeconomic status, and educational attainment in prostate cancer treatment randomised trials—is the evidence base applicable to the general patient population? |
topic | Prostate Cancer |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10403690/ https://www.ncbi.nlm.nih.gov/pubmed/37545851 http://dx.doi.org/10.1016/j.euros.2023.05.015 |
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