Do hospitals that participate in COVID-19 research differ from non-trial hospitals? A cross-sectional study of US hospitals

OBJECTIVES: To compare hospitals that did and did not participate in clinical trials evaluating potential inpatient COVID-19 therapeutics. METHODS: We conducted a cross-sectional study of hospitals participating in trials that were registered on clinicaltrials.gov between April and August 2020. Using the 2019 RAND Hospital Dataset and 2019 American Community Survey, we used logistic regression modeling to compare hospital-level traits including demographic features between trial and non-trial hospitals. RESULTS: We included 488 hospitals that were participating in 298 interventional trials and 4232 non-participating hospitals. After controlling for demographic and other hospital traits, we found that teaching status (OR 2.11, 95% CI 1.52–2.95), higher patient acuity (OR 7.48, 4.39, 13.1), and location in the Northeast (OR 1.83, 95% CI 1.18, 2.85) and in wealthier counties (OR: 1.32, 95% CI 1.16–1.51) were associated with increased odds of trial participation, while being in counties with more White residents was associated with reduced odds (OR 0.98, 95% CI 0.98–0.99). CONCLUSIONS: Hospitals participating and not participating in COVID-19 inpatient treatment clinical trials differed in many ways, resulting in important implications for the generalizability of trial data. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13063-023-07450-6.