Estimating Socio-Economic Status for Alzheimer's Disease Trials

Area of Science:

• Clinical research methodology
• Health equity
• Sociomedical sciences

Background:

• Socioeconomic status (SES) metrics are inconsistently collected in clinical trials, hindering generalizability assessments.
• This data gap limits understanding treatment efficacy across diverse patient subpopulations.
• Standardized SES data collection is essential for equitable clinical trial outcomes.

Purpose of the Study:

• To adapt and validate a socioeconomic status (SES) measure for use in clinical trials.
• To modernize the Hollingshead Index of Social Position with current occupational data.
• To establish a standardized method for SES data collection in multi-site studies.

Main Methods:

• Adapted the Hollingshead Two Factor Index of Social Position, a combined education and occupation metric.
• Updated the 1965 occupation list to reflect 2017 US Bureau of Labor Statistics career data.
• Implemented the revised SES measure within Alzheimer's Clinical Trials Consortium studies.

Main Results:

• A revised table of occupations was generated.
• Feasible collection of SES data using the modified Hollingshead Index was demonstrated in a multi-site clinical trial.
• SES scores were distributed across all strata, indicating broad applicability.

Conclusions:

• The modified Hollingshead Index offers a standardized approach for SES data collection.
• This method facilitates data aggregation, monitoring, and reporting in clinical trials.
• Standardized SES data enhances the interpretability and generalizability of trial results.