Racial and Ethnic Representation in Nephrolithiasis Guidelines: Are They Generalizable?

Area of Science:

• Urology
• Clinical Research Methodology
• Health Equity

Background:

• Clinical practice guidelines for kidney stone management rely on evidence from clinical trials.
• Assessing the demographic representativeness of study populations is crucial for generalizable healthcare recommendations.

Purpose of the Study:

• To evaluate the reporting of race, ethnicity, and other key demographic variables in clinical trials informing kidney stone care.
• To determine if patient populations in these studies are sufficiently diverse for broad applicability.

Main Methods:

• A systematic review was conducted of clinical trials referenced in American Urological Association/Endourological Society Guidelines for Kidney Stones.
• Study populations were analyzed for reported sex/gender, race, ethnicity, and country of origin.

Main Results:

• Of 287 included studies, only 6.3% reported race or ethnicity data.
• Among studies reporting these demographics, White patients comprised 48.5%, while minority groups were significantly underrepresented.
• International and cross-sectional studies were less likely to report race or ethnicity.

Conclusions:

• A significant gap exists in reporting patient race and ethnicity in kidney stone research.
• Underrepresentation of minority populations in cited studies compromises the generalizability of current kidney stone care guidelines.
• Future research must prioritize comprehensive demographic reporting and inclusive patient enrollment.