Reporting of Race, Ethnicity, Socioeconomic Status, and Educational Attainment in Traumatic Brain Injury Randomised...

Patient race, ethnicity, socioeconomic status, and educational attainment (Equality, diversity and Inclusion (EDI) characteristics) are related to patient outcome in traumatic brain injury (TBI). To minimise disparities in outcome, it is important to identify these distinct groups while evaluating treatment strategies. This systematic review assesses reporting of participant EDI characteristics in TBI randomised controlled trials (RCTs). We performed a comprehensive database search strategy to identify TBI RCTs until 2023 with a repeat search in 2025 to allow for full reporting of results. 443 RCTs described in a full text were included. Of these only 183 RCTs (41%) reported any EDI characteristics of included individuals. There is no evidence of reporting improving over time (OR = 1.02, 95% CI [0.98, 1.06], p = .338). Of RCTs reporting race 79.5% of included participants were white, 13.8% were black, 1.8% were Asian and 2.3% were indigenous. Multinational recruitment, larger study size and higher journal impact factor were not associated with a greater likelihood of reporting EDI characteristics. RCTs conducted in the US were found to have a much higher rate of reporting EDI data than those conducted elsewhere (70% vs. 25%, χ² = 60.2 p < .001). The US government funded 39.4% of all included RCTs which disclosed funding. To assess causes of heterogeneity in outcomes of patients of different EDI groups it is imperative that these characteristics of included RCT participants are routinely reported. Reporting of EDI characteristics is not improving over time and may worsen with a reduction in US government research funding. Systematic review registration no.: CRD42023428479 ( www.crd.york.ac.uk/prospero ).