有或没有临床研究计划的社区瘤实践是否不同? 患者和实践特征的比较
Ivy Altomare1, Xiaoliang Wang1, Maneet Kaur1
1Flatiron Health, Inc, New York, NY, USA.
JNCI cancer spectrum
|July 23, 2024
概括
具有较低临床试验参与度的社区瘤实践不成比例地服务于代表性不足的患者群体. 扩大这些实践中的研究机会对于解决试验不平等至关重要.
科学领域:
- 在瘤学瘤学.
- 临床试验 临床试验
- 健康差异 在健康上的差异
背景情况:
- 在社区环境中扩大临床试验准入,可以解决代表性不足的人群中积累的差异.
- 人们对社区瘤实践的特点知之甚少,这些实践不参与研究.
- 这项研究调查了美国社区瘤实践在临床研究参与度高与低之间的患者和实践特征的差异.
研究的目的:
- 确定与社区瘤学环境中高临床研究参与率与低临床研究参与率相关的患者和实践特征.
- 了解临床研究中的实践参与如何影响不同患者群体的代表性.
主要方法:
- 利用全国范围的电子健康记录衍生的,接受活跃癌症治疗的患者的非识别数据库.
- 包括2017年11月1日至2022年10月31日期间的178家社区瘤诊所和568,540名患者.
- 使用描述性分析和后勤回归来评估与研究参与水平相关的患者和实践特征.
主要成果:
- 低研究投入的实践治疗了较高比例的老年人 (≥75岁),非拉丁裔黑人和西班牙裔患者.
- 低参与度的实践也为最低社会经济地位五分之一的患者和没有保险或没有记录的保险的患者提供了更高的百分比.
- 高参与度的实践使得3.25%的患者参加试验,而低参与度的实践则为0.27%.
结论:
- 在瘤学临床试验中,历史上代表性不足的患者群体更频繁地在社区实践中接受治疗,试验访问有限.
- 投资于研究投入较低的实践可以扩大临床研究足迹.
- 这些努力对于解决临床试验代表性的持续不平等以及改善获得新型癌症治疗的机会至关重要.
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