区域和实践试验场所在扭曲的随机癌症试验招生中的作用
medRxiv : the preprint server for health sciences
|March 10, 2025
概括
地理位置和临床地点的选择显著影响癌症试验多样性. 战略必须解决区域和基于实践的少数民族和农村患者的不足,以改善癌症研究中的代表性.
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:
- 代表性临床试验对于推进癌症治疗至关重要.
- 试验的地理位置是对非代表性患者入学的一个不太了解的因素.
- 在癌症试验中,不同人群的参与不足,限制了研究结果的概括性.
研究的目的:
- 确定试验注册地区和实践的地理选择如何影响癌症药物试验中的患者代表性.
- 量化区域和实践选择对特定人口群体低入学率的贡献.
主要方法:
- 利用SEER-Medicare队列 (2014-2019) 年龄≥65岁的肺癌,乳腺癌,胰腺癌或癌患者.
- 在随机癌症药物试验中确定参与者.
- 在整个队列中评估年龄,性别,种族,民族和农村居住的流行率,招生地区,实践和试验.
主要成果:
- 地区和实践的选择占黑人,西班牙裔和农村患者未充分注册的50%以上.
- 根据比例代表,癌症试验的黑人患者数量比预期的少45%.
- 较少有黑人患者的地区和实践的招聘对这种差异作出了重大贡献 (分别为27%和35%).
结论:
- 癌症临床试验的多样化需要在涉及患者转诊和招生的地理区域和临床实践中进行战略变革.
- 解决区域和实践层面的差异对于实现癌症研究中的公平代表性至关重要.
- 未来的试验地点应该优先考虑那些可以增加代表性不足的人口入学率的领域和机构.
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