TY - JOUR
T1 - Representation of Hispanic Patients in Clinical Trials for Respiratory Failure
T2 - A Systematic Review
AU - Harlan, Emily A.
AU - Malley, Kaitlin
AU - Quiroga, Grecia
AU - Mubarak, Eman
AU - Lama, Pema
AU - Schutz, Amanda
AU - Cuevas, Adolfo
AU - Hough, Catherine L.
AU - Iwashyna, Theodore J.
AU - Armstrong-Hough, Mari
AU - Valley, Thomas S.
N1 - Publisher Copyright:
© 2025 Lippincott Williams and Wilkins. All rights reserved.
PY - 2025/1/13
Y1 - 2025/1/13
N2 - OBJECTIVES: Hispanic individuals comprise one-fifth of the U.S. population and Hispanic patients with acute hypoxemic respiratory failure (AHRF) experience higher odds of death compared with non-Hispanic White patients. Representation of Hispanic patients in clinical trials for respiratory failure is critical to address this inequity. We conducted a systematic review to examine the inclusion of Hispanic patients in randomized controlled trials for AHRF and assessed language as a potential barrier to enrollment. DATA SOURCES: National Library of Medicine PubMed, Elsevier Embase, and Cochrane Central Register of Controlled Trials databases through January 2024. STUDY SELECTION: Randomized controlled trials assessing AHRF interventions enrolling U.S. patients receiving mechanical ventilation, noninvasive mechanical ventilation, or high-flow nasal cannula were included. The systematic review was registered prospectively through PROSPERO (CRD42023437828). DATA EXTRACTION: Two authors independently screened studies and extracted data for each included study. DATA SYNTHESIS: Ninety-four trials published from 1975 to 2023 were included; 33.0% (n = 31) of studies reported ethnicity, and 11.2% of participants in studies reporting race or ethnicity (1,320/11,780) were identified as Hispanic. The proportion of Hispanic-identified participants was significantly lower than the U.S. Hispanic population from 1996 to 2019 (p < 0.01). Starting in 2020, the proportion of Hispanic-identified participants was significantly higher than the U.S. population (27.8% vs. 19.1%; p < 0.01). Two studies (4.9%) reporting race or ethnicity excluded non-English speaking participants; the remainder did not specify language requirements for enrollment. CONCLUSIONS: Hispanic-identified individuals were underrepresented in trials for AHRF until 2020 when Hispanic patient representation increased during COVID-19. Exclusion of participants who do not speak English may represent a barrier to trial enrollment.
AB - OBJECTIVES: Hispanic individuals comprise one-fifth of the U.S. population and Hispanic patients with acute hypoxemic respiratory failure (AHRF) experience higher odds of death compared with non-Hispanic White patients. Representation of Hispanic patients in clinical trials for respiratory failure is critical to address this inequity. We conducted a systematic review to examine the inclusion of Hispanic patients in randomized controlled trials for AHRF and assessed language as a potential barrier to enrollment. DATA SOURCES: National Library of Medicine PubMed, Elsevier Embase, and Cochrane Central Register of Controlled Trials databases through January 2024. STUDY SELECTION: Randomized controlled trials assessing AHRF interventions enrolling U.S. patients receiving mechanical ventilation, noninvasive mechanical ventilation, or high-flow nasal cannula were included. The systematic review was registered prospectively through PROSPERO (CRD42023437828). DATA EXTRACTION: Two authors independently screened studies and extracted data for each included study. DATA SYNTHESIS: Ninety-four trials published from 1975 to 2023 were included; 33.0% (n = 31) of studies reported ethnicity, and 11.2% of participants in studies reporting race or ethnicity (1,320/11,780) were identified as Hispanic. The proportion of Hispanic-identified participants was significantly lower than the U.S. Hispanic population from 1996 to 2019 (p < 0.01). Starting in 2020, the proportion of Hispanic-identified participants was significantly higher than the U.S. population (27.8% vs. 19.1%; p < 0.01). Two studies (4.9%) reporting race or ethnicity excluded non-English speaking participants; the remainder did not specify language requirements for enrollment. CONCLUSIONS: Hispanic-identified individuals were underrepresented in trials for AHRF until 2020 when Hispanic patient representation increased during COVID-19. Exclusion of participants who do not speak English may represent a barrier to trial enrollment.
KW - ethnicity
KW - health inequities
KW - respiratory insufficiency
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U2 - 10.1097/CCE.0000000000001193
DO - 10.1097/CCE.0000000000001193
M3 - Review article
AN - SCOPUS:85216964815
SN - 2639-8028
VL - 7
SP - e1193
JO - Critical Care Explorations
JF - Critical Care Explorations
IS - 1
ER -