Mr. NABEEL CHERIAN JOSH1,2,3, Dr. RAJNEESH KAUR1, Dr. DAVID TUNNICLIFFE2,3
1University of Sydney School of Medicine, Camperdown, Australia, 2Center for Kidney Research, The Children’s Hospital at Westmead, Westmead, Australia, 3Sydney School Public Health, University of Sydney, Camperdown, Australia
Aim
To examine the representation of ethnicity within randomised control trials (RCTs) on the management of glomerular disease.
Background
Ethnicity is a key determinant of clinical progression and outcomes of glomerular disease. However, the detail reporting of ethnicity in RCTs is unknown.
Methods
We conducted a meta-epidemiological study of RCTs on the management of glomerular disease. All RCTs identified in the KDIGO – Glomerular Diseases Guidelines published in 2021 were included. Dual data extraction was undertaken for reporting of ethnicity, subgroups undertaken and presence of effect modification. Differences in ethnicity reporting were analysed using a Chi-squared test or Fisher exact test. Linear association between the year of publication, reporting of ethnicity and ethnic groups was assessed using a Chi-squared test for linear-by-linear association.
Results
Overall, 500 RCTs were included, 88 (18%) trials reported ethnicity which increased over time (P = 0.019). Among the trials, Asian (11%), Caucasian (12%), African Descent (10%), Hispanic (4%), Native American (1%), Oceanian (<1%), mixed ethnicity (1%), and “other” ethnic groups (6%) were reported. Over time there was an increase in the diversity of ethnic groups reported in RCTs (p = 0.016). Most trials were conducted in Asia (n = 212, 42%), however, trials conducted in North America or multinational RCTs were more likely to report ethnicity.
Conclusions
A minority of RCTs on glomerular disease reported ethnicity. Although the reporting of ethnicity has improved, less than half of the studies conducted after 2010 have reported ethnicity. The lack of reporting on ethnicity may impact the generalisability of the findings of RCTs to clinical practice to improve health outcomes of people living with glomerular disease.
Biography:
Nabeel Josh is a third year medical student currently studying at the University of Sydney. His work thus far has been aimed at identifying potential gaps in the equity of nephrology research, specifically in glomerular disease. Although he has just begun his career in nephrology research, he hopes to further his exploration in the field and build on his experiences.