What are people recruited for clinical trials really worth?

Should patients selected for clinical trials be representative of a country’s population? This is the question asked by a team of researchers from the University of Alabama in Birmingham (United States). The latest study likely to change the way patients are recruited for clinical trials, researchers have detected a lack of objectivity and standardization of patients in cancer clinical trials.

The results of their study, published online in the journal Cancer, a peer-reviewed publication from the American Cancer Society (ACS), found that research professionals were not enrolling patients from a greater proportion of ethnic minorities in clinical trials, which may have consequences on the application of the results in the general population. According to the researchers, the participation of ethnic minorities in clinical cancer trials remains consistently lower than the proportion of minorities in the general American population.

Patients not sufficiently representative of the general population

For Raegan W. Durant, an assistant professor of preventive medicine at the University of Alabama at Birmingham who led the research, it’s vital to test results that patients are recruited from a representative sample of populations, to ensure that the results are applicable to the general population.

To carry out this research, Raegan Durant and his team of researchers interviewed 91 people, including leaders from five US cancer centers, clinical trial principal investigators, referring clinicians, and research staff. These interviews revealed five important themes.

Researchers found that language barriers and some other factors made communication difficult for participants in medical trials. It was also noted that screening cancer patients from minority groups was not considered appropriate, and some of these people described clinician time constraints and prior perceptions of minority patients as a challenge when screening. the conduct of the tests. Some also said that it was sometimes difficult to build trust with patients from minority groups. However, some people said ethnicity was irrelevant when selecting and recruiting participants for cancer clinical trials.

Researchers unconsciously install stereotype bias in their samples

According to Soumya Niranjan, first author of the document, also from the University of Alabama in Birmingham, the representativeness of the population is not fully ensured in these clinical trials, in particular because the researchers are biased by stereotypes on certain categories. . “During the research, we observed preconceptions that African Americans were less knowledgeable about cancer research studies, less likely to participate out of altruism, or simply less likely to complete all facets of cancer research. research study. These and other examples of bias based on stereotypes of minority potential participants raise concerns that non-whites are being offered fewer opportunities to participate in cancer research studies..”

Soumya Niranjan notes that in some cases, even when clinicians take an ethnically neutral stance, they sometimes forego some of the well-established methods of engaging minority participants when recruiting clinical trials.

Raegan Durant argues that “this study in no way indicates that all research and healthcare professionals are biased or that all minorities are denied the opportunity to participate in cancer research studies. However, the long-term importance of our findings hinges on the idea that biases can exist in virtually all forms of human interaction, and recruitment for cancer research studies is no exception. Once we recognize the potential presence of this bias in this context, we can better identify it, measure it, and start thinking about how best to eliminate it.”