Diversity in pulmonary rehabilitation clinical trials: a systematic review of the literature

Abstract

ABSTRACT Background Underrepresentation of minority groups in clinical trials may hinder the potential benefits of pulmonary rehabilitation (PR) programs for individuals with chronic obstructive pulmonary disease (COPD). The aim of this work was to determine whether participants in PR randomized control trials (RCTs) conducted in the U.S.A., Canada, the UK, and Australia are representative of ethnicity, sex, gender, and sociodemographic characteristics. Research design A systematic search was performed for relevant literature from inception to December 2022. Titles and abstracts were screened before undergoing a full article review. Relevant data on reporting of age, sex, gender, ethnicity, and sociodemographic characteristics of participants was extracted. Results Thirty-six RCTs met the inclusion criteria. Only six percent of publications reported on ethnicity, with ≥ 90% of participants reported as ‘White.’ All 36 papers reported on age, with the mean between 60-69 years old. 35 studies reported on sex (97%), with the majority (67%) reporting more male than female participants. There was no mention of different genders in any paper. Other sociodemographic factors were reported in 7 (19%) papers. Conclusions Inclusivity and representation in clinical trials are essential to ensure that research findings are generalizable. Clinical trialists need to consider the demographics of today’s society during recruitment.