Reporting of Participant Race and Ethnicity in Cerebrovascular Randomized Controlled Trials

Abstract

Randomized controlled trials (RCTs) provide information on appropriate management protocols in patients with cerebrovascular diseases. Despite growing evidence of race and ethnicity being independent predictors of outcomes, recent literature has drawn attention to inadequate reporting of these demographic profiles across RCTs. To our knowledge, the adherence to reporting race and/or ethnicity in cerebrovascular RCTs remains undescribed. Our study describes trends in the reporting of race and/or ethnicity across cerebrovascular RCTs. Web of Science was searched to identify the top 100-cited cerebrovascular RCTs. Additional articles were retrieved from guidelines issued by the American Heart Association (AHA) for the management of ischemic stroke, intracerebral hemorrhage (ICH) and aneurysmal subarachnoid hemorrhage (aSAH). Univariate and multivariate analyses were performed to assess for factors influencing reporting of race/ ethnicity. 65% of cerebrovascular RCTs lacked reporting of participant race and/ or ethnicity. Multivariate regression revealed that studies from North America had a 14.74- fold higher odds (95% CI: 4.574- 47.519] of reporting race/ ethnicity. Impact factor of the journal was associated with a 1.007-fold odds of reporting race/ ethnicity [95% CI: 1.000- 1.013]. Reporting of race and/or ethnicity did not increase with time, or vary according to the number of participating centers, median number of study participants, source of funding or category of RCT. Among RCTs that reported race, Blacks and Asians were underrepresented compared to Whites. 65% of prominent cerebrovascular RCTs lack adequate reporting of participant race/ ethnicity. Reasons for inadequate reporting of these variables remain unclear and warrant additional investigation.