Publication Of Guidelines Research Articles

Evolved Eugenics and Reinforcement of "Othering": Renewed Ethico-Legal Perspectives of Genome Editing in Reproduction.

This article extends an exploration into renewed ethico-legal perspectives of genome editing technologies, examined from an evolved conceptualization of eugenics in contemporary human reproduction. Whilst the ethico-legal conundrums presented by genome-editing technologies in various aspects of modern medicine have thus far inspired a comprehensive trove of academic scholarship-and notwithstanding the World Health Organization's (WHO) publication of guidelines on human genome editing in 2021-the legislative landscape for these technologies remain relatively unchanged. Accordingly, this paper presents the unresolved problematic questions that still require significant reflection. First, the paper highlights these questions, which primarily center around the tension between reproductive autonomy and the legal governance of reproductive/genome editing technologies by a democratic state. Secondly, the paper interrogates the evolved conceptualization of eugenics, exercised on the part of prospective parents as part of reproductive autonomy. By this, the paper predicates that it indirectly reinforces societal and systemic problems of discrimination and "othering", increasing reproductive inequalities in excluded communities. Thirdly, the paper attempts to offer narratives of intersectionality as a facilitating tool in a continuing dialogue to build belonging, foster a healthy and balanced exercise of reproductive autonomy, and increase reproductive equalities.

Factors influencing age of common allergen introduction in early childhood.

We evaluated factors influencing the timing of allergen introduction in the U.S., including updated peanut introduction guidelines. The Gastrointestinal Microbiome and Allergic Proctocolitis (GMAP) study is a prospective observational cohort in suburban Massachusetts. Infants' caregivers enrolled between 2014 and 2017, and they reported when they introduced common allergens to their child. Multivariable linear and survival regression analyses were used to examine factors influencing time of introduction of allergens. By 9 months, children old enough to be potentially affected by NIAID's 2017 peanut introduction guidelines were more often introduced to peanut than children enrolled well before guidelines publication [54% vs. 42%, OR: 1.63, CI: (1.03, 2.57), P = 0.03]. At any given time, Black children were 73% [HR: 0.27, CI: (0.11, 0.69), P = 0.006] less likely to be introduced to peanut as early as White children. Asian children were, respectively, 36% [HR: 0.64, CI: (0.47, 0.86), P = 0.003] and 26% [HR: 0.74, CI: (0.55, 0.97), P = 0.03] less likely to be introduced to peanut and egg as early as White children. A first child was 27% [HR: 1.27, CI: (1.04, 1.56), P = 0.02] more likely to have been introduced to peanut earlier than a non-first child. There was no association between age of introduction and sex, gestational age, family history of food allergy, or other allergic comorbidities. Updated introduction guidelines, race, and birth order all influenced earlier introduction of peanut. Further studies to evaluate current practices for allergen introduction with a focus on potential disparities are needed.

Factors associated with the author-reported cost-effectiveness threshold in high-income countries: systematic review and multivariable modelling.

The cost-effectiveness threshold (CET) is a key parameter to guide objective reimbursement decisions, yet very few countries have defined a reference CET, and there is no reference method for defining it. Our objective was to determine the factors explaining the author-reported CETs in the literature. Our systematic review targeted original articles referenced in EMBASE and published between 2010 and 2021. Selected studies had to use Quality-Adjusted Life-Year (QALY), and being conducted in high-income countries. Our explanatory variables were: estimated cost-effectiveness ratio (ICER), region of the world, source of funding, type of intervention, disease, year of publication, justification of the author-reported Cost-Effectiveness Threshold (ar-CET), economic perspective, and declaration of interest. Multivariable linear regression models implemented on R software were used, guided by a Directed Acyclic Graph. Two hundred and fifty four studies were included. The mean ar-CET was €63,338/QALY (standard deviation (SD) 34,965) overall, and €37,748/QALY (SD 20,750) in studies conducted in the British Commonwealth. The ar-CET increased slightly with the ICER (+ 66€/QALY for each additional 10,000€/QALY in the ICER, 95% confidence interval (IC) [31-102], p < 0.001), was higher in the United States (+ 36,225€/QALY; IC [25,582; 46,869]) and Europe (+ 10,352€/QALY; IC [72; 20,631]) compared to the British Commonwealth (p < 0.001), and was higher when the ar-CET was not defined a priori (+ 22,393€/QALY; [5809; 38,876]) compared to state recommendations defined ar-CET (p < 0.001). Our results underline the virtuous role of state recommendations in the choice of a low and homogeneous CET. We also highlight the need to integrate the a priori justification of the CET into good publishing guidelines.

The multiple sclerosis bladder consensus guidelines and pathway. One year on: where are we now?

The multiple sclerosis (MS) bladder is associated with an increased risk of neurogenic problems that are distressing for people with MS (PwMS), as well as being a leading cause of hospital admissions. Almost all PwMS will have bladder symptoms after 10 years of living with the disease, which impacts their quality of life and has a huge economic burden on the NHS for problems including urinary tract infections (UTIs). Following the publication of updated MS bladder management guidelines and the development of MS bladder pathways, Sue Thomas outlines the implementation progress that has been made within the past year.

Assessment of available health services at subcentres as per Indian public health standards guidelines in a district of Jammu and Kashmir India: A cross sectional study.

Subcentre is the lowest rung of a referral pyramid of health facilities. The purpose of health subcentre is mainly providing preventive and promotive services, but it also provides a basic level of curative services. To assess the existing services availability at subcentres and identification of gaps between minimum requirements as per Indian public health standards and actual availability of services at subcentres. It was a cross sectional observational study. Study units were subcentres. Fifty percent of subcentres of the district were selected using simple random sampling method. Check list prepared from Indian public health standards facility survey formats was used for data collection and collected data were analysed using statistical package for social sciences. Majority (58.8%) of the subcentres were catering a population in the range of 1000-3000. Ante-natal and child care related services were available in all subcentres. Intra-natal services were available in only two subcentres. Eighty five percent of subcentres were involved in providing school health related services. Most of the services as recommended by Indian public health standards were available in the studied subcentres. The lack of some services was mainly due to inadequate staff and infrastructure at subcentres. Comprehensive efforts are required to ensure adequate service delivery at all health centres.

분단 전후(1945~1953) 위령제의 재편과 위령 의례의 변화

The eight years before and after the division were the turbulent times of liberation, division, and war. This period required cultural planning to create members of a new era and group. During this period, the memorial was a major plan to secure the legitimacy of the group and form the identity of internal members through the meaning of death and the hierarchy of death. To this end, a memorial ceremony was held for the death of various ethnic groups from the past to the present immediately after liberation. The left and right sides each selected the object of the memorial ceremony and held a memorial ceremony to secure public support. However, as the political landscape of the liberation space changed, the memorial system began to be reorganized. Throughout the division, many memorial systems were forgotten in public space. However, the importance of the memorial ceremony for the soldiers and police who died was further emphasized. Through the Yeosu-Suncheon Incident and the battle on the 38th parallel, the status of the memorial ceremony for war dead was strengthened, while the scale of the implementation of the memorial ceremony was expanded. Throughout the war, the date of the three-gun joint memorial ceremony began to be regularized for the first time. In addition, on the day of the memorial service, the Republic of Korea requested the voluntary participation of the people through public action guidelines such as prohibition of drinking and dancing, silence, and self-reflection. However, as can be seen from the issue of the support of bereaved families, the gap between the state and the people regarding the decree still existed. Nevertheless, the three-gun joint memorial system was regularized on a nationwide scale under the leadership of the state, and became a representative memorial ceremony in Korea.

Designing an infographic webtool for public health.

To create and evaluate a public health informatics tool, Florence, for communicating information to the public. This user-centered design study included 3 phases: (1) an interview and survey study with public health practitioners to assess needs for creating infographics; (2) the application of assessment findings and public health-motivated design guidelines to the design and development of a public health-specific infographic design tool; and (3) a feasibility and usability study to evaluate the feasibility and usability of the tool. In phase 1, participants noted the importance of tailoring infographics to an audience and wanted flexible tools along with design guidance to help make fewer design decisions. In phase 2, we developed a prototype tool with: (1) layout and functionality familiar to PH users, (2) quick and intuitive ways to add and modify data in visualizations, and (3) health-focused visual elements. In phase 3, participants found Florence to be usable, providing an intuitive and straightforward experience, and that the focus on public health was useful. Based on needs assessments and existing literature, we created Florence along with public health practitioners to address their domain specific needs, ultimately leading to a tool that participants in our study deemed useful. Future research can build on our work to develop user-centered tools to meet their needs. Infographics are important for public health communication. Creating user-centered solutions to address the unique needs of public health can support communication efforts.

Management of Pediatric Pneumonia: A Decade After the Pediatric Infectious Diseases Society and Infectious Diseases Society of America Guideline.

Incomplete uptake of guidelines can lead to nonstandardized care, increased expenditures, and adverse clinical outcomes. The objective of this study was to evaluate the impact of the 2011 Pediatric Infectious Diseases Society and Infectious Diseases Society of America (PIDS/IDSA) pediatric community-acquired pneumonia (CAP) guideline that emphasized aminopenicillin use and de-emphasized the use of chest radiographs (CXRs) in certain populations. This quasi-experimental study queried a national administrative database of children's hospitals to identify children aged 3 months-18 years with CAP who visited 1 of 28 participating hospitals from 2009 to 2021. PIDS/IDSA pediatric CAP guideline recommendations regarding antibiotic therapy, diagnostic testing, and imaging were evaluated. Segmented regression interrupted time series was used to measure guideline-concordant practices with interruptions for guideline publication and the Coronavirus Disease 2019 (COVID-19) pandemic. Of 315 384 children with CAP, 71 804 (22.8%) were hospitalized. Among hospitalized children, there was a decrease in blood culture performance (0.5% per quarter) and increase in aminopenicillin prescribing (1.1% per quarter). Among children discharged from the emergency department (ED), there was an increase in aminopenicillin prescription (0.45% per quarter), whereas the rate of obtaining CXRs declined (0.12% per quarter). However, use of CXRs rebounded during the COVID-19 pandemic (increase of 1.56% per quarter). Hospital length of stay, ED revisit rates, and hospital readmission rates remained stable. Guideline publication was associated with an increase of aminopenicillin prescribing. However, rates of diagnostic testing did not materially change, suggesting the need to consider implementation strategies to meaningfully change clinical practice for children with CAP.

P-577 Understanding how healthcare professionals address the educational and emotional needs of patients seeking fertility care: an assessment of challenges and barriers across eight countries

Abstract Study question What are the current challenges and barriers preventing healthcare professionals (HCPs) from optimally addressing patients' educational and emotional needs in fertility care? Summary answer HCPs lack optimal knowledge of patients’ needs/preferences for educational and emotional support, have sub-optimal skills addressing them, and underutilize external resources (e.g., psychologists). What is known already Couples who have difficulty conceiving a child can face a turmoil of emotions, including anxiety and distress, especially when external social pressures are at play. All patients seeking fertility care deserve their educational and emotional needs to be heard and addressed, as advocated by The European Society of Human Reproduction and Embryology (ESHRE) guidelines. Nevertheless, a 2015 educational and behavioural needs assessment found that HCPs involved in reproductive medicine perceive their skills to identify the needs of patients for psychological and emotional support to be less than optimal, especially when discussing sensitive or distressing issues. Study design, size, duration This exploratory mixed-methods study triangulated data from a qualitative phase (76 interviews, June-August 2021) and a quantitative phase (323 surveys, November 2021). Participants included patients (qualitative phase, n = 28), physicians (both phases, n = 249) and laboratory specialists (both phases, n = 122) using assisted reproductive technologies (ART). Participants/materials, setting, methods Countries included Brazil, China, France, Germany, Italy, Mexico, Spain, and UK. Interviews were recorded, transcribed and coded. Thematic analyses were performed. Surveys assessed knowledge, skill, agreement, and task performance frequency using 5-point scales. Knowledge and skill ratings of none (1), basic (2) or intermediate (3), as opposed to advanced (4) or expert (5), were considered a gap. Descriptive analysis and crosstabulations with chi-square tests were performed to explore variations by country and professional role/specialty area. Main results and the role of chance Patient interviews indicated a need to improve HCPs’ ability to set realistic yet encouraging, expectations about conception outcomes. Underlying barriers to fulfilling this need included a lack of optimal knowledge amongst HCPs regarding patients’ preferences, skills addressing their needs, and an under-utilization of resources for psychological support. Survey results indicated 31-36% of physicians and laboratory specialists had a knowledge gap of patients’ preferences and needs for education and emotional support; 11-39% of physicians had a skill gap for a) educating their patients about factors contributing to couples’ infertility and treatments that can optimize chances of conception/pregnancy; b) setting patient expectations about successful fertility outcomes and next steps; and c) providing emotional support to patients/couples experiencing failure to conceive. For laboratory specialists, 23% reported ‘never’, ‘rarely’ or ‘sometimes’ contributing to patient education. When asked how often they “consult references provided by patient organizations regarding the psychological and emotional needs of patients” and “direct patients to support groups or forums (online or in-person)”, an average of 47-49% of surveyed HCPs said ‘never’, ‘rarely’ or ‘sometimes’. Only 49% of surveyed HCPs reported collaborating with psychologists specialized in infertility. The extent to which gaps affected HCPs varied by country and professional role/specialty area. Limitations, reasons for caution Although multiple countries were included in this exploratory mixed-methods study, due to small sample sizes, the likelihood of observing a difference in the frequency of reported challenges, barriers and gaps by country due to chance alone could not be excluded. Wider implications of the findings Several years after the publication of the ESHRE guidelines for psychosocial care, challenges related to providing adequate educational and emotional support to patients remain. This study identified opportunities and direction for continuing professional development to promote routine psychosocial care in fertility clinics. Trial registration number Not applicable for this mixed-methods self-reported educational needs assessment.

Impact of Professional Society Guideline Publications in Medicine Subspecialties From 2012 to 2022: Implications for Clinical Care and Health Policy

Clinical guidelines have become an integral part of clinical care. We assessed professional society-based clinical guidelines from 2012 to 2022 to elucidate the trends in numbers of documents, recommendations, and classes of recommendations. Our results found that 40% of the guidelines do not follow all recommendations made by the Institute of Medicine for trustworthy documents. There has been a significant increase in documents in cardiology, gastroenterology, and hematology/oncology. In addition, of more than 20,000 recommendations, there was significant variability in recommendations made by different professional societies within a specialty. In documents from 11 of the 14 professional societies, more than 50% of the recommendations are supported with the lowest levels of evidence. In cardiology, in addition to the guideline documents, 140 nonguideline documents provide 1812 recommendations using the guideline verbiage, and 74% of the recommendations are supported by the lowest level of evidence. These data have important implications for health care because guidelines and guideline-like documents can be used for health policy issues such as assessment of quality of care, medical liability, education, and payment.

Guideline recommendations on minimal blood vessel diameters and arteriovenous fistula outcomes.

Clinical guidelines provide recommendations on the minimal blood vessel diameters required for arteriovenous fistula creation but the evidence for these recommendations is limited. We compared vascular access outcomes of fistulas created in agreement with the ESVS Clinical Practice Guidelines (i.e. arteries and veins >2 mm for forearm fistulas and >3 mm for upper arm fistulas) with fistulas created outside these recommendations. The multicenter Shunt Simulation Study cohort contains 211 hemodialysis patients who received a first radiocephalic, brachiocephalic, or brachiobasilic fistula before publication of the ESVS Clinical Practice Guidelines. All patients had preoperative duplex ultrasound measurements according to a standardized protocol. Outcomes included duplex ultrasound findings at 6 weeks after surgery, vascular access function, and intervention rates until 1 year after surgery. In 55% of patients, fistulas were created in agreement with the ESVS Clinical Practice Guidelines recommendations on minimal blood vessel diameters. Concordance with the guideline recommendations was more frequent for forearm fistulas than for upper arm fistulas (65% vs 46%, p = 0.01). In the entire cohort, agreement with the guideline recommendations was not associated with an increased proportion of functional vascular accesses (70% vs 66% for fistulas created within and outside guideline recommendations, respectively; p = 0.61) or with decreased access-related intervention rates (1.45 vs 1.68 per patient-year, p = 0.20). In forearm fistulas, however, only 52% of arteriovenous fistulas created outside these recommendations developed into a timely functional vascular access. Whereas upper arm arteriovenous fistulas with preoperative blood vessel diameters <3 mm had similar vascular access function as fistulas created with larger blood vessels, forearm arteriovenous fistulas with preoperative blood vessel diameters <2 mm had poor clinical outcomes. These results support that clinical decision-making should be guided by an individual approach.

Reexamining Compliance with Gastric Emptying Scintigraphy Guidelines: An Updated Analysis of the Intersocietal Accreditation Commission Database.

Many variables can influence the results of gastric emptying scintigraphy (GES). A lack of standardization causes variability, limits comparisons, and decreases the credibility of the study. To increase standardization, in 2009 the Society of Nuclear Medicine and Molecular Imaging (SNMMI) published a guideline for a standardized, validated GES protocol for adults based on a 2008 consensus document. Laboratories must closely follow the consensus guideline to provide valid and standardized results as an incentive to achieve consistency in patient care. As part of the accreditation process, the Intersocietal Accreditation Commission (IAC) evaluates compliance with such guidelines. The rate of compliance with the SNMMI guideline was assessed in 2016 and showed a substantial degree of noncompliance. The aim of this study was to reassess compliance with the standardized protocol across the same cohort of laboratories, looking for changes and trends. Methods: The IAC nuclear/PET database was used to extract GES protocols from all laboratories applying for accreditation from 2018 to 2021, 5 y after the initial assessment. The number of labs was 118 (vs. 127 in the initial assessment). Each protocol was again evaluated for compliance with the methods described in the SNMMI guideline. The same 14 variables were assessed in a binary fashion: patient preparation (4 variables-types of medications withheld, withholding of these medication for 48 h, blood glucose ≤ 200 mg/dL, blood glucose recorded), meal (5 variables-use of consensus meal, nothing by mouth for 4 h or more, meal consumed within 10 min, documentation of percentage of meal consumed, meal labeled with 18.5-37 MBq [0.5-1.0 mCi]), acquisition (2 variables-anterior and posterior projections obtained, imaging each hour out to 4 h), and processing (3 variables-use of the geometric mean, decay correction of data, and measurement of percentage retention). Results: Protocols from the 118 labs demonstrated that compliance is improving in some key areas but remains suboptimal in others. Overall, labs were compliant with an average of 8 of the 14 variables, with a low of 1-variable compliance at 1 site, and only 4 sites compliant with all 14 variables. Nineteen sites met an 80% threshold for compliance (11+ variables). The variable with the highest compliance was the patient's taking nothing by mouth for 4 h or more before the exam (97%). The variable with the lowest compliance was the recording of blood glucose values (3%). Notable areas of improvement include the use of the consensus meal, now 62% versus previously only 30% of labs. Greater compliance was also noted with measurement of retention percentages (instead of emptying percentages or half-times), with compliance by 65% of sites versus only 35% 5 y prior. Conclusion: Almost 13 y after the publication of the SNMMI GES guidelines, there is improving but still suboptimal protocol adherence among laboratories applying for IAC accreditation. Persistent variation in the performance of GES protocols may significantly affect patient management, as results may be unreliable. Using the standardized GES protocol permits interpretation of results in a consistent manner that allows interlaboratory comparisons and fosters acceptance of the test validity by referring clinicians.

Key Articles and Guidelines in the Management of Pericardial Syndromes

Over the past two decades, emerging literature has shaped the management of pericardial syndromes and has evolved abundantly towards the creation of European guidelines for the diagnosis and management of pericardial diseases. However, since the publication of the European guidelines in 2015, more data surrounding the management of pericardial syndromes have been published. Comprehensive reference materials with the most updated literature are warranted and can be pivotal in helping pharmacists make evidence-based and clinical decisions for patients diagnosed with pericardial syndromes. This compilation of key articles and guidelines will serve as a resource for pharmacists who are responsible for the care of patients with pericardial syndromes.

FoMO, but not self-compassion, moderates the link between social media use and anxiety in adolescence

ABSTRACT Objective Social media use is ubiquitous during adolescence, and emerging research suggests an association with anxiety symptoms in some individuals. Two psychological constructs which may moderate this relationship are Fear of Missing Out (FoMO) and self-compassion. Higher FoMO tendencies may exacerbate the link between social media use and anxiety symptoms through greater fixation on social comparison, whereas higher self-compassion may weaken this link. The purpose of this study was to examine whether FoMO and self-compassion independently moderate the relationship between social media use and anxiety symptoms in adolescents. Method Participants included 951 adolescents (M age = 13.69, SD = 0.72; 54% male). Online questionnaires assessed frequency of social media use, anxiety symptoms, FoMO, and self-compassion. Results FoMO moderated the relationship between social media use and anxiety, ΔR 2 = .022, ΔF(1,945) = 26.26, p < .001. Increased social media use was associated with increased anxiety symptoms in adolescents high in FoMO and reduced anxiety for adolescents low in FoMO. Self-compassion was not a significant moderator. Conclusion These findings have implications for social media use, public guidelines and clinical practice and support adoption of a discerning approach to adolescent’s social media use.

Grounding and Deepening Academic Writing in Human Resource Development: The Role of Selecting and Representing the Supporting Literature

That all academic writing should be based on a comprehensive review of previous research is well understood. Yet how to accomplish this task given the burgeoning literature in our field and in the many contributing fields of study has received surprisingly little attention in publishing guidelines in HRD and related fields. To encourage the development of HRD scholarship as a distinct and yet interdisciplinary body of knowledge, discernment, justification, and clarity about the selection and representation of the existing literature are needed in three areas. Domain specificity is concerned with the link to the HRD disciplinary base, practice relevance situates the work in a recognized HRD practice domain, and communicative interest clarifies the author’s value stance. The conclusion addresses implications for novice and experienced writers, the training of graduate and professional students, and the editorial policies of the leading HRD journals.

Rates of reoperation after breast conserving cancer surgery in Western Australia before and after publication of the SSO-ASTRO margins guideline.

A 2014 SSO-ASTRO guideline on surgical margins aimed to reduce unnecessary reoperation after breast conserving surgery (BCS). We investigate whether publication of the guideline was associated with a reduction in reoperation in Western Australia (WA). In this retrospective, population-based cohort study, cases of newly-diagnosed breast cancer were identified from the WA Cancer Registry. Linkage to the Hospital Morbidity Data Collection identified index BCS for invasive cancer between January 2009 and June 2018 (N=8059) and reoperation within 90 days. Pre-guideline (2009-2013) and post-guideline (2014-2018) reoperation proportions were compared, and temporal trends were estimated with generalised linear regression. The pre-guideline reoperation proportion was 25.8% compared with 21.7% post-guideline (difference -4.0% [95% CI -5.9, -2.2, p<0.001], odds ratio [OR] 0.80 [95% CI 0.72, 0.89, p<0.001]). Absolute reductions were similar for repeat BCS (16.3% versus 14.6%; difference -1.8% [95% CI -3.4, -0.2, p=0.03]) and conversion to mastectomy (9.4% versus 7.2%; difference -2.2% [95% CI -3.4, -1.0, p<0.001]). Over the study period, there was an annual absolute change in reoperation of -0.8% (95% CI -1.2, -0.5, p<0.001). Accounting for this linear trend, the difference in reoperation between time periods was -0.5% (95% CI -4.3, 3.3; p=0.81), reflecting a non-significant reduction in conversion to mastectomy. Comparisons of pre- versus post-guideline time periods in WA showed reductions in reoperation that were similar to international estimates; however, an annual decline in reoperation predated the guideline. Analyses that do not account for temporal trends are likely to overestimate changes in reoperation associated with the guideline.

Assisted Living: New Initiatives, Brighter Future

Assisted Living: New Initiatives, Brighter Future

The Role of 18F-FDG PET/CT for the Diagnosis of Prosthetic Valve Endocarditis

The use of 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) in diagnostic algorithms for prosthetic valve endocarditis (PVE) has increased since publication of studies and guidelines advocating its use. The assessment of test accuracy and factors contributing to test accuracy have been limited by small study sizes. To address the problem, this systematic review was undertaken using individual patient data (IPD) meta-analysis techniques. The primary objective was to estimate the summary sensitivity and specificity of 18F-FDG PET/CT in diagnosing PVE. It also assessed the effect of patient factors on these estimates.

WHO International Standard Terminologies on Traditional Chinese Medicine: Use in Context, Creatively

WHO International Standard Terminologies on Traditional Chinese Medicine: Use in Context, Creatively

Race and ethnicity reporting by US federal standards in high-impact phase 2/3 oncology clinical trial publications.

1595 Background: There are 5 races defined by the US Office of Management &amp; Budget (OMB): White, Black, Asian, American Indian and Alaska Native (AIAN), and Native Hawaiian and other Pacific Islander (NHPI) with Hispanic ethnicity. Despite the existing 1997 race standards, race reporting in oncology clinical trials is still dismal. Here we aim to 1) quantify cancer trial publications reporting race/ethnicity, 2) determine representation in published trials, and 3) identify geographic patterns of reporting race/ethnicity by 1st author. Methods: PubMed/Embase were queried for phase 2/3 clinical trials of the 6 most common cancers, published in 4 high-impact journals between 2012-2022, each reviewed by 2 independent reviewers. Trials were excluded for non-US 1st author and those including multiple cancers. Representation quotients (RQ) for each race were calculated by dividing the percent of clinical trial patients by the proportion of year-matched, site-specific incident cancers in the US (Cancer in North America data). RQ of 1 represents equal clinical trial representation compared to US cancer incidence. Trial characteristics were recorded. Descriptive statistics were calculated. RQ statistics were calculated using Kruskal-Wallis tests with Bonferroni Corrections ( PBC) for multiple testing. Results: Of 1,149 publications assessed, 342 were included (224 JCO, 84 NEJM, 18 Lancet, and 16 JAMA) with 258,123 patients, 60% phase 3, and 45% US Northeast 1st author. By cancer site, 31% breast, 24% lung, 18% prostate, 18% kidney/bladder, 5% colorectal, and 4% endometrial publications were included. Race was reported in 245 publications (72%) varying by journal: 81% JAMA, 78% Lancet, 72% JCO, and 67% NEJM. Specific race/ethnicity were reported in 239 publications (70%) for White, 201 (59%) for Black, 185 (54%) for Asian, 62 (18%) for Hispanic, 48 (14%) for AIAN, and 29 (9%) for NHPI patients. Among publications reporting race, RQ varied after adjusting for multiple testing ( PBC&lt;.001) with median (IQR) RQ of 1.0 (0.9-1.1) for White, 0.6 (0.1-2.7) for Asian, 0.4 (0.1-0.7) for Black, 0.0 (0.0-0.0) for AIAN, and 0.00 (0.0-0.0) for NHPI patients. Stratified by cancer, RQ significantly differed by race for all cancers ( PBC&lt;.001), except colorectal ( PBC=.004) and endometrial cancer ( PBC&gt;.99). NHPI was the only race with median RQ of 0.00 for all cancers. AIAN and NHPI race reporting by 1st author was observed most in CA, while Hispanic was observed most in TX. Conclusions: While 72% of phase 2/3 cancer clinical trials published in high-impact journals report race, 91% do not report NHPI race. Indigenous patients have the lowest reporting in cancer clinical trials. Our findings support a call to action to mandate consistent race/ethnicity reporting for publication. US clinical trialists and publishers should comply with mandated US OMB federal reporting guidelines in oncology publications.