Story at a glance
- A new study found nearly half of OB-GYN clinical trials do not include data on race or ethnicity.
- Around one-quarter of OB-GYN publications also lack these data.
- Researchers suggest leadership within the field implement a standardized, antiracist approach for all studies to report race and ethnicity data.
All racial and ethnic representation in obstetrician-gynecologist (OB-GYN) research is suboptimal, according to authors of a new analysis on 1,300 clinical trials and more than 1,100 clinical trial publications.
Both clinical trials and scientific publications inform how medical professionals provide clinical care, but homogenous, non-representative research can have negative implications on OB-GYN care, the authors wrote in the report.
“We know that race and ethnicity reporting and representation in research are critical parts of health equity, public health and social justice,” said lead study author Jecca Steinberg in a release. Steinberg is a medical resident in the department of obstetrics and gynecology at Northwestern University Feinberg School of Medicine.
Of the clinical trials included, 51 percent reported race and ethnicity data, and three-quarters of publications did the same. Trials carried out between 2007 and 2020 were included in the study, along with publications from 2007 to 2021.
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Although American Indian or Alaskan Native, Asian, Black and Latina groups were underrepresented in trials and publications, underrepresentation varied by subspecialty, funder and race and ethnicity.
Of all the subspecialties analyzed, trials on obstetric and family planning were the most diverse, and can serve as a model for the field, the authors suggested. However, gynecology studies were significantly less likely to report race and ethnicity data than studies on obstetrics.
Research on gynecologic cancers, like cervical, ovarian and uterine, enrolled the least diverse participants, researchers found. These studies also had the lowest odds of representation of Black and Latina individuals of all gynecologic subspecialties assessed.
Urogynecology, a subspecialty of urology and gynecology, had the lowest proportion of Asian participants, data showed.
A growing body of research highlights the racial health disparities in maternal morbidity and mortality in the United States. CDC data show Black women are three times more likely to die from a pregnancy-related cause than their white counterparts.
But the new study found all OB-GYN subspecialties, and not just those related to pregnancy, lack representation.
“This issue is pervasive across the entire field,” said Steinberg.
“Diverse representation in research is critically important because clinical trials drive innovation in the field, including informing the newest practices and therapies. Clinical trials often offer access to the best cutting-edge therapies, and a lack of inclusion prevents certain populations from benefiting from trial participation.”
One reason behind the lack of representation data could be that most scientific journals don’t require data on race and ethnicity, the authors wrote in the study.
In addition, lack of access to academic medical centers could play a role, as many patients don’t receive care at offices that offer clinical trials due to cost barriers or differences in insurance coverage.
Studies might also exclude patients with certain conditions like diabetes and heart disease, which disproportionately affect people of color.
Researchers conclude OB-GYN leadership should require a standardized, antiracist approach to reporting race and ethnicity data for all studies.
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