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E-grāmata: Strategies for Ensuring Diversity, Inclusion, and Meaningful Participation in Clinical Trials: Proceedings of a Workshop

  • Formāts: 84 pages
  • Izdošanas datums: 24-Aug-2016
  • Izdevniecība: National Academies Press
  • Valoda: eng
  • ISBN-13: 9780309443586
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  • Formāts: 84 pages
  • Izdošanas datums: 24-Aug-2016
  • Izdevniecība: National Academies Press
  • Valoda: eng
  • ISBN-13: 9780309443586
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Even as the U.S. population becomes steadily more diverse, minorities and women remain underrepresented in clinical trials to develop new drugs and medical devices. Although progress in increasing minority participation in clinical trials has occurred, participation rates do not fully represent the overall population of minorities in the United States. This underrepresentation threatens the health of both these populations and the general population, since greater minority representation could reveal factors that affect health in all populations. Federal legislation has sought to increase the representation of minorities and women in clinical trials, but legislation by itself has not been sufficient to overcome the many barriers to greater participation. Only much broader changes will bring about the meaningful participation of all population groups in the clinical research needed to improve health. To examine the barriers to participation in clinical trials and ways of overcoming those barriers, the National Academies of Sciences, Engineering, and Medicine held a workshop in April 2015. This publication summarizes the presentations and discussions from the workshop.

Table of Contents



Front Matter 1 Introduction and Highlights of the Workshop 2 Historical Perspectives and Context 3 Scientific Issues: Clinically Meaningful Inclusion 4 Recruitment and Retention Issues: Patient, Provider, Institutional, and System Barriers 5 Potential Best Practices and Policy Options References Appendix A: Workshop Agenda Appendix B: Speaker Biographical Sketches Appendix C: Statement of Task
Acronyms and Abbreviations xiii
1 Introduction and Highlights of the Workshop
1(8)
Health Disparities and Clinical Trials
2(1)
Origins of the Workshop
3(2)
Highlights of the Workshop
5(2)
Organization of the Proceedings of a Workshop
7(2)
2 Historical Perspectives and Context
9(10)
The Historical and Social Origins of Race
9(2)
The Drawbacks of Mandated Inclusion
11(2)
Historical Perspectives on Meaningful Inclusion
13(1)
Latinos in Clinical Trials
14(2)
The Effects of Precision Medicine
16(3)
3 Scientific Issues: Clinically Meaningful Inclusion
19(10)
Overcoming the Biases of the Research Community
19(3)
Inclusion in Industry Trials
22(3)
Clinical Trials at the Patient-Centered Outcomes Research Institute
25(3)
Increasing Diversity Among Researchers
28(1)
4 Recruitment and Retention Issues: Patient, Provider, Institutional, and System Barriers
29(12)
The Integrity of Research and Clinical Trials
29(3)
Informed Consent and Other Factors
32(1)
Patient Perspectives on Clinical Trials
33(2)
Engaging Communities in HIV Research
35(4)
Immigrant Populations
39(2)
5 Potential Best Practices and Policy Options
41(12)
Potential Best Practices and Policies for Inclusion of Asian Americans into Clinical Trials
41(3)
Potential Best Practices and Policies for Inclusion of Native Americans into Clinical Trials
44(3)
A Cooperative Group Perspective on Potential Best Practices and Policy Options
47(2)
Achieving Diversity Among Researchers
49(1)
Potential Policy Changes
50(3)
REFERENCES
53(2)
APPENDIXES
A Workshop Agenda
55(4)
B Speaker Biographical Sketches
59(10)
C Statement of Task
69