Disparities in Clinical Trial Access Across US Urban Areas

Feyman, Yevgeniy; Provenzano, Frank A.; David, Frank S.

doi:10.1001/jamanetworkopen.2020.0172

Cited by 31 publications

(29 citation statements)

References 2 publications

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“…Despite high morbidity and mortality among PWUD in rural America, most clinical research is conducted among urban residents [ 13 ]. Results from clinical studies may not always translate to rural communities because of the various demographic, sociocultural, and infrastructural differences [ 14 – 17 ].…”

Section: Introductionmentioning

confidence: 99%

A cross-sectional survey of potential factors, motivations, and barriers influencing research participation and retention among people who use drugs in the rural USA

Hetrick

Young

Elman

et al. 2021

Trials

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Background Despite high morbidity and mortality among people who use drugs (PWUD) in rural America, most research is conducted within urban areas. Our objective was to describe influencing factors, motivations, and barriers to research participation and retention among rural PWUD. Methods We recruited 255 eligible participants from community outreach and community-based, epidemiologic research cohorts from April to July 2019 to participate in a cross-sectional survey. Eligible participants reported opioid or injection drug use to get high within 30 days and resided in high-needs rural counties in Oregon, Kentucky, and Ohio. We aggregated response rankings to identify salient influences, motivations, and barriers. We estimated prevalence ratios to assess for gender, preferred drug use, and geographic differences using log-binomial models. Results Most participants were male (55%) and preferred methamphetamine (36%) over heroin (35%). Participants reported confidentiality, amount of financial compensation, and time required as primary influential factors for research participation. Primary motivations for participation include financial compensation, free HIV/HCV testing, and contribution to research. Changed or false participant contact information and transportation are principal barriers to retention. Respondents who prefer methamphetamines over heroin reported being influenced by the purpose and use of their information (PR = 1.12; 95% CI: 1.00, 1.26). Females and Oregonians (versus Appalachians) reported knowing and wanting to help the research team as participation motivation (PR = 1.57; 95% CI: 1.09, 2.26 and PR = 2.12; 95% CI: 1.51, 2.99). Conclusions Beyond financial compensation, researchers should emphasize confidentiality, offer testing and linkage with care, use several contact methods, aid transportation, and accommodate demographic differences to improve research participation and retention among rural PWUD.

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Section: Introductionmentioning

confidence: 99%

A cross-sectional survey of potential factors, motivations, and barriers influencing research participation and retention among people who use drugs in the rural USA

Hetrick

Young

Elman

et al. 2021

Trials

View full text Add to dashboard Cite

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“…A recent paper demonstrated that unequal geographic access to clinical trials exists even in the USA [median clinical trial seats per 1,000 residents: 0.64, interquartile range (IQR): 0.25-1.01] [22]. In an analysis by Galsky et al [23], it was found that 45.6%, 50.2%, 52.2% and 38.4% of the patients with metastatic breast, prostate, colorectal and non-small cell lung cancers, respectively, will have to drive more than 1 hour to access a clinical trial site.…”

Section: Discussionmentioning

confidence: 99%

Geographic disparities in access to cancer clinical trials in India

Chakraborty¹,

Mallick²,

Luu³

et al. 2021

ecancer

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Introduction:The current study was aimed at quantifying the disparity in geographic access to cancer clinical trials in India. Methods:We collated data of cancer clinical trials from the Clinical Trial Registry of India and data on state-wise cancer incidence from the Global Burden of Disease Study. The total sample size for each clinical trial was divided by the trial duration to get the sample size per year. This was then divided by the number of states in which accrual was planned to get the sample size per year per state (SSY).For interventional trials investigating a therapy, the SSY was divided by the number of incident cancers in the state to get the SSY per 1,000 incident cancer cases. The SSY data was then mapped to visualise the geographical disparity. Results:We identified 181 ongoing studies, of which 132 were interventional studies. There was a substantial inter-state disparity-with a median SSY of 1.55 per 1,000 incident cancer cases (range 0.00-296.81 per 1,000 incident cases) for therapeutic interventional studies. Disparities were starker when cancer site-wise SSY was considered. Even in the state with the highest SSY, only 29.7% of the newly diagnosed cancer cases have an available slot in a therapeutic cancer clinical trial. Disparities in access were also apparent between academic (range: 0.21-226.60) and industry-sponsored trials (range: 0.17-70.21). Conclusion:There are significant geographic disparities in access to cancer clinical trials in India. Future investigations should evaluate the reasons and mitigation approaches for such disparities.

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“…A recent paper demonstrated that unequal geographic access to clinical trials exists even in the USA (median clinical trial seats per 1,000 residents 0.64, IQR: 0.25 -1.01) (21). In an analysis by Galsky et al, it was found that 45.6%, 50.2%, 52.2% and 38.4% of the patients with metastatic breast, prostate, colorectal and non-small cell lung cancers, respectively, will have to drive more than 1 hour to access a clinical trial site (22).…”

Section: Discussionmentioning

confidence: 99%

Geographic Disparities In Access To Cancer Clinical Trials In India

Chakraborty

Mallick

Luu

et al. 2020

Preprint

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Introduction The current study was aimed at quantifying the disparity in geographic access to cancer clinical trials in India. Methods We collated data of cancer clinical trials from the clinical trial registry of India (CTRI) and data on state-wise cancer incidence from the Global Burden of Disease Study. The total sample size for each clinical trial was divided by the trial duration to get the sample size per year. This was then divided by the number of states in which accrual was planned to get the sample size per year per state (SSY). For interventional trials investigating a therapy, the SSY was divided by the number of incident cancers in the state to get the SSY per 1,000 incident cancer cases. The SSY data was then mapped to visualise the geographical disparity.Results We identified 181 ongoing studies, of whom 132 were interventional studies. There was a substantial inter-state disparity - with a median SSY of 1.55 per 1000 incident cancer cases (range 0.00 - 296.81 per 1,000 incident cases) for therapeutic interventional studies. Disparities were starker when cancer site-wise SSY was considered. Even in the state with the highest SSY, only 29.7 % of the newly diagnosed cancer cases have an available slot in a therapeutic cancer clinical trial. Disparities in access were also apparent between academic (range: 0.21 - 226.60) and industry-sponsored trials (range: 0.17 - 70.21).Conclusion There are significant geographic disparities in access to cancer clinical trials in India. Future investigations should evaluate the reasons and mitigation approaches for such disparities.

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Disparities in Clinical Trial Access Across US Urban Areas

Cited by 31 publications

References 2 publications

A cross-sectional survey of potential factors, motivations, and barriers influencing research participation and retention among people who use drugs in the rural USA

A cross-sectional survey of potential factors, motivations, and barriers influencing research participation and retention among people who use drugs in the rural USA

Geographic disparities in access to cancer clinical trials in India

Geographic Disparities In Access To Cancer Clinical Trials In India

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