Clinical trials are one of the foundations of modern medicine. Data from clinical trials provides insights on how people are likely to respond to a treatment, which helps doctors understand when to use the treatment, how to advise patients who may receive it and what outcomes to expect from it.
“If we don’t have adequate representation in the trial, we can’t be sure how the treatment will affect people from different backgrounds,” says Zul Surani, associate director of Community Outreach and Engagement at the Cancer Research Center for Health Equity at Cedars-Sinai Cancer.
“There are historically marginalized communities all around us. Striving for equity means ensuring all persons get quality care. Clinical trials are a major part of that, as they can hold the key to a healthier future.”
Why diversity matters in clinical trials
As valuable as clinical trials are, they have long been limited by one shortcoming: a lack of ethnic, racial, sex and gender diversity. Participants have been mostly white, heterosexual males.
“If we’re testing treatments almost only on white males, we’re left with big gaps in knowledge,” says Dr. Robert Haile, director of the Cancer Research Center for Health Equity. “Genetics, environmental factors, lifestyle, gender and ethnic origin may all influence how individuals react to a drug.”
Study sponsors look for what’s called “generalizability.” This is when a trial is run with so many participants that if the drug works for most of them, researchers can assume it’ll work for most of the general population, too. That’s harder to determine if your trial volunteers don’t represent the whole community. For example, Black patients often need a different dose of drugs that treat asthma, blood pressure or heart disease than non-Hispanic whites, Asians or Hispanics do. Sometimes they need a different drug altogether.
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There are many examples of inequity in healthcare that go beyond patients’ ethnicity or race.
