Thread by @usnehal

My last #hackathon & #socialenterprise pitch was to improve minority participation in #clinicaltrials. This trial is has 74% black participants compared to usual 2.5%. Why?

Yes, we do need to expand access. Colon cancer kills.

#MedTwitter #BlackTwitter #NurseTwitter thoughts?

https://twitter.com/JazmynShaw1/status/1379843513718865921

In trials for new therapies however, you see this:

“Even though heart conditions disproportionately affect Black individuals, they accounted for only 2.5% of clinical trial participants in a global trials report by the Food and Drug Administration.”

statnews.com/2020/07/22/cli…

So black participants are the majority in WHICH studies?

Having been in executive suite, speaking on #access broadly, I saw non-clinicians use “access” to shame clinicians on self care or pointing out workplace issues. Yet same administrators would cut number of staff for budget

So I am always torn. In Pakistan, in many #LMIC countries, we see lady/lay health workers extending #access, often in more culturally matched ways, in villages, to promote #populationhealth. Still, admittedly, Pakistan has clear division between “haves” & “have nots”

The reason behind much of it is cost when healthcare consumes 20% of our GDP.

Invasive procedures are high risk. Perforating the bowel is pretty bad & needs not just skill but right setting... why outpatient invasive procedures tend to worry me.

scholarlycommons.law.case.edu/cgi/viewconten…

We do need to always use multiple lenses. There is this precedent and concerning history. We need trials in biomedical space to have more minority participants, not just the ones that, frankly, are driven by administrator priorities to reduce costs.

healthywomen.org/your-care/scie…

I looked up the authors. The senior author is a black male physician originally from Jamaica, with ~200 peer reviewed articles. Lead investigator is a white female nurse practitioner
Diverse team ✅

Am genuinely curious how you get 74% black participants in a study tho.

Would have liked more info on those excluded and why as well as which patients were approached but refused participation.

They say they will lower costs and fit into value based care.

Lower costs.. for whom? Government? Insurance? Hospitals? Patients?

Patients would prefer less invasive, I imagine. Lower risk. That colon prep I have done at least twice (all the hospitalizations as a kid) no fun.