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Ethnic minority (EM) groups are consistently under-represented in health research, including in conditions that disproportionately affect them (e.g. cardiovascular diseases), with this paradox notably laid bare during the COVID-19 pandemic [1]. Reviews have extensively documented the lack of ethnicity reporting in clinical trial publications globally [2, 3].
We conducted a review to investigate the proportion of UK-based randomised controlled trial (RCT) results publications that reported on participants’ ethnicity in three high-impact factor medical journals—The Lancet, New England Journal of Medicine (NEJM) and British Medical Journal (BMJ)—from 1st January 2020 to 6th July 2022 (start date based on existing strong evidence of poor practice pre-pandemic). We searched the three journals’ websites for ‘trial’ in the title and included all UK-based RCTs (international RCTs were only included if at least 50% of the sites were from the UK). Data extraction focused on three key areas: was ethnicity data reported; if yes, what information was collected and how was it used (e.g. sub-group analysis); if no, was this discussed or acknowledged as a limitation.
Of the 367 records identified, we screened 118 full texts and included 68 articles (Lancet 49; NEJM 3; BMJ 16). More than half the studies reported some ethnicity data (56%; 38), but more than a third of these (37%; 14) did not provide a detailed ethnicity breakdown (i.e. they stated population numbers/proportion for the White group only, with all other ethnic groups combined). When detailed ethnicity data was provided, this was usually broken down by intervention group, but the categories and the depth of information varied widely (see Table 1 for examples of ethnicity data collected). Only one study provided a detailed breakdown of the White ethnic group (English/Welsh/Northern Irish/British, White Irish, Any other White background). Of the studies that collected...