Randomized controlled trials (RCTs) are commonly considered the most reliable method for evaluating the effectiveness and safety of new medical treatments in clinical research. However, a recent investigation has revealed significant underrepresentation of people of color and white women in RCTs due to inherent biases.
A study published in the Journal of Ethnicity in Substance Abuse scrutinized 18 RCTs conducted over the past 15 years focusing on treatments for post-traumatic stress disorder and alcohol use disorder. Despite women experiencing post-traumatic stress and alcohol use disorder at higher rates compared to men, and people of color exhibiting more severe chronic conditions than white individuals, the majority of trial participants were white (59.5%) and male (around 78%).
Nicole Buchanan, a co-author of the study and a professor at Michigan State University’s Department of Psychology, emphasized the necessity for researchers to address limitations and shortcomings in RCTs. She highlighted the importance of overcoming barriers to inclusivity, as enhancing representation in trials is not only crucial for fairness but also imperative for improving the credibility of research and meeting the expectations of the public funding these studies through taxes.
The investigation identified flaws in the design and execution of RCTs that led to the underrepresentation of people of color and women. Trials were typically conducted in regions where white men were the predominant demographic, resulting in study samples mirroring the local population. Additionally, researchers often overlooked racial and gender differences, leading to the unintentional exclusion of diverse groups from participation.
Furthermore, the study noted a lack of regulations in scientific journals mandating sample diversity, equity, and inclusion tailored to the specific context of the research under examination.
Mallet Reid, another co-author of the study and a doctoral candidate at Michigan State University, emphasized the importance of including marginalized groups in research studies. Failing to engage these populations leaves clinicians and researchers uninformed about their unique challenges, perspectives, needs, and strengths. This ignorance can lead to inadequate support for marginalized groups dealing with trauma and addiction issues, perpetuating microaggressions or neglect in clinical settings.
