Diversity, equity, and inclusion in asthma clinical trials: A cross-sectional analysis

Background: Health inequity exists across the scientific and medical community, specifically in the development and design of clinical trials. There is a lack of diversity and representation of historically marginalized groups in the current landscape of clinical research, and our primary objective for this study was to evaluate recruitment and retention strategies for patients historically marginalized in asthma clinical trials. Objective: To evaluate the extent to which asthma clinical trials use recruitment and retention strategies that promote diversity and to identify persistent gaps in the representation of historically marginalized populations. Methods: We performed a search of major databases—Medline and Embase—to identify clinical trials that performed various interventions and treatment modalities for asthma. Screening and data extraction were performed in a masked and duplicate fashion to limit error. General study characteristics along with recruitment and retention strategies were recorded. Results: Overall, 121 clinical trials were included in our study. Of the included studies, 42 (42/121, 34.7%) reported the use of retention and recruitment strategies; 18 studies (18/121, 14.9%) explicitly stated their diversity goals for the participants. Conclusion: Approximately one-third of studies reported the use of recruitment strategies; however, the overall implementation and standardization of these strategies remain low in asthma clinical trials. Standardization of recruitment and retention methods combined with well-defined recruitment objectives is necessary to improve diversity, equity, and inclusion in clinical trials.