Diversity in Clinical and Biomedical Research: A Promise Yet to Be Fulfilled

Esteban Gonzalez Burchard and colleagues explore how making medical research more diverse would aid not only social justice but scientific quality and clinical effectiveness, too.

Vyšlo v časopise: Diversity in Clinical and Biomedical Research: A Promise Yet to Be Fulfilled. PLoS Med 12(12): e32767. doi:10.1371/journal.pmed.1001918
Kategorie: Policy Forum
prolekare.web.journal.doi_sk: 10.1371/journal.pmed.1001918


Esteban Gonzalez Burchard and colleagues explore how making medical research more diverse would aid not only social justice but scientific quality and clinical effectiveness, too.


1. US Congress. National Institutes of Health Revitalization Act of 1993: Act to Amend the Public Health Service Act to Revise and Extend the Programs of the National Institutes of Health, and for Other Purposes. Public Law Washington, DC; 1993 pp. 103–143.

2. Canto JG, Goldberg RJ, Hand MM, Bonow RO, Sopko G, Pepine CJ, et al. Symptom presentation of women with acute coronary syndromes: myth vs reality. Archives of internal medicine. 2007;167: 2405–2413. doi: 10.1001/archinte.167.22.2405 18071161

3. Gandhi M, Aweeka F, Greenblatt RM, Blaschke TF. Sex differences in pharmacokinetics and pharmacodynamics. Annu Rev Pharmacol Toxicol. 2004;44: 499–523. doi: 10.1146/annurev.pharmtox.44.101802.121453 14744256

4. Rathore SS, Wang Y, Krumholz HM. Sex-based differences in the effect of digoxin for the treatment of heart failure. N Engl J Med. 2002;347: 1403–1411. doi: 10.1056/NEJMoa021266 12409542

5. Clayton JA, Collins FS. Policy: NIH to balance sex in cell and animal studies. Nature. 2014;509: 282–283. 24834516

6. Remarks by the President in State of the Union Address | January 20, 2015. 2015. https://www.whitehouse.gov/the-press-office/2015/01/20/remarks-president-state-union-address-january-20-2015

7. Burchard EG, Ziv E, Coyle N, Gomez SL, Tang H, Karter AJ, et al. The importance of race and ethnic background in biomedical research and clinical practice. N Engl J Med. 2003;348: 1170–1175. doi: 10.1056/NEJMsb025007 12646676

8. Kaufman JS, Cooper RS, McGee DL. Socioeconomic status and health in blacks and whites: the problem of residual confounding and the resiliency of race. Epidemiology. 1997;8: 621–628. 9345660

9. Wu AH, White MJ, Oh SS, Burchard E. The Hawaii clopidogrel lawsuit: the possible effect on clinical laboratory testing. Per Med. 2015;12: 179–181. doi: 10.2217/pme.15.4

10. Mega JL, Simon T, Collet J-P, Anderson JL, Antman EM, Bliden K, et al. Reduced-function CYP2C19 genotype and risk of adverse clinical outcomes among patients treated with clopidogrel predominantly for PCI: a meta-analysis. JAMA: The Journal of the American Medical Association. 2010;304: 1821–1830. doi: 10.1001/jama.2010.1543 20978260

11. Fejerman L, Ahmadiyeh N, Hu D, Huntsman S, Beckman KB, Caswell JL, et al. Genome-wide association study of breast cancer in Latinas identifies novel protective variants on 6q25. Nat Commun. 2014;5: 5260. doi: 10.1038/ncomms6260 25327703

12. Carson P, Ziesche S, Johnson G, Cohn JN. Racial differences in response to therapy for heart failure: analysis of the vasodilator-heart failure trials. Vasodilator-Heart Failure Trial Study Group. J Card Fail. 1999;5: 178–187. 10496190

13. Ranjit N, Siefert K, Padmanabhan V. Bisphenol-A and disparities in birth outcomes: a review and directions for future research. J Perinatol. 2010;30: 2–9. doi: 10.1038/jp.2009.90 19587689

14. Chung W-H, Hung S-I, Hong H-S, Hsih M-S, Yang L-C, Ho H-C, et al. Medical genetics: a marker for Stevens-Johnson syndrome. Nature. 2004;428: 486–486. doi: 10.1038/428486a 15057820

15. Genovese G, Friedman DJ, Ross MD, Lecordier L. Association of trypanolytic ApoL1 variants with kidney disease in African Americans. Science. 2010 Aug 13;329(5993):841–5. doi: 10.1126/science.1193032 20647424

16. Gandhi M, Greenblatt RM, Bacchetti P, Jin C, Huang Y, Anastos K, et al. A single-nucleotide polymorphism in CYP2B6 leads to >3-fold increases in efavirenz concentrations in plasma and hair among HIV-infected women. The Journal of infectious diseases. 2012;206: 1453–1461. doi: 10.1093/infdis/jis508 22927450

17. Frasco MA, Mack WJ, Van Den Berg D, Aouizerat BE, Anastos K, Cohen M, et al. Underlying genetic structure impacts the association between CYP2B6 polymorphisms and response to efavirenz and nevirapine. AIDS. 2012;26: 2097–2106. doi: 10.1097/QAD.0b013e3283593602 22951632

18. Bhopal RS. Migration, Ethnicity, Race, and Health in Multicultural Societies. 2nd ed. Oxford University Press; 2014.

19. Institute of Medicine (US) Committee on the Review and Assessment of the NIH’s Strategic Research Plan and Budget to Reduce and Ultimately Eliminate Health Disparities. Examining the Health Disparities Research Plan of the National Institutes of Health: Unfinished Business. Thomson GE, Mitchell F, Williams MB, editors. Washington (DC): National Academies Press (US); 2006.

20. Chen MS, Lara PN, Dang JHT, Paterniti DA, Kelly K. Twenty years post-NIH Revitalization Act: enhancing minority participation in clinical trials (EMPaCT): laying the groundwork for improving minority clinical trial accrual: renewing the case for enhancing minority participation in cancer clinical trials. Cancer. 2014;120 Suppl 7: 1091–1096. doi: 10.1002/cncr.28575 24643646

21. Burchard EG, Oh SS, Foreman MG, Celedón JC. Moving toward True Inclusion of Racial/Ethnic Minorities in Federally Funded Studies. A Key Step for Achieving Respiratory Health Equality in the United States. Am J Respir Crit Care Med. 2015;191: 514–521. doi: 10.1164/rccm.201410-1944PP 25584658

22. American Cancer Society. Cancer Facts & Figures 2014. Atlanta: American Cancer Society; 2014.

23. Murthy VH, Krumholz HM, Gross CP. Participation in cancer clinical trials: race-, sex-, and age-based disparities. JAMA: The Journal of the American Medical Association. 2004;291: 2720–2726. doi: 10.1001/jama.291.22.2720 15187053

24. Chow EA, Foster H, Gonzalez V, McIver L. The Disparate Impact of Diabetes on Racial/Ethnic Minority Populations. Clinical Diabetes. 2012;30: 130–133. doi: 10.2337/diaclin.30.3.130

25. Sardar MR, Badri M, Prince CT, Seltzer J, Kowey PR. Underrepresentation of women, elderly patients, and racial minorities in the randomized trials used for cardiovascular guidelines. JAMA Intern Med. American Medical Association; 2014;174: 1868–1870. doi: 10.1001/jamainternmed.2014.4758 25264856

26. LaVeist TA, Gaskin D, Richard P. Estimating the economic burden of racial health inequalities in the United States. Int J Health Serv. 2011;41: 231–238. doi: 10.2190/HS.41.2.c 21563622

27. National Prevention Council. National Prevention Strategy. Washington, DC: US Department of Health and Human Services, Office of the Surgeon General; 2011.

28. Wendler D, Kington R, Madans J, Van Wye G, Christ-Schmidt H, Pratt LA, et al. Are racial and ethnic minorities less willing to participate in health research? PLoS Med. 2006;3: e19. doi: 10.1371/journal.pmed.0030019 16318411

29. Powe NR, Gary TL. Clinical Trials. In: Beech BM, Goodman M, editors. Race & Research: Perspectives on Minority Participation in Health Studies. Washington, DC: American Public Health Association Press; 2004. pp. 61–78.

30. Durant RW, Wenzel JA, Scarinci IC, Paterniti DA, Fouad MN, Hurd TC, et al. Perspectives on barriers and facilitators to minority recruitment for clinical trials among cancer center leaders, investigators, research staff, and referring clinicians: enhancing minority participation in clinical trials (EMPaCT). Cancer. 2014;120 Suppl 7: 1097–1105. doi: 10.1002/cncr.28574 24643647

31. George S, Duran N, Norris K. A systematic review of barriers and facilitators to minority research participation among African Americans, Latinos, Asian Americans, and Pacific Islanders. Am J Public Health. 2014;104: e16–31. doi: 10.2105/AJPH.2013.301706 24328648

32. Sharrocks K, Spicer J, Camidge DR, Papa S. The impact of socioeconomic status on access to cancer clinical trials. Br J Cancer. 2014;111: 1684–1687. doi: 10.1038/bjc.2014.108 25093493

33. Maxwell AE, Bastani R, Vida P, Warda US. Strategies to recruit and retain older Filipino-American immigrants for a cancer screening study. J Community Health. 2005;30: 167–179. doi: 10.1007/s10900-004-1956-0 15847243

34. Johnson VA, Edwards KA, Sherman SL, Stephens LD, Williams W, Adair A, et al. Decisions to participate in fragile X and other genomics-related research: Native American and African American voices. J Cult Divers. 2009;16: 127–135. 19824292

35. Association of American Medical Colleges. The Diversity Research Forum: The Importance and Benefits of Diverse Faculty in Academic Medicine: Implications for Recruitment, Retention, and Promotion. Washington, DC; 2009.

36. National Science Foundation. Doctorate recipients from US colleges and universities [Internet]. [cited 11 Sep 2015]. http://www.nsf.gov/statistics/sed/2013/data/tab24.pdf

37. Rockey S. Diversity—Looking at the Numbers [Internet]. [cited 24 Sep 2014]. http://nexus.od.nih.gov/all/2012/07/20/diversity-looking-at-the-numbers

38. Rockey S. New NIH Study on Diversity [Internet]. [cited 23 Sep 2014]. http://nexus.od.nih.gov/all/2011/08/18/new-nih-study-on-diversity/

39. Ginther DK, Schaffer WT, Schnell J, Masimore B, Liu F, Haak LL, et al. Race, ethnicity, and NIH research awards. Science. 2011;333: 1015–1019. doi: 10.1126/science.1196783 21852498

40. Freedom of Information Act Request. NIH/Office of Extramural Research. 2014.

41. Reardon S. NIH to probe racial disparity in grant awards. Nature. 2014;512: 243–243. doi: 10.1038/512243a 25143096

42. NIH VideoCast—Advisory Committee to the Director—December 2014 (Day 1) [Internet]. [cited 18 Dec 2014]. http://videocast.nih.gov/summary.asp?live=15269&bhcp=1

43. National Research Council, Committee on the Science of Team Science. Enhancing the Effectiveness of Team Science. Cooke NJ, Hilton ML, editors. Washington (DC): National Academies Press (US); 2015.

44. Freeman RB, Huang W. Collaboration: Strength in diversity. Nature. 2014;513: 305. doi: 10.1038/513305a 25230634

45. Tabak LA, Collins FS. Weaving a richer tapestry in biomedical science. Science. 2011;333: 940–941. doi: 10.1126/science.1211704 21852476

46. Request for Information: NIH Precision Medicine Cohort. 2015. http://grants.nih.gov/grants/guide/notice-files/NOT-OD-15-096.html

47. Collins FS, Varmus H. A new initiative on precision medicine. N Engl J Med. 2015;372: 793–795. doi: 10.1056/NEJMp1500523 25635347

48. NIH Precision Medicine Initiative [Internet]. [cited 1 Sep 2015]. http://www.nih.gov/precisionmedicine/events.htm

49. ACD Precision Medicine Initiative Working Group Public Workshop. Participant Engagement and Health Equity Workshop Summary [Internet]. [cited 1 Sep 2015]. http://www.nih.gov/precisionmedicine/2015-07-01-workshop-summary.pdf

50. PA-15-034: Administrative Supplements for Research on Sex/Gender Differences (Admin Supp) [Internet]. [cited 30 Dec 2014]. http://grants.nih.gov/grants/guide/pa-files/PA-15-034.html

51. Rockey S. New Efforts to Maximize Fairness in NIH Peer Review [Internet]. [cited 23 Sep 2014]. http://nexus.od.nih.gov/all/2014/05/29/new-efforts-to-maximize-fairness-in-nih-peer-review/

52. CSR Announces Winners of its America COMPETES Challenges to Maximize Fairness in NIH Peer Review, [Internet]. [cited 14 Dec 2014]. http://public.csr.nih.gov/Documents/LearnMoreabouttheWinningIdeas.pdf

53. NIH proposes critical initiatives to sustain future of US biomedical research [Internet]. [cited 1 Sep 2015]. http://www.nih.gov/news/health/dec2012/od-07.htm

54. Enhancing the Diversity of the NIH-Funded Workforce [Internet]. [cited 16 Dec 2014]. http://commonfund.nih.gov/diversity/Initiatives

55. King G. Institutional racism and the medical/health complex: a conceptual analysis. Ethn Dis. 1996 Winter-Spring;6(1–2):30–46.

Interné lekárstvo

Článok vyšiel v časopise

PLOS Medicine

2015 Číslo 12
Najčítanejšie tento týždeň
Najčítanejšie v tomto čísle

Zvýšte si kvalifikáciu online z pohodlia domova

Eozinofilní granulomatóza s polyangiitidou
nový kurz

Betablokátory a Ca antagonisté z jiného úhlu
Autori: prof. MUDr. Michal Vrablík, Ph.D., MUDr. Petr Janský

Autori: doc. MUDr. Petr Čáp, Ph.D.

Farmakoterapie akutní a chronické bolesti

Získaná hemofilie - Povědomí o nemoci a její diagnostika

Všetky kurzy
Zabudnuté heslo

Nemáte účet?  Registrujte sa

Zabudnuté heslo

Zadajte e-mailovú adresu, s ktorou ste vytvárali účet. Budú Vám na ňu zasielané informácie k nastaveniu nového hesla.


Nemáte účet?  Registrujte sa