Race and ethnicity reporting has improved significantly in pediatric clinical trials, but there is still underrepresentation of certain racial and ethnic groups, according to a study published online March 14 in Pediatrics.

Ryan C.L. Brewster, M.D., from Boston Children’s Hospital, and colleagues conducted a cross-sectional study of U.S.-based clinical trials registered on ClinicalTrials.gov that enrolled participants aged younger than 18 years between October 2007 and March 2020 to examine race and ethnicity reporting and representation in pediatric clinical trials.

The researchers found that among 1,183 trials, including 405,376 participants, there was a significant increase in race and ethnicity reporting from 27 to 87 percent in 2007 to 2018. The median proportional enrollment of Asian American, American Indian, Black, Hispanic, and White children was 0.6, 0.0, 12.0, 7.1, and 66.4 percent, respectively.

Relative to U.S. population demographics, Asian American, Black, and Hispanic participants were underrepresented. Asian American and Hispanic participants were most consistently underrepresented across diagnoses compared with expected proportions based on disease prevalence and hospitalizations.

“As structural racism becomes increasingly recognized as a public health crisis, the time could not be more opportune to hold pediatric clinical trials to a standard that advances the promises of biomedical progress for all children,” the authors write.

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