Inequities in glaucoma research: an analysis of Cochrane systematic reviews and randomized trials

IF 7.3 2区医学 Q1 HEALTH CARE SCIENCES & SERVICES

Journal of Clinical Epidemiology Pub Date : 2025-02-08 DOI:10.1016/j.jclinepi.2025.111717

Mostafa Bondok , Omar Dewidar , Abdullah Al-Ani , Rishika Selvakumar , Edsel Ing , Jacqueline Ramke , Christian El-Hadad , Karim F. Damji , Tianjing Li , Vivian Welch

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引用次数: 0

Abstract

Objectives

To understand the level of equity considerations within Cochrane systematic reviews (CSR) on glaucoma and their primary studies.

Methods

A review of equity considerations in systematic reviews on glaucoma published in The Cochrane Library from inception (2003) to January 31, 2024 and a sample of recently published primary studies included in those reviews (n = 122). Extraction was performed by two independent reviewers using a prepiloted extraction form based on a validated, contemporary, structured equity framework. If consensus could not be reached, a third reviewer was involved.

Results

A total of 40 CSRs on glaucoma were identified, all of which exclusively included randomized control trials (RCTs) or quasi-RCTs. Twenty-nine (72.5%) reviews acknowledged populations experiencing inequities in glaucoma care; none were able to perform subgroup analysis due to data unavailability in primary studies. Six (15.0%) reviews considered equity-relevant factors when discussing applicability or limitations of study findings to specific populations. Seventy-four (46.8%) review authors were women, while 84 (53.2%) were men. Most review authors were primarily affiliated with institutions in the European Region (85, 53.8%) or the Americas (55, 34.8%), while none were primarily affiliated with institutions in Africa or low-income countries. Most RCTs were conducted in the Americas (32.8%), European Region (27.9%), or in high-income countries (72.1%). While most RCTs reported gender or sex of participants (107, 87.7%), only half reported race or ethnicity (61, 50.0%). No RCTs reported place of residence, occupation, socioeconomic status (SES), or social capital of participants. Approximately half (51.7%) of the participants in these RCTs were female.

Conclusion

Equity considerations can be better addressed in research on glaucoma. Reporting of patient sociodemographic in RCTs, particularly race and ethnicity, as well as global representation were insufficient. This may limit the generalizability and applicability of intervention efficacy to populations experiencing inequities and people from low-income countries.

查看原文本刊更多论文

青光眼研究中的不公平：Cochrane系统评价和随机试验分析。

目的：了解青光眼Cochrane系统评价（CSR）及其初步研究中公平性考虑的水平。方法：对Cochrane图书馆自2003年创刊至2024年1月31日发表的青光眼系统综述中的公平性考虑进行综述，并选取这些综述中近期发表的主要研究样本（n=122）。提取由两名独立的审查人员使用基于经过验证的现代结构化股权框架的预先导提取表单进行。如果不能达成一致意见，则需要第三位审稿人。结果：共确定了40个针对青光眼的CSRs，所有CSRs均包含随机对照试验（rct）或准rct。29篇（72.5%）综述承认人群在青光眼护理方面存在不公平；由于缺乏原始研究的数据，没有人能够进行亚组分析。6篇（15.0%）综述在讨论研究结果对特定人群的适用性或局限性时考虑了公平相关因素。74位（46.8%）为女性，84位（53.2%）为男性。大多数综述作者主要隶属于欧洲地区（85,53.8%）或美洲（55,34.8%）的机构，而没有一个主要隶属于非洲或低收入国家的机构。大多数随机对照试验在美洲（32.8%）、欧洲地区（27.9%）或高收入国家（72.1%）进行。虽然大多数随机对照试验报告了参与者的性别（107,87.7%），但只有一半报告了种族或民族（61,50.0%）。没有随机对照试验报告参与者的居住地、职业、社会经济地位或社会资本。在这些随机对照试验中，大约一半（51.7%）的参与者是女性。结论：青光眼的研究可以更好地解决公平性问题。随机对照试验中患者社会人口学的报告，特别是种族和民族，以及全球代表性不足。这可能会限制干预效果对经历不平等的人群和低收入国家人群的普遍性和适用性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Clinical Epidemiology 医学-公共卫生、环境卫生与职业卫生

CiteScore

12.00

自引率

6.90%

发文量

320

审稿时长

44 days

期刊介绍： The Journal of Clinical Epidemiology strives to enhance the quality of clinical and patient-oriented healthcare research by advancing and applying innovative methods in conducting, presenting, synthesizing, disseminating, and translating research results into optimal clinical practice. Special emphasis is placed on training new generations of scientists and clinical practice leaders.