Race, ethnicity of trial patients 'highly correlated' with staff of site investigators: study

Private physician practices are better at reflecting the diversity of their clinical trial patients than academic medical centers and community hospitals are, according to a new survey of nearly 3,200 trial sites worldwide.

Almost half of surveyed personnel at independent sites and private practices in the U.S. are representative of minority populations, whereas academic medical centers and community hospitals hover around one-third. In Europe, the number is drastically different; nearly all (93%) of investigative site staff are white. 

That's according to new data out Tuesday from the Tufts Center for the Study of Drug Development, which is based at the university's medical school. 

One of the primary goals of the survey was to map the diversity of global investigative sites, said Ken Getz, professor and director of the center, in an interview with Fierce CRO. 

"Hard to believe, but that has never been done before, and so we really wanted to gather some baseline information," Getz said. The study, which compiled information from 3,187 different trial sites worldwide, took about six to seven months to conduct, he added. About 50% were in the U.S., 33% in Europe and 17% elsewhere. 

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Getz said it wasn't surprising to see that the race and ethnicity of site personnel correlates to that of patients enrolled at the site.

"This is one of those studies where I think, for a very long time, clinical research professionals have intuitively known that that relationship exists between site personnel and the study volunteers enrolled in our trials," Getz said. "This study, our study, essentially corroborates that intuition and provides hard data and evidence to show just how strong that relationship really is."

In U.S. private practices, about 56% of site personnel are white, 22% are Black/African American, 11% are Latinx, 8% are Asian and 5% fall under other categories. In academic and community hospital settings, white personnel comprise 68% of staff.

Vaccines were the most diverse therapeutic area, with 54.8% of site staff being white, 24.2% Latinx, 9.8% Black or African American and 7.7% Asian. 

The study found that as the diversity of site staff increases, the diverse makeup of patients rises. 

With more diversity among its rank and file, sites are more likely to point to diversity as critical to success and have operating procedures in place to support such efforts, the study concluded. 

Patient-to-staff diversity should remain a core focus area even as trials become more virtual, Getz said. 

“Our study here really suggests also that as more trials begin to pick up remote and virtual approaches, that relationship between site personnel, whether it’s in person or remote, still needs to reflect the diversity of the population that the site is serving," Getz said.