Evidence map›Paper›PMID 40746650›Full record

ReviewBJA open2025

Equity of participants in clinical trials in critical care and perioperative medicine research: a systematic review.

Joanna Kae Ling Wong, Caroline Thomas, Hannah Gravett, Kavi Thobhani, Ayah Mekhaimar, Jan Man Wong, Yize Isalina Wan

Abstract readReview
In one paragraph

Review in BJA open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Joanna Kae Ling WongDepartment of Anaesthesia, Royal London Hospital, Barts Health NHS Trust, London, UK.
Caroline ThomasDepartment of Anaesthesia, St James's University Hospital, Leeds Teaching Hospitals NHS Trust, Leeds, UK.
Hannah GravettDepartment of Anaesthesia, Doncaster Royal Infirmary, Doncaster and Bassetlaw Teaching Hospitals NHS Trust, Doncaster, UK.
Kavi ThobhaniBarts and The London School of Medicine, Queen Mary University of London, London, UK.
Ayah MekhaimarCritical Care and Peri-operative Medicine Research group, William Harvey Research Institute, Faculty of Medicine, Queen Mary University of London, London, UK.
Jan Man WongDepartment of Anaesthesia, Homerton University Hospital, Homerton Healthcare NHS Foundation Trust, London, UK.
Yize Isalina WanWilliam Harvey Research Institute, Queen Mary University of London, London, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Underrepresentation in critical care and perioperative randomised controlled trials (RCTs) limit generalisability and drive health inequity. This systematic review of large, high-quality RCTs analysed representation and reporting trends of equity data over 10 yr. Methods: We searched MEDLINE, Embase, and Clinicaltrials.gov between 01 January 2013 and 11 May 2023 for RCTs recruiting adults (age ≥18 yr) receiving a critical care/perioperative intervention. We examined study characteristics, completeness of participant characteristic reporting, considerations accounting for participant characteristics, differential missing data rates, participant representativeness, and considerations to improve equitable recruitment. Participant characteristics were defined using the PROGRESS framework: Place of residence, Race/ethnicity/culture/language, Occupation, Gender/sex, Religion, Education, Socioeconomic status, and Social capital. We assessed risk of bias using the Cochrane Risk of Bias 2 tool. Results: We included 60 trials (52 critical care, eight perioperative medicine) involving 155 036 participants. Mean (sd) age was 62.9 (4.1) yr. Gender/sex ( Conclusions: Large, high-quality critical care and perioperative RCTs inconsistently collect and report equity data. Female and non-White participants are underrepresented. These findings potentially limit generalisability of research findings. Further work is required to promote equitable study designs. Systematic review protocol: PROSPERO (CRD42023401126).

Indexed as

critical careequityperioperative medicinerandomised clinical trialsrecruitment

Identifiers

PMID40746650
PMCPMC12311584

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.