Improving Representation in Clinical Trials and Research

The United States has long made substantial investments in clinical research with the goal of improving the health and well-being of our nation. There is no doubt that these investments have contributed significantly to treating and preventing disease and extending human life. Nevertheless, clinical research faces a critical shortcoming. Currently, large swaths of the U.S. population, and those that often face the greatest health challenges, are less able to benefit from these discoveries because they are not adequately represented in clinical research studies. While progress has been made with representation of white women in clinical trials and clinical research, there has been little progress in the last three decades to increase participation of racial and ethnic minority population groups. This underrepresentation is compounding health disparities, with serious consequences for underrepresented groups and for the nation.At the request of Congress, Improving Representation in Clinical Trials and Research: Building Research Equity for Women and Underrepresented Groups identifies policies, procedures, programs, or projects aimed at increasing the inclusion of these groups in clinical research and the specific strategies used by those conducting clinical trials and clinical and translational research to improve diversity and inclusion. This report models the potential economic benefits of full inclusion of men, women, and racial and ethnic groups in clinical research and highlights new programs and interventions in medical centers and other clinical settings designed to increase participation.Table of ContentsFront MatterSummary1 The Committee's Task2 Why Diverse Representation in Clinical Research Matters and theCurrent State of Representation within the Clinical ResearchEcosystem3 Policies to Improve Clinical Trial and Research Diversity:History and Future Directions4 Barriers to Representation of Underrepresented and ExcludedPopulations in Clinical Research5 Facilitators of Successful Inclusion in Clinical Research6 Recommendations for Improving Representation in Clinical Trialsand Clinical ResearchEpilogue: Envisioning a New FutureReferencesAppendix A: Quantifying the Potential Health and Economic Impactsof Increased Trial DiversityAppendix B: Key Trends in Demographic Diversity in Clinical TrialsAppendix C: Improving Representativeness in Clinical Trials andResearch: Facilitators to Recruitment and Retention ofUnderrepresented Groups