J Natl Med Assoc
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Comparative Study
Racial/Ethnic composition of study participants in FDA-approved oncology new molecular entities, 2006-2008.
The US Food and Drug Administration (FDA) has an ongoing interest in identifying the race/ethnicity of clinical trial participants to ensure they are representative of the people who will use the products once they are approved, and differences in response to medical products have already been observed in racial/ethnic subgroups of the US population. As a result, we reviewed the racial/ethnic composition of study participants in clinical trials of FDA-approved oncology products. Oncology products were chosen because of the disparate incidence and impact of cancer in racial/ethnic communities. ⋯ A comparison of the racial/ ethnic composition showed the participation of whites and blacks or African Americans have decreased, while that of Latinos, Asians, and Native Hawaiians/Pacific Islanders has increased. The results suggest better attention to compliance with collection and reporting, as the percentage of US study participants whose race and/or ethnicity could not be determined decreased from 31% to < 1%. With respect to product labeling, the current study found 6 (60%) included race-based findings.
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Multicenter Study Comparative Study
Sickle cell disease patients' perceptions of emergency department pain management.
Patients with sickle cell disease (SCD) experience painful crises that often require admission to the emergency department (ED) for pain management. Factors such as ED overcrowding and negative perception and stigmatization of SCD may impact patients' perceptions of the quality of pain management in the ED. Data from a multisite prospective cohort study was assessed to determine whether demographic (age and sex), clinical (time to administration of initial analgesia, number of analgesic doses, discharge disposition, and clinical site), or interpersonal factors (separately measured perceptions of being treated with trust and respect by ED triage nurses, nurses, and physicians) were associated with patient ratings of their pain management in the ED. ⋯ Overall, patients reported being treated with trust and respect by ED clinicians. Adjusted logistic regression analyses indicated that ED clinical site 1 (odds ratio [OR], 10.42; 95% confidence interval [Cl], 1.44-7.36) and being treated with trust and respect by the ED physician (OR, 25.53; 95% CI, 2.07-314.96) predicted good ED pain management ratings. Interpersonal health care experiences may be an important indicator of patient satisfaction and quality of care received by patients with SCD in the ED.
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Comparative Study
A preclinical medical student curriculum to introduce health disparities and cultivate culturally responsive care.
To evaluate the efficacy of a newly reformed curriculum for teaching culturally responsive care and to build awareness of health and health care disparities in first-year medical students. Secondary outcomes were to determine if a progressive approach to teaching this content would improve not only knowledge of vulnerable groups but also awareness of inherent personal biases and cultural assumptions, which contribute to inequitable care. ⋯ Our findings demonstrate that this innovative curriculum was successful in improving students' knowledge of vulnerable populations and health disparities. Our progressive curricular approach also successfully increased participant awareness of health disparities by requiring students to assess the socioeconomic and environmental factors of inequitable care. Additionally, it emphasized a process of continuous self-appraisal in delivering culturally responsive care.