Language barriers could mean the black and ethnic minority (BAME) communities are being underrepresented or excluded from diabetes research trials.
For the first time, a study has looked at the role of language in recruiting ethnic minority patients to type 2 diabetes trials.
BAME people are more prone to developing type 2 diabetes in comparison to the wider population.
If the participants of the trial are not representational of the groups of people who are affected by the condition, it is difficult to generalise the findings and determine whether the treatment will beneficial, experts said.
Lead author Dr Talia Isaacs, from the University of Bristol’s Graduate School of Educatio, said: “Randomised controlled trials (RCT) test the effectiveness of new medical treatments. Ideally, the group of patients participating in a trial should reflect the wider population who will be using the treatment.”
The researchers, who were also from Bristol’s School of Social and Community Medicine and School for Policy Studies, found that when making decisions about patient eligibility for trial participatio, language was only mentioned in half of the 58 trials they looked at.
Dr Daniel Hunt, assistant professor in discourse analysis from the University of Nottingham, and a co-author of the study, said: “There were no common procedures across RCTs to assess if patients had the necessary language ability to take part in the RCTs.
“For example, some listed different combinations of language skills as being considered (speaking, listening, reading, and writing) whereas others referred to patients’ native speaker status.”
Dr Isaacs added: “None specified how the stated language criterion was measured. This suggests that decisions about whether or not patients have adequate language skills to participate in RCTs could be based on trial recruiters’ subjective decisions, which may be biased.”
A total of 79 articles from 58 RCTS were included in the study and nearly two-thirds of the RCTs included in the review provided information about the ethnic composition of the sample of patients recruited.
However, less than a third of the studies that reported on this recruited a sizeable proportion of ethnic minorities.
Many studies which had high participation rates were mainly in the US and involved a wide range of different telehealth technologies. Some intervention or trial materials were provided in another language, other than English.
Dr Isaacs said: “As a result of our findings, we recommend clearer guidelines for reporting on recruited patients’ sociodemographic characteristics, including language background and ethnicity.
“A practical language assessment tool should be developed in future research to minimise the possibility of patients being unfairly excluded from RCTs based on trial recruiters’ arbitrary judgments.”
This study, which was part of a Marie Curie grant, was carried out by an interdisciplinary research team at the Universities of Bristol and Nottingham. It was supported by the Medical Research Council (MRC) ConDuCT-II Hub at the University of Bristol’s School of Social and Community Medicine, which conducts leading methodological research on RCTs, including ways of optimising recruitment to trials.

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