TY - JOUR AU - Isaacs, Talia AU - Hunt, Daniel AU - Ward, Danielle AU - Rooshenas, Leila AU - Edwards, Louisa PY - 2016 DA - 2016/09/26 TI -少数民族患者的纳入和语言在2型糖尿病远程医疗试验中的作用:JO - J Med Internet Res SP - e256 VL - 18 IS - 9kw -远程医疗KW -远程医疗KW - 2型糖尿病KW -糖尿病KW -少数民族KW -试验招募KW -系统评价KW -语言KW -英语熟练度KW -健康交流AB -背景:2型糖尿病是一种严重的、普遍的代谢疾病，对少数民族患者的影响尤其严重。远程保健干预可促进2型糖尿病监测和预防继发并发症。然而，旨在测试远程保健干预措施有效性的试验可能招募不足或排除少数民族患者，语言是招募的潜在障碍。少数民族在试验中的代表性不足限制了研究结果对这一关键患者群体的外部有效性。目的:本系统综述检查了(1)针对2型糖尿病的远程健康随机对照试验(rct)中纳入少数民族患者的研究报告实践和患病率，以及招募高比例少数民族患者相关的试验特征，以及(2)纳入的rct中报告使用英语语言能力作为患者筛查标准的比例，以及他们如何和为什么这样做。方法:在以英语为母语的西方国家，以2型糖尿病为成人主要疾病的学术期刊上发表的远程健康随机对照试验被纳入研究。主要综述排除了针对种族的随机对照试验，但纳入了事后亚组分析。摘要和全文筛选、偏倚风险评估和数据提取由两位审稿人独立进行。结果:在检索中确定的3358条记录中，79篇文章包括58项rct。 Nearly two-thirds of the RCTs (38/58) reported on the ethnic composition of participants, with a median proportion of 23.5% patients (range 0%-97.7%). Fourteen studies (24%) that included at least 30% minority patients were all US-based, predominantly recruited from urban areas, and described the target population as underserved, financially deprived, or uninsured. Eight of these 14 studies (57%) offered intervention materials in a language other than English or employed bilingual staff. Half of all identified RCTs (29/58) included language proficiency as a participant-screening criterion. Language proficiency was operationalized using nonstandardized measures (eg, having sufficient “verbal fluency”), with only three studies providing reasons for excluding patients on language grounds. Conclusions: There was considerable variability across studies in the inclusion of ethnic minority patients in RCTs, with higher participation rates in countries with legislation to mandate their inclusion (eg, United States) than in those without such legislation (eg, United Kingdom). Less than 25% of the RCTs recruited a sizeable proportion of ethnic minorities, which raises concerns about external validity. The lack of objective measures or common procedures for assessing language proficiency across trials implies that language-related eligibility decisions are often based on trial recruiters’ impressionistic judgments, which could be subject to bias. The variability and inconsistent reporting on ethnicity and other socioeconomic factors in descriptions of research participants could be more specifically emphasized in trial reporting guidelines to promote best practice. Trial Registration: PROSPERO International Prospective Register of Systematic Reviews: CRD42015024899; http://www.crd.york.ac.uk/PROSPERO/display_record.asp?ID=CRD42015024899 (Archived by WebCite at http://www.webcitation.org/6kQmI2bdF) SN - 1438-8871 UR - //www.mybigtv.com/2016/9/e256/ UR - https://doi.org/10.2196/jmir.6374 UR - http://www.ncbi.nlm.nih.gov/pubmed/27670360 DO - 10.2196/jmir.6374 ID - info:doi/10.2196/jmir.6374 ER -