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International Journal of Environmental... Sep 2021There is increasing potential to improve the research and reporting on the health and wellbeing of Indigenous and Tribal peoples through the collection and (re)use of... (Review)
Review
There is increasing potential to improve the research and reporting on the health and wellbeing of Indigenous and Tribal peoples through the collection and (re)use of population-level data. As the data economy grows and the value of data increases, the optimization of data pertaining to Indigenous peoples requires governance that defines who makes decisions on behalf of whom and how these data can and should be used. An international a priori PROSPERO (#CRD42020170033) systematic review was undertaken to examine the health research literature to (1) identify, describe, and synthesize definitions and principles; (2) identify and describe data governance frameworks; and (3) identify, describe, and synthesize processes, policies and practices used in Indigenous Data Governance (ID-GOV). Sixty-eight articles were included in the review that found five components that require consideration in the governance of health research data pertaining to Indigenous people. This included (1) Indigenous governance; (2) institutional ethics; (3) socio-political dynamics; (4) data management and data stewardship; and (5) overarching influences. This review provides the first systematic international review of ID-GOV that could potentially be used in a range of governance strategies moving forward in health research.
Topics: Health Services, Indigenous; Humans; Native Hawaiian or Other Pacific Islander
PubMed: 34639617
DOI: 10.3390/ijerph181910318 -
Annals of Epidemiology Aug 2016Hepatitis C virus (HCV) is highly prevalent among correctional populations. We aimed to explore racial and ethnic disparities in hepatitis C antibody (anti-HCV)... (Meta-Analysis)
Meta-Analysis Review
PURPOSE
Hepatitis C virus (HCV) is highly prevalent among correctional populations. We aimed to explore racial and ethnic disparities in hepatitis C antibody (anti-HCV) prevalence in U.S. correctional populations.
METHODS
We systematically searched the literature for reports of anti-HCV prevalence among U.S. jail and prison populations, by race and ethnicity. We calculated summary prevalence estimates for non-Hispanic White, non-Hispanic Black, Hispanic, and "Other" race/ethnicity jail detainees and prisoners and determined the proportion of anti-HCV positive persons from racial/ethnic minority backgrounds.
RESULTS
Few studies reported anti-HCV prevalence data by race and ethnicity, and they suffered from methodologic weaknesses. Anti-HCV prevalence was highest among non-Hispanic Whites (35% [95% CI: 28%, 43%; k = 9], compared to 26% [95% CI: 21%, 32%; k = 10] among racial and ethnic minorities). However, the majority (63%) of persons with anti-HCV were from racial and ethnic minority backgrounds.
CONCLUSIONS
Racial and ethnic minority persons appear to comprise the majority of HCV burden in U.S. correctional settings. Universal screening and treatment of HCV infection in correctional settings may impact on community-level health disparities.
Topics: Ethnicity; Female; Health Status Disparities; Hepacivirus; Hepatitis C; Hepatitis C Antibodies; Humans; Male; Needs Assessment; Prevalence; Prisoners; Prisons; Racial Groups; United States
PubMed: 27480479
DOI: 10.1016/j.annepidem.2016.06.013 -
Journal of Racial and Ethnic Health... Dec 2022The aim of this systematic review and meta-analysis was to determine whether differences in reported fall rates exist between different ethnic groups. Searches were... (Meta-Analysis)
Meta-Analysis Review
The aim of this systematic review and meta-analysis was to determine whether differences in reported fall rates exist between different ethnic groups. Searches were carried out on four databases: Medline, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Scopus, and Web of Science. Only English language studies with community-dwelling participants aged 60 + years were included. Studies also needed to compare fall prevalence for at least two or more ethnic groups. Two reviewers independently screened all articles and evaluated study quality. Twenty-three articles were included for systematic review, and meta-analyses were carried out on the 16 retrospective studies that reported falls in the previous 12 months. The Asian group demonstrated significantly lower fall prevalence than all other ethnic groups at 13.89% (10.87, 16.91). The Hispanic group had a fall prevalence of 18.54% (12.95, 24.13), closely followed by the Black group at 18.60% (13.27, 23.93). The White group had the highest prevalence at 23.77% (18.66, 28.88). Some studies provided adjusted estimates of effect statistics for the odds/risk of falls, which showed that differences still existed between some ethnic groups even after adjusting for other risk factors. Overall, differences in fall prevalence do appear to exist between different ethnic groups, although the reasons for these differences currently remain undetermined and require further investigation. These findings highlight the need to provide more ethnically tailored responses to public health challenges, which could potentially increase the adherence to prevention interventions, and allow for a more targeted use of resources.
Topics: Humans; Aged; Accidental Falls; Retrospective Studies; Racial Groups; Independent Living; Ethnicity
PubMed: 34786654
DOI: 10.1007/s40615-021-01179-1 -
Gastrointestinal Endoscopy Jul 2024Substantial differences exist in pancreatic cancer outcomes across ethnoracial stratifications. We sought to assess racial, ethnic, sex, and age reporting and inclusion... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND AND AIMS
Substantial differences exist in pancreatic cancer outcomes across ethnoracial stratifications. We sought to assess racial, ethnic, sex, and age reporting and inclusion of participants in pancreatic cancer screening studies.
METHODS
A systematic search of Cochrane Library, Ovid Embase, Google Scholar, Ovid MEDLINE, PubMed, Scopus, and Web of Science Core Collection from inception to 2022 was conducted. Original studies on pancreatic cancer screening were identified and assessed for reporting and inclusion on race, ethnicity, sex, and age. The pooled proportions of study participants for these characteristics were calculated and compared with population-based benchmarks.
RESULTS
Among 27 eligible pancreatic cancer screening studies, 26 reported data on either sex, race, or ethnicity, with a total of 5273 participants. Information on participant sex was reported by 26, race by 12, and ethnicity by 8 studies. Participants in these studies were almost all white (pooled proportion, 93.1%; 95% confidence interval [CI], 89.7-96.4) and non-Latino (pooled proportion, 97.4%; 95% CI, 94.0-100), and these groups were over-represented when compared with the general population. Female participants were well represented, with a pooled proportion of 63.2% (95% CI, 59.9-66.6). When reported, mean or median participant age was <60 years. Meta-regression revealed higher proportions of female participants in studies from the United States (P = .002). No association between increasing participation of racial or ethnic under-represented populations and study quality, ascending year of publication, or source of study funding was noted.
CONCLUSIONS
Substantial disparities in race, ethnicity, sex, and age reporting and inclusion in pancreatic cancer studies were noted, even among high-quality and publicly funded studies.
Topics: Humans; Pancreatic Neoplasms; Early Detection of Cancer; Age Factors; Sex Factors; Ethnicity; Racial Groups; Healthcare Disparities; Female; Patient Selection; Male
PubMed: 38432492
DOI: 10.1016/j.gie.2024.02.014 -
Australian and New Zealand Journal of... Feb 2016To describe the main characteristics of systematic reviews addressing questions of chronic disease and related risk factors for Indigenous Australians. (Review)
Review
OBJECTIVE
To describe the main characteristics of systematic reviews addressing questions of chronic disease and related risk factors for Indigenous Australians.
METHODS
We searched databases for systematic reviews meeting inclusion criteria. Two reviewers assessed quality and extracted characteristics using pre-defined tools.
RESULTS
We identified 14 systematic reviews. Seven synthesised evidence about health intervention effectiveness; four addressed chronic disease or risk factor prevalence; and six conducted critical appraisal as per current best practice. Only three reported steps to align the review with standards for ethical research with Indigenous Australians and/or capture Indigenous-specific knowledge. Most called for more high-quality research.
CONCLUSION
Systematic review is an under-utilised method for gathering evidence to inform chronic disease prevention and management for Indigenous Australians. Relevance of future systematic reviews could be improved by: 1) aligning questions with community priorities as well as decision maker needs; 2) involvement of, and leadership by, Indigenous researchers with relevant cultural and contextual knowledge; iii) use of critical appraisal tools that include traditional risk of bias assessment criteria and criteria that reflect Indigenous standards of appropriate research.
IMPLICATIONS
Systematic review method guidance, tools and reporting standards are required to ensure alignment with ethical obligations and promote rigor and relevance.
Topics: Australia; Chronic Disease; Disease Management; Humans; Native Hawaiian or Other Pacific Islander; Risk Factors
PubMed: 26558444
DOI: 10.1111/1753-6405.12476 -
Homo : Internationale Zeitschrift Fur... Apr 2016The coracoclavicular joint (CCJ) is considered as a rare articulation in humans. Though rarely it could be symptomatic, its presence should be acknowledged by... (Meta-Analysis)
Meta-Analysis Review
The coracoclavicular joint (CCJ) is considered as a rare articulation in humans. Though rarely it could be symptomatic, its presence should be acknowledged by physicians. The aim of this systematic review is to conduct an evidence synthesis on the prevalence of this condition in different ethnic populations. Thirty nine studies including 51 sub-studies met the inclusion criteria. The meta-analytical results showed true prevalence values of ≃5%, ≃7% and ≃2.7% from skeletal, cadaveric and radiological studies, respectively. The bilateral occurrence of CCJ was found to be approximately the half of the crude prevalence and that in all study types. European populations showed the least frequency whereas the Eastern Asian and Native American populations showed the highest values in skeletal/cadaveric studies. European, modern American, Native American and modern South American populations showed the least CCJ occurrence rates in radiological studies. The Chinese population stood out from all other ancestries with a prevalence of 21%, followed by the Southeast Asians with a frequency of 6%. No association was found with variables such as sex or side. This evidence-based anatomical and anthropological review shed the light on the rare and poorly investigated CCJ. It yielded more accurate overall and ancestry-based frequencies from skeletal, cadaveric and radiological studies.
Topics: Clavicle; Female; Humans; Joint Diseases; Male; Prevalence; Racial Groups; Scapula
PubMed: 26804629
DOI: 10.1016/j.jchb.2015.12.003 -
Current Drug Abuse Reviews Mar 2011Alcohol (AUD) and other substance use disorders (SUD) are common among adolescents. The CRAFFT (Car, Relax, Alone, Forget, Friends, Trouble, 1999) was developed as a... (Meta-Analysis)
Meta-Analysis Review
INTRODUCTION
Alcohol (AUD) and other substance use disorders (SUD) are common among adolescents. The CRAFFT (Car, Relax, Alone, Forget, Friends, Trouble, 1999) was developed as a brief screening instrument for adolescents to measure AUD and SUD. This systematic review examines the psychometric properties of the CRAFFT.
METHODS
We performed a systematic review using Cochrane Database for Systematic Reviews, Pubmed/Medline, Embase (1980 to present), PsycInfo, and Google Scholar using the keywords "CRAFFT", "CRAFFT questionnaire", "alcohol misuse", "alcohol abuse", "alcohol dependence" "alcohol", "substance misuse", and "substance abuse" and "substance dependence".
RESULTS
We report 11 studies on validity and six studies on reliability. Populations examined were clinic patients including hospital-based clinic patients, primary care patients, emergency room patients, Native-Americans, sexually transmitted diseases clinic patients, substance users, a general population group, and enlisting military concripts. In general, the CRAFFT was found to be a good screening instrument for gradations of alcohol and substance misuse including problem use, abuse, and dependence. At optimal cut-points, sensitivities of the CRAFFT ranged from 0.61 to 1.00, and specificities ranged from 0.33 to 0.97. The CRAFFT showed modest to adequate internal consistency values ranging from 0.65 to 0.86, and high test-retest reliability.
CONCLUSION
The CRAFFT has adequate psychometric properties for detecting AUD and SUD in adolescents. However, more studies of the psychometric properties of the CRAFFT need to be carried out to further assess and improve generalizability to other populations. Gender and ethnic differences also require further examination, as do versions that are adapted for different languages and cultures.
Topics: Adolescent; Alcoholism; American Indian or Alaska Native; Child; Diagnostic and Statistical Manual of Mental Disorders; Ethnicity; Female; Humans; Male; Military Personnel; Observer Variation; Patients; Psychometrics; Reproducibility of Results; Sex Characteristics; Substance-Related Disorders; Surveys and Questionnaires; Young Adult
PubMed: 21466499
DOI: 10.2174/1874473711104010057 -
American Journal of Public Health Mar 2013To investigate the possibility of a Hispanic mortality advantage, we conducted a systematic review and meta-analysis of the published longitudinal literature reporting... (Meta-Analysis)
Meta-Analysis Review
To investigate the possibility of a Hispanic mortality advantage, we conducted a systematic review and meta-analysis of the published longitudinal literature reporting Hispanic individuals' mortality from any cause compared with any other race/ethnicity. We searched MEDLINE, PubMed, EMBASE, HealthSTAR, and PsycINFO for published literature from January 1990 to July 2010. Across 58 studies (4 615 747 participants), Hispanic populations had a 17.5% lower risk of mortality compared with other racial groups (odds ratio = 0.825; P < .001; 95% confidence interval = 0.75, 0.91). The difference in mortality risk was greater among older populations and varied by preexisting health conditions, with effects apparent for initially healthy samples and those with cardiovascular diseases. The results also differed by racial group: Hispanics had lower overall risk of mortality than did non-Hispanic Whites and non-Hispanic Blacks, but overall higher risk of mortality than did Asian Americans. These findings provided strong evidence of a Hispanic mortality advantage, with implications for conceptualizing and addressing racial/ethnic health disparities.
Topics: Hispanic or Latino; Humans; Longitudinal Studies; Mortality; Racial Groups; United States
PubMed: 23327278
DOI: 10.2105/AJPH.2012.301103 -
Journal of the Royal Society of Medicine Sep 2023The cardiorenal protective effects of sodium-glucose co-transporter 2 inhibitors (SGLT2-Is) and glucagon-like peptide 1 receptor agonists (GLP1-RAs) across racial and...
Racial, ethnic and regional differences in the effect of sodium-glucose co-transporter 2 inhibitors and glucagon-like peptide 1 receptor agonists on cardiovascular and renal outcomes: a systematic review and meta-analysis of cardiovascular outcome trials.
OBJECTIVES
The cardiorenal protective effects of sodium-glucose co-transporter 2 inhibitors (SGLT2-Is) and glucagon-like peptide 1 receptor agonists (GLP1-RAs) across racial and ethnic groups are not well defined. By conducting a systematic review and meta-analysis of all randomised, placebo-controlled, cardiovascular disease (CVD) outcomes trials (CVOTs), we aimed to compare racial/ethnic as well as regional patterns in the effects of SGLT2-Is and GLP1-RAs on cardiovascular and renal outcomes in patients with type 2 diabetes (T2D).
DESIGN
Trials were identified from MEDLINE, Embase, the Cochrane Library, and search of bibliographies to 7 July 2023. Setting North America, South/Central America, Europe (Eastern and Western), Asia, Australia-New Zealand (Pacific), Asia/Pacific, and Africa.
SETTING
North America, South/Central America, Europe (Eastern and Western), Asia, Australia-New Zealand (Pacific), Asia/Pacific, and Africa.
PARTICIPANTS
people with type 2 diabetes enrolled in cardiovascular outcome trials of SGLT2-Is and GLP1-RAs.
MAIN OUTCOME MEASURES
Outcomes were (i) major adverse cardiovascular events (MACE), (ii) composite CVD death/heart failure (HF) hospitalization; (iii) composite renal outcome; and (iv) their components. Study-specific hazard ratios (HRs) with 95% confidence intervals (CIs) were pooled.
RESULTS
In total, 14 unique CVOTs (7 comparing SGLT2-Is vs placebo and 7 comparing GLP1-RAs vs placebo) were eligible. The proportion of participants enrolled in the trials ranged from 66.6-93.2% for White populations, 1.2-21.6% for Asian populations, 2.4-8.3% for Black populations and 0.9-23.1% for Other populations. The HR (95% CI) for MACE comparing SGLT2-Is vs placebo was 0.92 (0.86-0.98), 0.69 (0.53-0.92) and 0.70 (0.54-0.91) for White, Asian and Hispanic/Latino populations, respectively. Comparing GLP1-RAs vs placebo, the corresponding HR (95% CI) was 0.88 (0.80-0.97), 0.76 (0.63-0.93) and 0.82 (0.70-0.95), respectively. SGLT2-Is reduced the risk of all other cardiorenal outcomes in White and Asian populations, except for HF hospitalizations in Asians. No effects were observed in Black populations except for a reduced risk of HF hospitalizations by SGLT2-I. SGLT1-Is reduced the risk of composite CVD death/HF hospitalization in North America and Europe, whereas GLP1-RAs reduced the risk of MACE in Europe. GRADE certainty of evidence ranged from moderate to high.
CONCLUSIONS
There appears to be substantial racial/ethnic differences in the cardiorenal effects of SGLT2-Is and GLP1-RAs in patients with T2D, with consistent benefits observed among White and Asian populations and consistent lack of benefits in Black populations. Whether the differences are due to issues with under-representation of Black populations and low statistical power or racial/ethnic variations in the pharmacokinetics, pharmacodynamics and safety of SGLT2-Is and GLP1-RAs need further investigation.PROSPERO Registration: CRD42023401734.
PubMed: 37734450
DOI: 10.1177/01410768231198442 -
JAMA Network Open Jan 2023As the field of medicine strives for equity in care, research showing the association of social determinants of health (SDOH) with poorer health care outcomes is needed... (Meta-Analysis)
Meta-Analysis
IMPORTANCE
As the field of medicine strives for equity in care, research showing the association of social determinants of health (SDOH) with poorer health care outcomes is needed to better inform quality improvement strategies.
OBJECTIVE
To evaluate the association of SDOH with prostate cancer-specific mortality (PCSM) and overall survival (OS) among Black and White patients with prostate cancer.
DATA SOURCES
A MEDLINE search was performed of prostate cancer comparative effectiveness research from January 1, 1960, to June 5, 2020.
STUDY SELECTION
Two authors independently selected studies conducted among patients within the United States and performed comparative outcome analysis between Black and White patients. Studies were required to report time-to-event outcomes. A total of 251 studies were identified for review.
DATA EXTRACTION AND SYNTHESIS
Three authors independently screened and extracted data. End point meta-analyses were performed using both fixed-effects and random-effects models. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guideline was followed, and 2 authors independently reviewed all steps. All conflicts were resolved by consensus.
MAIN OUTCOMES AND MEASURES
The primary outcome was PCSM, and the secondary outcome was OS. With the US Department of Health and Human Services Healthy People 2030 initiative, an SDOH scoring system was incorporated to evaluate the association of SDOH with the predefined end points. The covariables included in the scoring system were age, comorbidities, insurance status, income status, extent of disease, geography, standardized treatment, and equitable and harmonized insurance benefits. The scoring system was discretized into 3 categories: high (≥10 points), intermediate (5-9 points), and low (<5 points).
RESULTS
The 47 studies identified comprised 1 019 908 patients (176 028 Black men and 843 880 White men; median age, 66.4 years [IQR, 64.8-69.0 years]). The median follow-up was 66.0 months (IQR, 41.5-91.4 months). Pooled estimates found no statistically significant difference in PCSM for Black patients compared with White patients (hazard ratio [HR], 1.08 [95% CI, 0.99-1.19]; P = .08); results were similar for OS (HR, 1.01 [95% CI, 0.95-1.07]; P = .68). There was a significant race-SDOH interaction for both PCSM (regression coefficient, -0.041 [95% CI, -0.059 to 0.023]; P < .001) and OS (meta-regression coefficient, -0.017 [95% CI, -0.033 to -0.002]; P = .03). In studies with minimal accounting for SDOH (<5-point score), Black patients had significantly higher PCSM compared with White patients (HR, 1.29; 95% CI, 1.17-1.41; P < .001). In studies with greater accounting for SDOH variables (≥10-point score), PCSM was significantly lower among Black patients compared with White patients (HR, 0.86; 95% CI, 0.77-0.96; P = .02).
CONCLUSIONS AND RELEVANCE
The findings of this meta-analysis suggest that there is a significant interaction between race and SDOH with respect to PCSM and OS among men with prostate cancer. Incorporating SDOH variables into data collection and analyses are vital to developing strategies for achieving equity.
Topics: Aged; Humans; Male; Prostate; Prostatic Neoplasms; Social Determinants of Health; United States; White; Black or African American
PubMed: 36630135
DOI: 10.1001/jamanetworkopen.2022.50416