Dr Vivienne Hau Highlights the Need for Better Trial Design for Patient Diversity

Getting a more diverse patient population in clinical trials may be as simple as including paperwork in more languages, but good training among investigators and study coordinators can help identify unconscious biases that may also have an impact, explained Vivienne Hau, MD, clinical assistant professor with the Kaiser Permanente Bernard J. Tyson School of Medicine.

Transcript

How can implicit bias be addressed in designing retina clinical trials?

It’s rather interesting, being involved in clinical trials myself, how in many of these studies, there is a lack of forms that are just within the languages of those that we're trying to include in some of these studies. So, on one hand, we say we want to be more inclusive, we want to diversify the patient population that we're doing these trials on, but we're not providing the tools that are necessary for us to be successful in recruiting these individuals. And one way to do that is ensuring that we actually have paperwork within the languages that are needed.

But the other thing is, we also need to understand how to approach some of these communities. You know, there's a lot of distrust in some communities when it comes to research and trials because of historical reasons. And so, we need to build better relationships. One of the more effective ways is ensuring that those doctors that work in those communities are being trained and being site selected to be part of these trials, so that they can help recruit these individuals, because getting people involved who are from the communities can be so much more effective than trying to have a site that may have expertise in doing clinical trials but trying to go to communities that they've never been to before. And so, these are some ways that we can do a much better job of.

And the other thing is implicit bias in itself. Unconscious bias. A lot of this we don't even know of ourselves that we do. I think most of us don't believe we are racist or doing things against individuals. But a lot of it’s we just don't realize what we're doing based upon our long-lived experiences and not being able to see those sort of situations where it can be some sort of bias or type of discrimination. And so having good training for those involved in these trials, I think is important. So perhaps that might be something we need to incorporate more within our medical schools and residencies and fellowships. And it may be part of some of these trial startups, that it's part of the education and training that needs to be done for [primary investigators] and staff and study coordinators.