Evidence map›Paper›PMID 40354770›Full record

ArticleInjury2025

Ethnic and racial minority patients are under-represented in US clinical trials for surgical management of hip fractures.

Jason Silvestre, Jaimo Ahn, Mitchel B Harris, Langdon A Hartsock, Gerard P Slobogean

Abstract read
In one paragraph

Article in Injury, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Jason SilvestreMedical University of South Carolina, Charleston, SC, United States. Electronic address: jasonsilvestremd@gmail.com.
Jaimo AhnUniversity of Michigan Medical School, Ann Arbor, MI, United States.
Mitchel B HarrisMassachusetts General Hospital, Boston,MA, United States.
Langdon A HartsockMedical University of South Carolina, Charleston, SC, United States.
Gerard P SlobogeanUniversity of Maryland Shock Trauma, Baltimore, MD, United States.

Funding

Development of orthopaedic surgeon-scientist expertise in patient-oriented researchK24AR076445 · NIAMS · UNIVERSITY OF MARYLAND BALTIMORE · PI Gerard Slobogean · 2020 to 2026
$1.1M
NIAMS NIH HHS K24 AR076445
6 · The paper itself

Abstract

introductionThe impact of social determinants on clinical outcomes following surgeries for orthopaedic injuries are well-documented. In this study, we sought to quantify the representation of women, racial, and ethnic minorities in US-based clinical trials for hip fracture surgery.

methodsThis was a cross-sectional analysis of patients enrolled in US-based, interventional clinical trials for hip fractures registered on ClinicalTrials.gov (2000-2022). Participation-to-prevalence ratios (PPRs) were calculated for demographic groups in clinical trials relative to their prevalence among patients receiving hip fracture surgery in the National Inpatient Sample (2006-2015). PPRs between 0.8-1.2 were considered equitable representation. PPRs<0.8 were considered underrepresentation and PPRs>1.2 were considered overrepresentation. Temporal trends were analyzed between previous (2000-2010) and contemporary (2011-2022) periods.

resultsThere were thirty-eight hip fracture clinical trials involving 6937 participants included in this study. All clinical trials reported sex, but only sixteen trials (42 %) reported race and ten trials (26 %) reported ethnicity. In total, trial participants were predominately White (89.3 %) and female (68.0 %). Few patients were non-White including Asian (7.2 %), Black (2.1 %), and Hispanic (0.8 %). Female (PPR=0.97) and male (PPR=1.07) patients had equitable representation. However, Hispanic (PPR=0.22), and African American (PPR=0.51) patients were underrepresented. White patients (PPR=1.00) had equitable representation while Asian patients were overrepresented (PPR=4.50). The rate of race (P < 0.001) and ethnicity (P = 0.010) reporting increased between previous and contemporary periods.

conclusionRecruitment of racial and ethnic minorities into hip fracture clinical trials remains limited. The impact of social determinants on outcomes after trauma surgery requires equitable representation of all groups in clinical trials to ensure translatability of results. Stakeholders across healthcare, industry, and government must work to address these disparities.

Indexed as

Clinical Trials as TopicEthnicityHip FracturesMinority GroupsPatient SelectionRacial GroupsAgedCross-Sectional StudiesFemaleHumansMaleMiddle AgedUnited StatesEthnicityFractureHipOrthopedicsRaceSurgeryTraumaTrialsWomen

Identifiers

PMID40354770
PMCPMC12232919

What Socratic holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.