SynthesisCirculation. Cardiovascular imaging2025
Representation of Older Adults and Women in Randomized Trials of Noninvasive Imaging for Chest Pain.
Synthesis in Circulation. Cardiovascular imaging, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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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.
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.
Who cites it
2 citing papers in PubMed.
- Equity, diversity, and inclusion: variations in clinical and academic radiology.Insights into imaging · 2026Article
- Re-evaluating stress testing paradigms in older adults.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2025Article
Corrections and comments
- Update of
Authors and funding
15 authors.
Funding
Abstract
backgroundNoninvasive imaging is widely used for both initial diagnosis and guided management of ischemic heart disease. Older adults and women with ischemic heart disease may have different responses to imaging and subsequent treatment outcomes compared to younger adults and men. We aimed to study the representation of older adults and women in randomized controlled trials of noninvasive imaging among patients with acute and stable chest pain.
methodsWe conducted a systematic search across PubMed, ClinicalTrials.gov, and guidelines to identify randomized controlled trials of noninvasive imaging-guided diagnosis and management for ischemic heart disease that were published between 2002 and 2023. Participation-to-prevalence ratio (PPR) was estimated for age subgroups of <65, 65 to 74, ≥75 years, and women. PPR of <0.8, 0.8 to 1.2, and >1.2 indicated underrepresentation, appropriate representation, and overrepresentation, respectively.
resultsAmong 53 randomized controlled trials, age and sex breakdown were available in 21 (n=35 503) and 53 (n=55 893) trials, respectively. The median age across all trials was 57.4 years (interquartile range, 55.0-60.2). Participants <65 years of age were overrepresented with a median PPR of 2.13 (interquartile range, 1.73-2.43), whereas those 65 to 74 years and ≥75 years of age were underrepresented with median PPRs of 0.74 (interquartile range, 0.56-0.83) and 0.21 (interquartile range, 0.11-0.33), respectively. Women were adequately represented with a median PPR of 1.2 (1.06-1.32).
conclusionsAlthough women were appropriately represented, adults ≥65 years, especially those ≥75 years, were underrepresented in these trials. Future randomized controlled trials involving imaging for chest pain should target enrollment of older adults to improve generalizability of results to this population.
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Registered trials
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.