Evidence map›Paper›PMID 42329314›Full record

ArticlePharmaceutical medicine2026

Language as an Eligibility Criterion in Pediatric Study Protocols Conducted in Europe (2007-2024) Reported in the ClinicalTrials.gov Database.

Begonya Nafria, Alexander Perera, Segolene Gaillard, Martine Dehlinger-Kremer, Pamela Dicks, Ricardo M Fernandes, Gilles Vassal, Pirkko Lepola, Gunter F Egger, Lucy Bray and 2 more

Abstract read
In one paragraph

Article in Pharmaceutical medicine, 2026. 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

12 authors.

Begonya NafriaPatient Engagement in Research Department, Institut de Recerca Sant Joan de Déu (IRSJD), Santa Rosa 39-57, 08950, Esplugues de Llobregat, Spain. begonya.nafria@sjd.es.ORCID http://orcid.org/0000-0002-4494-3663
Alexander PereraB2slab, Institut de Recerca i Innovació en Salut, Universitat Politècnica de Catalunya, Barcelona, Spain.
Segolene GaillardCIC 1407, Inserm, Kids France, CHU-Lyon, Lyon, France.
Martine Dehlinger-KremerUCB Biosciences, Monheim, Germany.
Pamela DicksNHS-NRS Children, NHS Grampian, Royal Aberdeen Children's Hospital, Aberdeen, UK.
Ricardo M FernandesClinical Pharmacology and Therapeutics, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal.
Gilles VassalGustave Roussy, Villejuif, France.
Pirkko LepolaHelsinki University Hospital and University of Helsinki, Helsinki, Finland.
Gunter F EggerEuropean Network of Paediatric Research at the European Medicines Agency (Enpr-EMA); Paediatric Medicines Office, European Medicines Agency (EMA), Amsterdam, Netherlands.
Lucy BrayEdge Hill University, Ormskirk, UK.
Barbara E BiererMulti-Regional Clinical Trials Center of Brigham and Women's Hospital and Harvard, Boston, MA, USA.
Bob PhillipsCentre for Reviews and Dissemination, University of York, York, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundOne of the challenges in accessing cross-border clinical trials involving international participants in Europe is language diversity, with 32 official languages in the European continent. Some patients have reported being excluded from trials owing to their native language, and in certain studies, language has been used as an eligibility criterion for participation. Considering that pediatric studies in Europe are not conducted in all countries, cross-border access to clinical trials may represent the only therapeutic opportunity for children living with rare diseases for which no approved treatment exists.

objectiveThis study aimed to assess the use of language as an eligibility criterion in pediatric clinical trial protocols conducted in Europe (2007-2024) and published in the Clinicaltrials.gov database. It evaluated the frequency and context of language requirements and whether these were scientifically justified. The overall objective was to identify potential sources of language-based discrimination that may prevent cross-border access to pediatric clinical trials.

methodsThe 32 official languages of the European continent were used as keywords to search the eligibility criteria of 1,754 pediatric clinical trial protocols for studies conducted in Europe between 2007 and 2024 and registered in the largest clinical trial registry, ClinicalTrials.gov, via an Application Programming Interface. Acceptable scientific justifications to use language as an eligibility criterion were defined as being (1) related to specific therapeutic areas that required language or cognitive assessments in communication with the health professionals, who do not speak the patient's language or (2) related to the use of patient- or caregiver-reported outcome measures that had only been validated in specific languages.

resultsThe majority of the study protocols (95.2%) did not include any reference to European official languages in the eligibility criteria. Of the 85 study protocols that did include language requirements, only 23 (27.1%) had a scientific justification for the use of this criterion. The most frequent European languages required as eligibility criteria were English (20%) and French (16.5%).

conclusionsA minority of European paediatric studies (4.8%) included language in eligibility criteria in the study protocols, but of those that did, most offered no reasonable explanation for the restriction. To prevent language-based discrimination within the European regulatory framework, we recommend that ethics committees should require justification for any language-based eligibility criteria. Additionally, including dedicated sections on cross-border access in clinical trial protocols will help ensure the provision of appropriate resources such as translations, interpreters, travel, and accommodation when recruiting international participants.

Indexed as

Clinical Trials as TopicLanguagePatient SelectionPediatricsChildDatabases, FactualEuropeHumansRegistries

Identifiers

PMID42329314
PMCPMC13332970

What Socratic holds

Textmetadata
LicenceCC BY-NC
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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.