Presented by: Dima Raskolnikov MD
Montefiore/Albert Einstein College of Medicine

Introduction

Guidelines from the American Urological Association (AUA) and Endourological Society represent the highest level of evidence that inform clinical practice. However, the clinical trials on which they are based may not include sufficiently diverse patient populations to make their results generalizable. We hypothesized that the majority of clinical trials that guide kidney stone care fail to report the racial composition of their study populations.   

Materials

We reviewed AUA/Endourological Society Guidelines for the Medical and Surgical Management of kidney stones for all referenced clinical trials. Studies reporting human subjects research were included. Study populations were reviewed for reported sex/gender, race, ethnicity, and study country of origin.

Results

,

Of the 380 studies referenced in these Guidelines, 293 reported the results of human subjects research and were included in our analysis. Only 20 of 293 studies (6.8%) reported the race/ethnicity of their subjects, while 254 (87%) reported sex/gender. Racial representation as a percentage of all patients on which the Guidelines are based is described in the Table. Studies from the United States (144 of 293, 49%) were more likely to report the race/ethnicity of their study populations than those performed in other countries (p=0.017).

Conclusion

A small minority (6.8%) of clinical trials on which the AUA/Endourological Society Guidelines for kidney stone care are based report the racial/ethnic composition of their study populations. Among those studies that do report this data, minority patients are poorly represented. Future studies should report this data and include minority patients in order to ensure that Guidelines are broadly generalizable.

Funding

None

Co-Authors

Benjamin Green, MD
Montefiore/Albert Einstein College of Medicine

Emily Hunt,
Montefiore/Albert Einstein College of Medicine

Julia Nadelmann,
Montefiore/Albert Einstein College of Medicine

Kara Watts, MD
Montefiore/Albert Einstein College of Medicine

Alex Small, MD
Montefiore/Albert Einstein College of Medicine