Journal of affective disorders · 2026
Representation of racial and ethnic minorities in U.S. depression trials comparing psychotherapy vs. controls: A meta-analysis using state population benchmarks.
СтатьяМетаанализОбзорНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Segre Lisa, Tong Lingyao, Kaya Aglio Esra, Miguel Clara, de Ponti Nino, Harrer Mathias, Durman Guldehan, Deberg Jennifer, Karyotaki Eirini, Cuijpers Pim
Аннотация
INTRODUCTION: Psychotherapies for depression are effective. To generalize to the diverse U.S. population, clinical trials must adequately represent racial/ethnic minority groups. Prior reviews of diversity of clinical trial participants are limited by incomplete reporting of race/ethnicity, use of national rather than state-level comparators, and pooling practices where a few diverse trials skew estimates.
METHODS: We evaluated racial/ethnic representation in U.S. randomized trials comparing psychotherapy with an inactive control in depressed adults using meta-analysis with state-specific population benchmarks. We assessed reporting of race/ethnicity and, using meta-analysis, evaluated minority representation relative to state population benchmarks. Analyses included sensitivity and subgroup tests (through 2001 and 2002 onward) and meta-regressions assessing links between minority representation and treatment effectiveness. Seventy-six trials (98 comparisons; 8819 participants) were included.
RESULTS: Race/ethnicity was not reported in 29.1% of studies. The "total minority" estimate suggested slight overrepresentation (+2%) but was inconsistent across sensitivity analyses and obscured subgroup differences in representation and temporal patterns. Subgroup analyses showed uneven representation, with Black participants overrepresented and Hispanic/Latino, Asian, and multiracial participants persistently underrepresented. Psychotherapy showed a moderate effect (g = 0.62). The apparent association between greater minority representation and lower treatment effectiveness was no longer significant after adjustment for trial characteristics or exclusion of high-risk-of-bias trials.
DISCUSSION: Incomplete reporting limits evaluation of representativeness. Aggregate "total minority" estimates obscures important subgroup differences, including persistent underrepresentation of some racial/ethnic groups. More complete reporting and subgroup-specific analyses are needed to evaluate racial/ethnic representation in depression treatment clinical trials.
METHODS: We evaluated racial/ethnic representation in U.S. randomized trials comparing psychotherapy with an inactive control in depressed adults using meta-analysis with state-specific population benchmarks. We assessed reporting of race/ethnicity and, using meta-analysis, evaluated minority representation relative to state population benchmarks. Analyses included sensitivity and subgroup tests (through 2001 and 2002 onward) and meta-regressions assessing links between minority representation and treatment effectiveness. Seventy-six trials (98 comparisons; 8819 participants) were included.
RESULTS: Race/ethnicity was not reported in 29.1% of studies. The "total minority" estimate suggested slight overrepresentation (+2%) but was inconsistent across sensitivity analyses and obscured subgroup differences in representation and temporal patterns. Subgroup analyses showed uneven representation, with Black participants overrepresented and Hispanic/Latino, Asian, and multiracial participants persistently underrepresented. Psychotherapy showed a moderate effect (g = 0.62). The apparent association between greater minority representation and lower treatment effectiveness was no longer significant after adjustment for trial characteristics or exclusion of high-risk-of-bias trials.
DISCUSSION: Incomplete reporting limits evaluation of representativeness. Aggregate "total minority" estimates obscures important subgroup differences, including persistent underrepresentation of some racial/ethnic groups. More complete reporting and subgroup-specific analyses are needed to evaluate racial/ethnic representation in depression treatment clinical trials.