Diversity and Inclusion in Clinical Trials Are Preconditions for Equity

• Published in: Clinical psychology (New York, N.Y.) N.Y.), 2022-06, Vol.29 (2), p.94-96
• Main Author: Schmaling, Karen B.
• Format: Article
• Language: English
• Subjects: Dialectical Behavior Therapy; Ethnic Identity; Gender Identity; Inclusion; Sexual Minority Groups; Sexual Orientation; Treatment Outcomes
• ISSN: 0969-5893; 1468-2850
• DOI: 10.1037/cps0000068

Comments on an article by M. S. Harned et al. (see record 2022-20738-001). Harned and colleagues were able to obtain additional data by request to the authors. Although more identity data had been collected than was reported in the published studies, diverse methods were used which precluded some comparisons. They also found that the proportions of participants’ race and ethnicity were comparable to their representation in the U.S. population, albeit some in very small absolute numbers. However, none of the RCTs examined differences in treatment efficacy by identities, either singly or in combination. It is reasonable to imagine that disparities in the prevalence of a condition such as BPD— such as the overrepresentation of sexual orientation minorities with BPD compared to the population—may extend to disparities in treatment outcomes. Unfortunately, the reporting of participants’ identities and analyses of differential treatment effects by identity dimensions has been deficient with other psychotherapies. Harned and colleagues’ decision to limit their review to studies conducted in the United States is reasonable given the possible between-country heterogeneity in the application of DBT and in the comparability of some identity categories. Nonetheless, it is promising that they identified over 100 studies of non-standard DBT. Harned and colleagues make several sound recommendations about the need to systematically assess and report participant characteristics. They observe that current journal article reporting standards are silent regarding standards for reporting participant characteristics. The results by Harned and colleagues add to a growing literature documenting the need to improve the assessment of identities among the participants in our clinical trials as a necessary precondition of ensuring equitable representation in our samples, which in turn are needed to determine if our treatments are equitably effective. (PsycInfo Database Record (c) 2022 APA, all rights reserved)