Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2025 Feb 19;48(1):247.
doi: 10.1007/s10143-025-03343-1.

Racial, ethnic, and socioeconomic disparities in clinical trial reporting for metastatic spine tumors: An exploration of North American studies

Ali Haider Bangash  1 , Rose Fluss  2 , Ananth S Eleswarapu  3 , Mitchell S Fourman  1   3 , Yaroslav Gelfand  1   2 , Saikiran G Murthy  1   2 , Reza Yassari  1   2 , Rafael De la Garza Ramos  4   5
Affiliations
Review

Racial, ethnic, and socioeconomic disparities in clinical trial reporting for metastatic spine tumors: An exploration of North American studies

Ali Haider Bangash et al. Neurosurg Rev. .

Abstract

Purpose: The objective of this study was to evaluate the reporting of racial, ethnic, and socioeconomic data in clinical trials exploring the management of metastatic spine disease (MSD).

Methods: We undertook a cross-sectional analysis of North American completed and published clinical trials registered on ClinicalTrials.gov exploring the management of patients with MSD. Data on patient demographics, trial characteristics, reporting of race and ethnicity, distribution of racial and ethnic groups, and reporting of socioeconomic measures was extracted from ClinicalTrials.gov and related publications identified through PubMed and Google Scholar searches. An exploratory data analysis was performed, followed by Pearson's Chi-square and binary logistic regression analyses to explore associations of covariates with racioethnic reporting.

Results: Out of 158 completed trials, only 8% (12 of 158) met inclusion criteria with published results. These 12 trials included a total of 1,568 patients with a mean age of 61 years. Almost half (42%; (5 of 12)) of trials did not report race, while only 17% (2 of 12) of trials reported ethnicity. In trials reporting complete racial data (n = 5), 77% (377 of 493) patients were White, 15% (n = 73) Black or African American, and 4% (n = 19) Asian. American Indian/Alaska Native and Native Hawaiian/Other Pacific Islander patients were severely underrepresented (0.4% and 0.2%, respectively). Of the two trials reporting ethnicity, 94% (479 of 514) patients were Not Hispanic or Latino. Sponsoring body of the trial, trial phase, intervention type, number of trial patients, or mean age of patients were not significantly associated with racioethnic reporting. Notably, no trial reported any measures of socioeconomic status.

Conclusion: Our review revealed significant gaps in the reporting of racial, ethnic, and socioeconomic data in MSD clinical trials, with substantial underrepresentation of minority groups. This underrepresentation limits the generalizability of trial findings and may perpetuate health disparities. Coordinated efforts from researchers, clinicians, policymakers, and funding bodies are needed to improve diversity in future trials. Strategies such as targeted outreach, community engagement, and more inclusive eligibility criteria should be implemented to ensure that trial populations better reflect the diversity of MSD patients in the general population.

Keywords: Diversity; Employment; Insurance; Metastatic spine disease; Race; Socioeconomic status; Vulnerability.

PubMed Disclaimer

Conflict of interest statement

Declarations. Ethics approval: Being a cross-sectional analysis of published trials, ethics approval was not required to be sought. Competing interests: The authors declare no competing interests. Consent to participate: Being a cross-sectional analysis of published trials, the consent to participate was not required to be sought.

Figures

Fig. 1
Fig. 1
Racial diversity of patients included in trials exploring management of spinal metastasis
Fig. 2
Fig. 2
Ethnic diversity of patients included in trials exploring management of spinal metastasis
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Van den Brande R, Cornips EM, Peeters M, Ost P, Billiet C, Van de Kelft E (2022) Epidemiology of spinal metastases, metastatic epidural spinal cord compression and pathologic vertebral compression fractures in patients with solid tumors: a systematic review. J Bone Oncol 35:100446. 10.1016/j.jbo.2022.100446 - PMC - PubMed
    1. Shakil H, Malhotra AK, Badhiwala JH et al (2024) Contemporary trends in the incidence and timing of spinal metastases: a population-based study. Neuro-Oncol Adv 6(1):vdae051. 10.1093/noajnl/vdae051 - PMC - PubMed
    1. Jaipanya P, Chanplakorn P (2022) Spinal metastasis: narrative reviews of the current evidence and treatment modalities. J Int Med Res 50(4):3000605221091665. 10.1177/03000605221091665 - PMC - PubMed
    1. Morimoto T, Toda Y, Hakozaki M et al (2024) A new era in the management of spinal metastasis. Front Oncol 14:1374915. 10.3389/fonc.2024.1374915 - PMC - PubMed
    1. Hung B, Pennington Z, Hersh AM et al (2021) Impact of race on nonroutine discharge, length of stay, and postoperative complications after surgery for spinal metastases. J Neurosurg Spine 36(4):678–685. 10.3171/2021.7.SPINE21287 - PubMed

LinkOut - more resources