eprintid: 10140795
rev_number: 13
eprint_status: archive
userid: 608
dir: disk0/10/14/07/95
datestamp: 2022-01-12 09:55:48
lastmod: 2022-01-12 09:56:54
status_changed: 2022-01-12 09:55:48
type: article
metadata_visibility: show
creators_name: Engleitner, H
creators_name: Jha, A
creators_name: Herron, D
creators_name: Nelson, A
creators_name: Rees, G
creators_name: McNally, N
creators_name: Williams, B
creators_name: Nachev, P
title: Enrolment in clinical research at UCLH and geographically distributed indices of deprivation [version 1; peer review: awaiting peer review]
ispublished: pub
divisions: UCL
divisions: B02
divisions: C07
divisions: D07
divisions: F82
divisions: C08
divisions: D14
divisions: GA3
divisions: B07
divisions: H15
keywords: Equity, fairness, clinical research, geostatistics, deprivation
note: Copyright:  © 2021 Engleitner H et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
abstract: Healthcare should be judged by its equity as well as its quality. Both aspects depend not only on the characteristics of service delivery but also on the research and innovation that ultimately shape them. Conducting a fully-inclusive evaluation of the relationship between enrolment in primary research studies at University College London Hospitals NHS Trust and indices of deprivation, here we demonstrate a quantitative approach to evaluating equity in healthcare research and innovation.

We surveyed the geographical locations, aggregated into Lower Layer Super Output Areas (LSOAs), of all England-resident UCLH patients registered as enrolled in primary clinical research studies. We compared the distributions of ten established indices of deprivation across enrolled and non-enrolled areas within Greater London and within a distance-matched subset across England. Bayesian Poisson regression models were used to examine the relation between deprivation and the volume of enrolment standardized by population density and local disease prevalence.

A total of 54593 enrolments covered 4401 LSOAs in Greater London and 10150 in England, revealing wide geographical reach. The distributions of deprivation indices were similar between enrolled and non-enrolled areas, exhibiting median differences from 0.26% to 8.73%. Across Greater London, enrolled areas were significantly more deprived on most indices, including the Index of Multiple Deprivation; across England, a more balanced relationship to deprivation emerged. Regression analyses of enrolment volumes yielded weak biases, in favour of greater deprivation for most indices, with little modulation by local disease prevalence.

Primary clinical research at UCLH has wide geographical reach. Areas with enrolled patients show similar distributions of established indices of deprivation to those without, both within Greater London, and across distance-matched areas of England. We illustrate a robust approach to quantifying an important aspect of equity in clinical research and provide a flexible set of tools for replicating it across other institutions.
date: 2021-12-14
publisher: F1000 Research Ltd
official_url: https://doi.org/10.12688/wellcomeopenres.17300.1
oa_status: green
full_text_type: pub
language: eng
primo: open
primo_central: open_green
verified: verified_manual
elements_id: 1910788
doi: 10.12688/wellcomeopenres.17300.1
lyricists_name: McNally, Nicholas
lyricists_name: Nachev, Parashkev
lyricists_name: Rees, Geraint
lyricists_name: Williams, Bryan
lyricists_id: NMCNA75
lyricists_id: PNACH75
lyricists_id: GEREE91
lyricists_id: BWILL10
actors_name: Flynn, Bernadette
actors_id: BFFLY94
actors_role: owner
full_text_status: public
publication: Wellcome Open Research
volume: 6
article_number: 342
citation:        Engleitner, H;    Jha, A;    Herron, D;    Nelson, A;    Rees, G;    McNally, N;    Williams, B;           Engleitner, H;  Jha, A;  Herron, D;  Nelson, A;  Rees, G;  McNally, N;  Williams, B;  Nachev, P;   - view fewer <#>    (2021)    Enrolment in clinical research at UCLH and geographically distributed indices of deprivation [version 1; peer review: awaiting peer review].                   Wellcome Open Research , 6     , Article 342.  10.12688/wellcomeopenres.17300.1 <https://doi.org/10.12688/wellcomeopenres.17300.1>.       Green open access   
 
document_url: https://discovery.ucl.ac.uk/id/eprint/10140795/1/406e9ce2-59ec-4894-a06e-2411a8c90a2c_17300_-_parashkev_nachev.pdf