ReviewMeasuring the effects of CVD interventions and studies across socioeconomic groups: A brief review
Section snippets
Background
Many chronic health conditions are known to have a socio-economic gradient, with poor outcomes more prevalent amongst groups of lower socio-economic status. There is a vast body of literature that consistently demonstrates that there is a pronounced inverse relationship between cardiovascular disease and socioeconomic status [1], [2], [3], [4], [5], [6], [7], [8], [9], [10], [11]. The results of the Whitehall Study provided landmark longitudinal evidence for this: the prevalence of angina
Methods
A review of the literature was conducted by searching PubMed. A flow diagram showing how the final sample was arrived at is provided in Fig. 1.
Results
A total of 414 articles were identified that were published in the clinical trial category of PubMed and reported results relevant to cardiovascular disease. Of these, 32 reported the socioeconomic status of their participants (8%) at baseline (Table 1).
Education attainment was by far the most common baseline socio-economic variable considered (in 28 out of 32 studies), followed by income (5 out of 32 studies). Rurality (3 studies), a composite socioeconomic status measure (2 studies),
Discussion
The authors found that only a minority of CVD-related clinical trials or observational studies assess the outcomes of their studies by socioeconomic status. Despite widespread recognition of the socioeconomic gradient associated with CVD prevalence and mortality, only 5% assessed whether the outcomes differed across socio-economic groups. A recent report noted that only a minority of RCTs reporting on stroke treatments undertook a baseline assessment of the socioeconomic demographic
Conclusions
The authors recommend that more attention is given in the study design phase to measuring the socioeconomic characteristics of participants at enrolment, and in the evaluation of study outcomes, assessing the effectiveness of the trial, or differences in reported outcomes across socio-economic groups. Without explicitly measuring the outcomes of studies across socioeconomic groups, researchers may be unintentionally producing and advocating healthcare options that are less effective amongst
Funding
Part of Dr. Callander's salary came from a National Health and Medical Research Council (NHMRC) Early Career Fellowship.
Conflict of interest
The authors report no relationships that could be construed as a conflict of interest.
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This author takes responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.