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A systematic review of ethnic diversity in clinical trial participation in Aotearoa

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From Māori Health Review Issue 120
Authors:
  • Te Paa S et al.
Summary:

Ethnicity reporting in New Zealand-based randomised controlled trials (RCTs) is inadequate and non-standardised, according to a review of trials undertaken between 2010 and 2020. Trials had been registered in the Australia New Zealand Clinical Trials Registry and published in a peer-reviewed journal. Of 342 trials meeting inclusion criteria, 103 did not report ethnicity data. In the remaining 239 studies involving a total of 295,254 participants, 6.1% of participants were reported as European, 2.9% as Māori, 1.4% as Pacific peoples, 7.5% as Asian, 2.5% as Middle Eastern/Latin American/African and 9.0% as Other Ethnicity. However, 70.6% of participants were unable to be categorised for ethnicity. The study authors concluded that ethnicity reporting should be considered mandatory for RCTs undertaken in New Zealand.

Comment:
As the authors say, it’s impossible to know whether research is serving those with the greatest health need. This matters because participation in clinical trials is itself associated with better care and outcomes including improved monitoring, access to novel therapies and specialist teams. If Indigenous peoples are excluded from trials, they are also excluded from some of the best healthcare available.
Reference: N Z Med J. 2026;139(1628):14-21.
Abstract
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Independent commentary by Dr. Matire Hardwood

Dr Matire Harwood (Ngapuhi) has worked in Hauora Māori, primary health and rehabilitation settings as clinician and researcher since graduating from Auckland Medical School in 1994. She also holds positions on a number of boards, committees and advisory groups including the Health Research Council. Matire lives in Auckland with her whānau including partner Haunui and two young children Te Rangiura and Waimarie.

Research Review publications are intended for New Zealand health professionals.

Disclaimer: This publication is not intended as a replacement for regular medical education but to assist in the process. The reviews are a summarised interpretation of the published study and reflect the opinion of the writer rather than those of the research group or scientific journal. It is suggested readers review the full trial data before forming a final conclusion on its merits.

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