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Dr James Hamrick: Community Practices Help Increase Diversity in Clinical Trials

Community practices are crucial for helping to increase diversity in clinical trials, said James Hamrick, MD, MPH, Kaiser Permanente and Flatiron Health.

Community practices are crucial for helping to increase diversity in clinical trials, said James Hamrick, MD, MPH, Kaiser Permanente and Flatiron Health.


How can we diversify the patient population in clinical trials?

Diversity within clinical trials has been an issue for a long time and it continues to be. And, I think one thing that you can do with a huge community network, so one thing that community oncology can do is they can provider that denominator, so to speak, of patients that really do reflect the US population right now.

So, if you have a network that stretches across the country that’s rural and urban, that goes from small 1 doctor practices to very large, sophisticated practices with dozens of oncologists, then you really are getting a good snapshot of what the US population looks like. And that’s crucial, because we know that there are groups of patients that are traditionally underrepresented. Whether it be on racial lines or gender lines or age lines or socioeconomic lines, we know that the traditional clinical trials model that we’ve been operating under does not truly represent the real world. And oncologists know this well. We’ve always know it. And, so, you’re always trying to extrapolate. So, I think, having a network that touches all of the different places that cancer patients in our country get care is one huge step in terms of increasing diversity.

In addition, there is a shift in the mindset. So, there have been very good reasons for some populations in the United States to not trust clinical research. You think of Tuskegee [syphilis experiment] and it’s very reasonable to be skeptical of the motives of clinical research. I think we’re moving to an era where more and more people understand that we have a lot more safeguards for patients and research subjects now—that’s hugely important.

And, actually now people understand that, “Hey, the best cancer care is care that has access for cutting-edge trials.” So, I think that’s a transformative moment, and that’s a message that we need to continue to send as the oncology community is that: “You should be asking your doctor and your practice about access to trials.” Because that really is a hallmark of excellence in care.

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