Australian Aboriginal children:- the randomised controlled trial and special populations

Article type
Authors
Morris PS, Leach AJ, Baker P, Mathews JD
Abstract
Introduction: Improving the health of Aboriginal children is regarded as a national priority. The identification of effective medical therapies will assist with improving health outcomes, and could allow Aboriginal people to have greater control over the process.

Objective: To identify and assess the RCT's, (randomised controlled trials), involving Australian Aboriginal children, or populations living in similar circumstances.

Methods: Electronic searching of Medline (1966-95), the Australasian Medical Index (1970-95), and hand searching of The Aboriginal and Torres Strait Islander Health Information Bulletin and 'Aboriginal Health: an annotated Bibliography' were performed. Experts in the area of Aboriginal child health were consulted to try and locate any other studies not listed.

Results: 4 RCT's involving Australian Aboriginal children were found. 2 other studies were controlled but not randomised. 5 of the 6 studies were listed on Medline, and the 6th study was on the Australasian Medical Index. This represents a very small number of studies both in terms of Australian research, and within the Aboriginal Health field. Identification of RCT's involving similar populations was more problematic and relied on inefficient searching strategies. While several hundred studies were found, it was often difficult to ascertain their clinical relevance. Few studies from developing countries assessed outcomes other than death or severe illness.

Discussion: RCT's involving Aboriginal children are rare. The generalisability of findings from other populations is not clear. These facts may be contributing to the lack of effective therapies being provided to Aboriginal communities. A more systematic approach to research involving Aboriginal people is desirable, and enterprises like the Cochrane Collaboration could have an enormous impact. However, to realise its full potential, the issue of equality, (Cochrane's third 'E'), should be reconsidered.