Illuminating the shadows: a critical examination of Equity, Diversity, and Inclusion in a scoping review on SARS-CoV-2 testing strategies

Article type
Authors
Saif-Ur-Rahman K1, Movsisyan A2, Kothari K3, Conway T1, Tierney M1, Madden C1, Taneri P1, O'Halloran J4, Nurdin N5, Murphy L6, Mulholland D7, Tricco A8, Devane D1
1Evidence Synthesis Ireland And Cochrane Ireland, University Of Galway, Galway, Ireland
2Consultant to Methods and Standards Team, World Health Organization, Geneva, Switzerland
3Consultant to Library & Digital Information Networks, World Health Organization, Kobe, Japan
4UCD Centre for Experimental Pathogen Host Research (CEPHR), University College Dublin, Dublin, Ireland
5Royal College of Physicians, Dublin, Ireland
6Occupational Health, Healthy Workplace Unit, Dublin, Ireland
7Public Health, Health Service Executive, Dublin, Ireland
8Li Ka Shing Knowledge Institute, St.Michael's Hospital, Unity Health Toronto, Toronto, Canada
Abstract
Background: There is a significant gap in the representation of equity, diversity, and inclusion (EDI) characteristics within health research.
Objective: This study aims to highlight the critical role of incorporating EDI considerations into health-related research. It focuses on how these factors can affect health outcomes and the efficacy of interventions across diverse populations.
Methods: We employed the PRO-EDI (tools to help reviewers make equity, diversity, and inclusion assessments) criteria, a set of tools designed for equity, diversity, and inclusion assessments. The tool encompasses factors such as age, sex, gender, ethnicity, socioeconomic status, educational level, location, and other pertinent aspects. Our scoping review involved a detailed examination of randomised controlled trials, cohort studies, case-control studies, and cross-sectional studies.
Results: In this scoping review, we analysed 17 studies using the PRO-EDI framework, which was pivotal in identifying significant gaps in evidence from an EDI perspective. Our evaluation revealed a marked deficiency in EDI representation across the studies. Most provided data only on age and sex, with scant details on gender, ethnicity, socioeconomic status, educational levels, and geographical location (urban or rural). Notably, only seven studies mentioned participants' ethnicity, and a mere one study addressed socioeconomic status, emphasising a critical shortfall in representing diverse population groups. None of the studies included conducted analysis considering EDI-related variables.
The scarcity of thorough EDI reporting in primary research underscores the necessity of incorporating these aspects into research design and dissemination. Addressing these shortcomings enables researchers to develop a more inclusive and equitable body of evidence. Such an evidence base is vital for comprehending the diverse effects and results of interventions across various population groups. Furthermore, detailed analyses that contextualise EDI elements are essential to understand how findings differ in various contexts.
Conclusions: This study emphasises the vital necessity of incorporating EDI considerations into health-related research, essential for a thorough understanding of the impacts and outcomes on varied population groups. It is crucial to address these reporting gaps to devise inclusive and effective public health strategies and policies.