Use of a Best Practice Alert (BPA) to Increase Diversity Within a US-Based Autism Research Cohort.
Gabrielle F Duhon, Andrea R Simon, Danica L Limon and 3 others
PMID 34997882WHAT IT FOUND
Placing a research-recruitment alert in five primary care clinics identified as many patients of color interested in an autism study as all 22 subspecialty clinics combined.
However, providers dismissed the alert more often for Hispanic patients and those with public insurance, suggesting potential bias in who gets offered research opportunities.
Key findings
01Five primary care practices identified nearly the same volume of Interested patients of color as all 22 subspecialty practices combined.
02Within primary care practices, the alert was dismissed significantly more often for Hispanic patients compared to non-Hispanic patients.
03Patients with public insurance in primary care practices had significantly lower rates of Interested responses compared to those with private insurance.
STILL TO COME
How it was doneWhat they found
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What it does not show
The study did not measure actual enrollment or completion rates, only initial interest and provider responses to the alert. The surveillance period overlapped with the onset of the COVID-19 pandemic, which disrupted healthcare visits and may have affected provider engagement and patient responsiveness. Small sample sizes within specific racial subgroups prevented meaningful comparisons by individual race, leading to a dichotomized 'White vs. families of color' analysis. The study relied on provider-reported responses to the BPA, which may be subject to selection bias or alert fatigue, particularly in subspecialty settings where the alert had been active longer. The BPA included a filter that prevented it from firing for patients requiring an interpreter, which may have systematically excluded non-English speaking families from the 'Interested' pool.
The easy way to misread this
Do not interpret the high number of 'Interested' patients in primary care as evidence that these families enrolled in the study. The paper reports provider responses to an alert, not actual study participation or completion rates.