{
  "abstract": "Introduction Robotic surgery has been widely adopted across surgical specialties since its introduction in the 1980s, making it important to assess the representation of patients from varying demographic backgrounds in clinical trials. The objective of this study was to evaluate the demographic representativeness of randomised controlled trials (RCTs) on robotic surgery.Research Design and Methods This systematic review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. PubMed, Embase and Web of Science databases were searched for English-language RCTs conducted between January 2000 and December 2022. Only RCTs that enrolled participants of both sexes and compared robotic surgery with a non-robotic comparator were included. Primary outcomes included the reporting of participants’ demographic information, specifically sex, age, race and ethnicity, the inclusion of subgroup analyses based on these demographics and the distribution of demographics within each study.Results Out of 75 RCTs, 71 (95%) trials reported participant sex, 73 (97%) RCTs reported age and four (5%) RCTs reported race or ethnicity. Six (8%) RCTs provided sex-specific results, three (4%) RCTs provided age-specific outcomes and no RCTs reported outcomes based on race or ethnicity. The average percentage of female patients per RCT was 47.1% and the average age was 59.7 (SD=9) years. Of the RCTs that reported race or ethnicity, 59.5% of the population was Caucasian, 25.0% was Hispanic, 13.9% was African American and 1.6% was Asian/Pacific Islander/other.Conclusions There was underreporting of demographic data, especially race and ethnicity of participants, a lack of demographic-specific study outcomes and underrepresentation of women and non-white participants across RCTs. This study highlights the need for greater efforts to improve diversity in robotic surgery clinical trials.",
  "authors": [
    {
      "affiliations": [
        "University of California San Francisco Department of Medicine, San Francisco, California, USA"
      ],
      "name": "Sara Varadharajulu"
    },
    {
      "affiliations": [
        "The University of Chicago Pritzker School of Medicine, Chicago, Illinois, USA"
      ],
      "name": "Robin Ji"
    },
    {
      "affiliations": [
        "Department of Medicine, Section of Cardiology, San Francisco VA Medical Center, San Francisco, California, USA",
        "University of California San Francisco Philip R Lee Institute for Health Policy Studies, San Francisco, California, USA"
      ],
      "name": "Sanket Dhruva"
    },
    {
      "affiliations": [
        "Department of Epidemiology and Biostatistics, University of California San Francisco School of Medicine, San Francisco, California, USA"
      ],
      "name": "John Neuhaus"
    },
    {
      "affiliations": [
        "Optum Center for Research and Innovation, Optum Health LLC, Eden Prairie, Minnesota, USA"
      ],
      "name": "Ken Cohen"
    },
    {
      "affiliations": [
        "University of California San Francisco Philip R Lee Institute for Health Policy Studies, San Francisco, California, USA",
        "Division of Cardiology, University of California San Francisco Department of Medicine, San Francisco, California, USA"
      ],
      "name": "Rita Redberg"
    }
  ],
  "title": "Representation in robotic surgery randomised controlled trials: a systematic review",
  "uid": "c9b128d2-792d-5e89-9aa3-3bc5cb3f43f1"
}