African Representation in Randomized Controlled Trials Published in Leading Medical and Cardiovascular Journals, 2019-2024.

In this study, we sought to quantify African representation in RCTs published from 2019 to 2024 in: 1) 5 leading general medical journals; and 2) 3 leading CV journals.

在这项研究中，我们旨在量化2019年至2024年间在以下两个领域发表的RCTs中非洲的代表性：1）5种领先的综合医学期刊；以及2）3种领先的CV期刊。

Methods

We conducted a systematic reviewof RCTs published from 2019 to 2024 in the British Medical Journal, the Journal of the American Medical Association, The Lancet, Nature Medicine, and the New England Journal of Medicine, and in Circulation, the European Heart Journal, and the Journal of the American College of Cardiology.

我们对2019年至2024年间在《英国医学杂志》、《美国医学会杂志》、《柳叶刀》、《自然医学》和《新英格兰医学杂志》以及在《循环》、《欧洲心脏杂志》和《美国心脏病学会杂志》上发表的随机对照试验(RCTs)进行了系统综述。

Eligible studies included traditional, pragmatic, cluster, and stepped-wedge RCTs.

符合条件的研究包括传统、实用、群组和阶梯式RCTs。

African representation was assessed by trial scope (Africa-only vs multicontinental), country and regional participation, disease category, and African authorship.

通过试验范围（仅限非洲与多大陆）、国家和区域参与、疾病类别以及非洲作者身份来评估非洲代表性的表现。

Results

Among 2,138 RCTs published in leading general medical journals, only 83 (3.9%) were conducted exclusively in Africa, and 195 (9.1%) were multicontinental studies including at least 1 African site.

在主要普通医学期刊上发表的2,138项随机对照试验中，仅83项（3.9%）是在非洲单独进行的，另外195项（9.1%）是包括至少一个非洲站点的多大陆研究。

In the CV journals, 2 out of 334 RCTs (0.6%) were conducted exclusively in Africa, and African sites were included in only 9 multicontinental trials (2.7%).

在心血管期刊中，334项随机对照试验（RCTs）中有2项（0.6%）仅在非洲进行，而非洲地点仅包括在9个多大陆试验（2.7%）中。

South Africa accounted for the majority of Africa-based RCTs across both journal categories.

南非在两个期刊类别中均占据了非洲基础RCTs的大多数。

Regionally, southern Africa predominated and central Africa was minimally represented.

从地区上看，南部非洲占主导地位，中部非洲的代表性最小。

Trials published in general medical journals and conducted exclusively in Africa largely focused on infectious diseases (n = 63; 75.9%), with only 3 addressing cardiovascular disease (CVD).

在综合医学期刊上发表并在非洲专门进行的试验主要集中在传染病(n = 63; 75.9%)，只有3个研究涉及心血管疾病(CVD)。

In contrast, Africa-including multicontinental trials more frequently investigated noncommunicable diseases, including CVD.

相比之下，包括多大陆试验在内的非洲研究更频繁地调查了非传染性疾病，包括心血管疾病（CVD）。

African leadership was common in Africa-only trials but rare in multicontinental studies.

非洲领导在仅限非洲的试验中很常见，但在多大陆研究中却很少见。

Conclusions

African countries are profoundly underrepresented in RCTs published in the world's most influential medical and CV journals.

在世界最权威的医学和心血管期刊发表的随机对照试验（RCTs）中，非洲国家的代表性严重不足。

Addressing this imbalance requires expanding African participation in global trials, investing in local research capacity, and promoting equitable leadership to strengthen the relevance and validity of clinical evidence.

解决这一不平衡需要扩大非洲在全球试验中的参与度，投资于当地的研究能力，并促进公平的领导力，以加强临床证据的相关性和有效性。

(Underrepresentation of African Countries in Randomized Controlled Trials: A Systematic Reviewof Leading General Medical and Cardiovascular Journals; CRD42024603157).

(随机对照试验中非洲国家的代表性不足：对主要普通医学和心血管期刊的系统评价; CRD42024603157).