POS1467-HPR DEMOGRAPHIC DISPARITIES: A COMPARATIVE ANALYSIS OF RESEARCH COHORT VS. CLINIC POPULATION REPRESENTATIVENESS WITHIN RHEUMATOLOGY
Authors: G. Buss, E. Hawkins, S. Kale, Y. Ahmed, R. Wilson, L. Tomson, R. Taylor Gotch, M. Castelino
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> The National Institute of Health and Care Research (NIHR) Equality, Diversity and Inclusion strategy has called for the widening of access and participation within research. In response to this we previously presented a cross-sectional analysis of a random dataset of 10,000 patients seen by the Rheumatology service at University College London Hospital (UCLH), accessed from the Electronic Health Record (EHS) system implemented in 2019 (Ahmed <i>et al.</i>, 2023). To explore our previous findings suggestive of disparity between gender and age, we carried out a further comprehensive analysis of all patients under the care of the rheumatology outpatient service. <h3>Objectives:</h3> 1.Compare demographic identifiers of the complete rheumatology patient cohort against those who have participated in rheumatology research at UCLH. 2.Determine significant disparities between cohorts. <h3>Methods:</h3> Using the EHS we ran a report to identify patients who had attended outpatient care from the rheumatology service since 2019. Ethnicity, age-group, gender, postcode, and research status were collected and categorised. Postcode was associated with a Multiple Disparity Index (MDI) score (imd-by-postcode, 2019), a government tool scoring from 1 (most deprived) to 10 (least deprived).We compared the whole clinic population to the research cohort. A descriptive analysis was carried out and statistical analysis using z-score comparison (cZ) and one-way ANOVA test. <h3>Results:</h3> 23,891 patients were identified using the EHS in the given time period with 3,639 of those being research participants (15.28%). There was no significant disparity between the two groups in terms of sex (general cohort: 33% male, 63% female vs. research cohort: 35% male, 65% female; cZ = &lt;1). Patients from lower MDI scoring postcodes were represented in higher proportions in the research group than those from higher MDI scoring postcodes (see Figure 1). When age distribution was considered, this was similar across most categories of age groups except those in the 25-44yrs age range (see Figure 2). <h3>Conclusion:</h3> In comparison to our previous analysis (Ahmed et al., 2023) we noted that the complete cohort was 5.38% more research active with more representation from the lower MDI scoring postcodes. In addition the results from the complete cohort suggest there is a significant over representation of a younger age range in comparison to the clinic cohort. The majority of studies at UCLH are observational, therefore our results may not be reflective of what would be observed in a predominantly interventional research cohort. The majority of literature surrounds participation in CTIMP studies rather than observational studies. However, in relation to our findings we would need to explore the possibility of researcher bias in approach and selection of participants, as well as study design, as contributing factors to observed disparity. <h3>REFERENCES:</h3> [1] https://imd-by-postcode.opendatacommunities.org/imd/2019, last accessed on 01 November 2023. [2] Ahmed Y., Hawkins E., Wilson R, J'bari H., Tomson L, Taylor Gotch R, Butt M, Castelino M (2023). Characterisation of Research Participants: A Preliminary Exploration Using Electronic Patient Case Record (EPCR) [Poster Presentation]. European Alliance of Associations for Rheumatology Conference 2023, Milan, Italy. <h3>Acknowledgements:</h3> The UCH Electronic Health Record team who maintain and upgrade the system, and their assistance in audit reporting. All the patients who have participated in research at UCH. <h3>Disclosure of Interests:</h3> <b>None declared.</b>