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Exclusion of Non-English Speakers in Published Emergency Medicine Research - A Comparison of 2004 and 2014

Micheal Brodeur, John Herrick, Jose Guardioloa, Peter Richman.


Background: Non-English speakers (NES) as a proportion of the United States population have steadily increased in recent years. There remains substantial risk of excluding NES from research. Objective: To assess whether the percentage of emergency medicine (EM) studies that exclude Non-English speakers from participation has changed with time. Methods: In a structured fashion, the lead investigator analyzed all original research articles in Academic Emergency Medicine and Annals of Emergency Medicine retrospectively for 2004 and prospectively for 2014. An independent investigator conducted a blind review of a sample of articles to assess for interobserver agreement. Demographic data were analyzed using descriptive statistics. Chi-square, t-tests, and linear regression models were utilized; alpha set at 0.05. Cohen’s kappa calculated to assess interrater reliability. Results: We included a total of 236 original research articles. Overall, 11% excluded NES from research (10% AEM, 12% Annals). Cohen’s kappa (nonweighted) was 0.73. Comparing all articles in 2004 vs. 2014, research excluded NES 6% vs. 16% of the time respectively (P=0.02). This was not statistically significant when comparing year to year for AEM (7.3% vs. 14.5%; P=0.12) and Annals (6.7% vs. 19%; P=0.06) separately. Factors affecting NES exclusion included type of study design (P

Key words: non-English speakers, Emergency Medicine Research.

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