# Narrative Review of Emergency Medicine Clinical Research Examining Exclusion by Language

## TL;DR

This paper reviews emergency medicine studies and finds that over half exclude patients who prefer languages other than English.

## Contribution

The study quantifies the exclusion of non-English language patients in emergency medicine clinical research from 2018–2023.

## Key findings

- 58% of eligible studies excluded non-English language preferred patients.
- 69% of interventional studies excluded non-English language preferred patients.
- 47% of health equity-focused studies excluded non-English language preferred patients.

## Abstract

Over 20% of the United States population speaks a language other than English, and many use the emergency department (ED) to access healthcare. However, there remains concern that patients preferring languages other than English are under-represented in clinical research. Thus, our goal was to assess the proportion of ED studies that excluded patients for recruitment due to language.

We conducted a narrative review using seven search engines for 2018–2023. We included studies if they mentioned language of participants and prospectively enrolled patients in an ED or prehospital setting. We excluded studies if they only included patients <18 years and/or were conducted exclusively outside the US. Two independent reviewers reviewed studies. Analyses included descriptive statistics.

Of the 10,513 studies we identified, 281 were eligible for review; 163 (58%) excluded non-English language preferred (NELP) patients. Among the 107 interventional studies, 69% excluded NELP patients. Of the 135 studies focused on health equity/social emergency medicine, 47% excluded NELP patients.

We found 163 (58%) studies conducted in the ED that mention language and excluded NELP patients. Additional work is needed to encourage and support inclusive study designs.