Etemadi, M. orcid.org/0000-0001-8523-1876, Macefield, R. orcid.org/0000-0002-6606-5427, Avery, K. orcid.org/0000-0001-5477-2418 et al. (12 more authors) (2026) Are equity, diversity and inclusion considered in early-phase studies evaluating innovative and developing surgical procedures? Protocol for a scoping review. BMJ Open, 16 (2). e112489. ISSN: 2044-6055
Abstract
Introduction
Increased risks and concerns regarding patient safety in early-phase studies exist because knowledge about the new intervention is still accumulating. This means that narrow eligibility criteria are needed. However, if early-phase studies are narrow in their inclusion, for example, by not including diverse populations, there is a potential risk that new therapies have insufficient relevant efficacy and safety data. Existing research has explored equity, diversity and inclusion (EDI) factors in early-phase pharmaceutical studies, but it has not been possible to find studies that have systematically examined whether EDI factors have been considered in surgical studies reporting innovative procedures. We aim to examine how EDI factors are considered in early-phase surgical studies and surgical innovation reports to explore how this may impact on later-phase evaluation and inclusive intervention implementation.
Methods and analysis
A scoping review following the JBI (Joanna Briggs Institute) and Arksey and O’Malley’s five-step process is being conducted. We will search Scopus, PubMed and Web of Science for surgical early-phase studies. A two-step screening process for eligibility is being used. Independent double screening will take place for 20% of the papers. Eligible articles will report early evaluation of an innovative surgical/invasive procedure. Excluded will be comparative and later-phase studies and early evaluations of pharmaceutical products even in a surgical setting. Data on article details, patient eligibility and whether protected characteristics are reported and considered will be extracted. Information about EDI considerations reported in the introduction or discussion of the papers will also be extracted. Findings will be discussed with a patient advisory group. A content synthesis approach will be undertaken and descriptive summaries presented.
Ethics and dissemination
This study does not require ethical approval being a secondary analysis. The findings will be disseminated through academic journal publications and oral presentations.
Metadata
| Item Type: | Article |
|---|---|
| Authors/Creators: |
|
| Copyright, Publisher and Additional Information: | © Author(s) (or their employer(s)) 2026. Re-use permitted under CC BY. Published by BMJ Group. https://creativecommons.org/licenses/by/4.0/ This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. |
| Dates: |
|
| Institution: | The University of Sheffield |
| Academic Units: | The University of Sheffield > Faculty of Medicine, Dentistry and Health (Sheffield) > School of Medicine and Population Health |
| Date Deposited: | 11 Feb 2026 10:35 |
| Last Modified: | 11 Feb 2026 10:35 |
| Status: | Published |
| Publisher: | BMJ |
| Refereed: | Yes |
| Identification Number: | 10.1136/bmjopen-2025-112489 |
| Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:237813 |
Download
Filename: e112489.full.pdf
Licence: CC-BY 4.0

CORE (COnnecting REpositories)
CORE (COnnecting REpositories)