Marginalized racial and ethnic groups, women, and other historically disenfranchised populations are substantially underrepresented in clinical trials, despite increasing concern about this issue among policymakers, patient advocates, and some industry leaders. A recent report from the National Academies of Sciences, Engineering, and Medicine (NASEM) brought additional, much-needed attention to this problem and suggested a number of reforms to the clinical research enterprise.1 But interest and investment in efforts to improve diversity and representativeness in trials are unlikely to be sustained if the goals of diversification aren't clearly articulated and understood.
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