Advocacy, Economics, and Health Policy

Geographical Accessibility of Interventional Radiology Clinical Trials

Location: Concourse Foyer Kiosk

First Author(s)

NJ

Nathan Ji, BS

Medical Student
Icahn School of Medicine at Mount Sinai
New York, New York, United States

Co-Author(s)

DA

Dany Alkurdi, AB

Medical Student
Icahn School of Medicine at Mount Sinai, United States
JK

Josh Kim, BS

Medical Student
Icahn School of Medicine at Mount Sinai, United States
AS

Arvind Sommi, BS

Medical Student
Icahn School of Medicine at Mount Sinai, United States
EA

Ezdean Alkurdi, BS

Medical Student
UMass Chan Medical School, United States
KG

Kirema Garcia-Reyes, MD

Assistant Professor of Radiology
Icahn School of Medicine at Mount Sinai, United States

Purpose: Interventional radiology (IR) is rapidly expanding, yet equitable participation in clinical trials remains limited. Geographic and demographic disparities in access may undermine representation and trial validity. This study evaluates trends in accessibility of IR clinical trials across urban–rural settings and racial groups in the United States.

Methods/Materials: U.S.-based IR clinical trials registered on ClinicalTrials.gov (2005–2024) were retrospectively analyzed. Trial site ZIP codes were linked to U.S. Census Bureau demographic and geographic data. Distances from census ZIP codes to the nearest trial site were calculated using geospatial methods. Accessibility was compared across Rural–Urban Commuting Area (RUCA) categories and racial groups using regression models and independent t-tests.

Results: A total of 1,828 trials across 542 ZIP codes were included. Trial availability increased modestly over time (slope = 1.6 trials/year, p = 0.022). Average distance to the nearest trial decreased by 3.19 km/year (p = 0.011), yet disparities persisted. Metropolitan residents lived within ~50 km of a trial site, compared with >110 km for rural residents (all RUCA comparisons, p < 0.0001). Racial differences were also significant: Asians had the shortest distances (16 km in metropolitan areas), while American Indians had the greatest (>160 km across all RUCA categories). Pairwise comparisons showed significance for whites vs. Blacks (p = 0.0090), whites vs. American Indians (p = 0.0040), and whites vs. other races (p = 0.0200).

Conclusions: While the number of clinical trials and overall accessibility have improved, inequities persist for rural residents and American Indian populations. Race and geography jointly influence access burdens, underscoring the need for trial expansion beyond academic centers into community and private practice settings. Strategic trial placement is essential to ensure equitable participation and representation in IR research.