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Addressing the language barriers to inclusion in paediatric emergency medicine research
  1. Hannah Walsh1,
  2. Silothabo Dliso2,
  3. Shrouk Messahel1
  1. 1Department of Paediatric Emergency Medicine, Alder Hey Children’s NHS Foundation Trust, Liverpool, UK
  2. 2Department of Paediatric Research, Alder Hey Children’s NHS Foundation Trust, Liverpool, UK
  1. Correspondence to Dr Shrouk Messahel, Emergency Department, Alder Hey Children's Hospital, Liverpool, L12 2AP, UK; Shrouk.Messahel{at}

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There are many challenges to ensuring good representation within a research study, one such challenge is spoken language.1 In countries where the primary spoken language is English, such as the UK, it has been observed that people who require translation services are frequently excluded from participating in research studies.2–5

The implications of language-based exclusion in research are that essential data could be missed; including how different groups of people present clinically in relation to disease, or differences in responsivity to treatments.6–9 Exclusion based on language ability has the potential to lead to greater disparities in health outcomes, as well as limiting the generalisability of the study outcomes.9 In addition, children from households that express limited comfort with communication in English are more likely to experience higher communication-related adverse events, medical errors and mortality.10–12

Paediatric emergency departments are ideal environments from which to recruit people for health research. They facilitate recruitment at first presentation as well as the recruitment of people who are not ultimately admitted or who may not require follow-up within the hospital.13 They act as the interface between primary and secondary care, and are a vital safety net.14 Emergency departments are potentially the area where there is the most diversity in a single healthcare setting regarding demographics of people and the conditions and severity they may present with.13

Research practices regarding language inclusivity in paediatric emergency medicine (PEM) research are not well documented. Moreover, there is limited data regarding exclusion from research based on language ability in general medical literature in the UK. Here, we explore current research to identify practices around language inclusivity in research, and what challenges researchers face including people requiring translation services.

Evidence of problem

English language skill has been shown to be a valid indicator of health status …

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  • Twitter @shroukmessahel

  • Contributors SM conceived the idea. HW and SD wrote the manuscript with SM oversight. All authors reviewed the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Commissioned; externally peer reviewed.