A study published in 2018 in the Milbank Quarterly, a peer-reviewed policy journal, investigated whether studies reviewed by the FDA for high-risk medical devices are proven safe and effective for women, minorities, or patients over 65 years of age.[43] The law encourages patient diversity in clinical trials submitted to the FDA for review. The study determined that most high-risk medical devices are not tested and analyzed to ensure that they are safe and effective for all major demographic groups. Therefore, they do not provide information about safety or effectiveness that would help patients and physicians make well informed decisions.