Comis Robert L, Miller Jon D, Aldigé Carolyn R, Krebs Linda, Stoval Ellen
Coalition of National Cancer Cooperative Groups, Philadelphia, PA 19103, USA.
J Clin Oncol. 2003 Mar 1;21(5):830-5. doi: 10.1200/JCO.2003.02.105.
The objective of this study is to understand the attitudes of American adults toward participation in cancer clinical trials.
A national probability sample of 1,000 adults aged 18 and older living in noninstitutional settings was interviewed by telephone by Harris Interactive during March and April 2000. One participant was selected from each household selected for the study. The resulting data were weighted to reflect the full adult population of the United States as reported in Current Population Reports. An Index of Participation in a Cancer Clinical Trial was computed, using a confirmatory factor analysis and converting the factor scores into a 0-to-100 scale.
Approximately 32% of American adults (64 million individuals) indicate that they would be very willing to participate in a cancer clinical trial if asked to do so. An additional 38% of adults (76 million individuals) scored in a range that indicates that they are inclined to participate in a cancer clinical trial if asked, but hold some questions or reservations about participation. Projected rates of diagnosis, eligibility, and recruitment indicate that substantially more patients are willing to participate than are actually accrued.
These results indicate that the primary problem with accrual is not the attitudes of patients, but rather that the loss of potential participants is the result of the unavailability of an appropriate clinical trial and the disqualification of large numbers of patients. The pool of willing patients is further reduced by the reluctance of some physicians to engage in accrual.
本研究的目的是了解美国成年人对参与癌症临床试验的态度。
2000年3月至4月期间,哈里斯互动公司通过电话对1000名居住在非机构环境中的18岁及以上成年人进行了全国概率抽样访谈。从入选研究的每个家庭中选取一名参与者。对所得数据进行加权,以反映《当前人口报告》中所报告的美国全部成年人口情况。使用验证性因素分析计算癌症临床试验参与指数,并将因素得分转换为0至100的量表。
约32%的美国成年人(6400万人)表示,如果被要求参与癌症临床试验,他们会非常愿意。另外38%的成年人(7600万人)得分表明,如果被邀请,他们倾向于参与癌症临床试验,但对参与持有一些疑问或保留意见。预计的诊断、资格和招募率表明,愿意参与的患者比实际招募的患者多得多。
这些结果表明,招募的主要问题不是患者的态度,而是潜在参与者的流失是由于缺乏合适临床试验以及大量患者被取消资格所致。一些医生不愿参与招募,这进一步减少了愿意参与的患者群体。