Khalil Susan S, Silverman Henry J, Raafat May, El-Kamary Samer, El-Setouhy Maged
Ain Shams University, Cairo, Egypt.
BMC Med Ethics. 2007 Aug 29;8:9. doi: 10.1186/1472-6939-8-9.
Medical research must involve the participation of human subjects. Knowledge of patients' perspectives and concerns with their involvement in research would enhance recruitment efforts, improve the informed consent process, and enhance the overall trust between patients and investigators. Several studies have examined the views of patients from Western countries. There is limited empirical research involving the perspectives of individuals from developing countries. The purpose of this study is to examine the attitudes of Egyptian individuals toward medical research. Such information would help clarify the type and extent of concerns regarding research participation of individuals from cultural, economic, and political backgrounds that differ from those in developed countries.
We conducted semi-structured interviews with 15 Egyptian individuals recruited from the outpatient settings (public and private) at Ain Shams University in Cairo, Egypt. Interviews were taped, transcribed, and translated. Thematic analysis followed.
All individuals valued the importance of medical research; however most would not participate in research that involved more than minimal risk. Individuals were comfortable with studies involving surveys and blood sampling, but many viewed drug trials as being too risky. All participants valued the concept of informed consent, as they thought that their permission to be in a research study was paramount. Many participants had discomfort with or difficulty in the understanding several research concepts: randomization, double-blind, and clinical equipoise. Trust in the physicians performing research was important in deciding to participate in clinical research. The small sample size and the selection bias associated with obtaining information from only those who agreed to participate in a research study represent limitations in this study.
Overall, individuals in our sample recognize the value of medical research and have a great deal of trust regarding medical research and their participation in research. There were, however, concerns with the level of research risks associated with several types of medical research. Many also demonstrated confusion with certain research methodologies. We recommend 1) enhanced educational efforts regarding general research concepts to enhance the validity of informed consent and 2) further survey studies in other areas of Egypt to determine the generalizability of our results.
医学研究必须涉及人类受试者的参与。了解患者对参与研究的看法和担忧,将有助于提高招募效率,改进知情同意程序,并增强患者与研究者之间的整体信任。多项研究调查了西方国家患者的观点。涉及发展中国家个人观点的实证研究有限。本研究的目的是调查埃及个人对医学研究的态度。此类信息将有助于阐明来自与发达国家文化、经济和政治背景不同的个人在参与研究方面的担忧类型和程度。
我们对从埃及开罗艾因夏姆斯大学门诊(公立和私立)招募的15名埃及个人进行了半结构化访谈。访谈进行了录音、转录和翻译。随后进行了主题分析。
所有受访者都重视医学研究的重要性;然而,大多数人不会参与风险超过最低限度的研究。受访者对涉及调查和采血的研究感到放心,但许多人认为药物试验风险太大。所有参与者都重视知情同意的概念,因为他们认为参与研究必须得到他们的许可。许多参与者对几个研究概念感到不适或理解困难:随机化、双盲和临床 equipoise。对进行研究的医生的信任在决定参与临床研究中很重要。本研究的局限性在于样本量小以及仅从同意参与研究的人那里获取信息存在选择偏差。
总体而言,我们样本中的个人认识到医学研究的价值,并对医学研究及其参与研究有很大的信任。然而,他们对几种医学研究相关的风险水平存在担忧。许多人对某些研究方法也表现出困惑。我们建议:1)加强关于一般研究概念的教育工作,以提高知情同意的有效性;2)在埃及其他地区进行进一步的调查研究,以确定我们结果的普遍性。