Fortun P, West J, Chalkley L, Shonde A, Hawkey C
Department of Gastroenterology, University Hospital Nottingham, UK.
QJM. 2008 Aug;101(8):625-9. doi: 10.1093/qjmed/hcn067. Epub 2008 May 16.
Information sheets for clinical research are becoming increasingly complex but the extent to which they are understood is uncertain.
To assess, as our primary outcome, recall by healthy volunteers of key facts in a patient information sheet in a phase 3 clinical trial. As secondary outcomes, we examined whether there was a difference between medical student and non-medically trained volunteers.
Questionnaire to determine recall by healthy volunteers of informed consent information.
Eighty-two healthy volunteers participating in a capsule endoscopy study were given a 13 page written information sheet and allowed to asked questions. After indicating they were ready to give consent they were asked to complete a 6-item questionnaire covering the identity and adverse effects of trial treatments and of the procedure, the duration of the trial and value of the inconvenience allowance.
All 82 healthy volunteers were questioned. Of the volunteers, 74 (90%) had university level education and 49 (60%) were clinical medical students. However, only 10 subjects (12%) could name the three trial drugs. The maximum number of risks remembered was 6 (n = 2) of 23. Only 14 (17%) could name three or more potential risks of the medication they might be exposed to, whilst 17 (20%) could identify none. Most subjects (77/82, 90%) identified capsule endoscopy as the trial procedure and impaction/obstruction as its main risk (52/82, 64%). All but one subject (98.8%) could recall the exact value of the inconvenience payment.
A comprehensive information sheet resulted in limited recall of trial risks. Shorter information sheets with a test and feedback session should be trialled so that informed consent becomes valid informed consent.
临床研究的信息表正变得日益复杂,但人们对其理解程度尚不确定。
作为主要结果,评估健康志愿者在一项3期临床试验中对患者信息表中关键事实的记忆情况。作为次要结果,我们研究了医学生志愿者和未接受医学培训的志愿者之间是否存在差异。
通过问卷调查确定健康志愿者对知情同意信息的记忆情况。
82名参与胶囊内镜检查研究的健康志愿者收到一份13页的书面信息表,并可提问。在表示准备好同意后,他们被要求完成一份包含6个项目的问卷,内容涉及试验治疗和程序的性质及不良反应、试验持续时间以及不便津贴的金额。
对所有82名健康志愿者进行了询问。其中74名(90%)志愿者具有大学学历,49名(60%)是临床医学生。然而,只有10名受试者(12%)能说出三种试验药物的名称。记住的风险最多为23项中的6项(n = 2)。只有14名(17%)受试者能说出他们可能接触的药物的三种或更多潜在风险,而17名(20%)受试者一项也说不出。大多数受试者(77/82,90%)能说出胶囊内镜检查是试验程序,且堵塞/梗阻是其主要风险(52/82,64%)。除一名受试者外,所有受试者(98.8%)都能回忆起不便津贴的确切金额。
一份全面的信息表导致对试验风险的记忆有限。应尝试使用配有测试和反馈环节的更简短信息表,以使知情同意成为有效的知情同意。