University of Texas Southwestern Medical Center, Dallas, TX.
J Oncol Pract. 2012 Mar;8(2):91-6. doi: 10.1200/JOP.2011.000335. Epub 2011 Dec 6.
Low rates of participation in cancer clinical trials have been attributed to patient, institutional, and study characteristics. However, few studies have examined factors related to the consent process. We therefore evaluated the impact of consent timing and experience on markers of patient interest in research.
We performed a retrospective analysis of patients enrolled in a cancer center tissue repository. During enrollment, patients were asked if they were willing to be contacted in the future to provide medical follow-up information and/or to participate in other clinical research. We analyzed the association between patient responses to these questions and consent process factors using univariate analysis and multivariate logistic regression.
Of 922 patients evaluated, 85% agreed to be contacted to provide follow-up information, and 83% agreed to be contacted to participate in future research studies. In univariate analysis, willingness to be contacted for future research was associated with consenter experience (P = .01) and had a trend toward association with the timing of enrollment in relation to diagnosis (P = .08), but it was not associated with patient sex, race, or diagnosis. In multivariate analysis, responses remained associated with consenter experience (P = .02).
Factors related to the consent process, including consenter experience and timing of study enrollment, are significantly associated with or have a trend toward association with markers of patient interest in clinical research. These understudied and potentially modifiable variables warrant further evaluation.
参与癌症临床试验的比例较低,其原因可归咎于患者、机构和研究特征。然而,很少有研究探讨与同意过程相关的因素。因此,我们评估了同意时机和经验对研究中患者兴趣标志物的影响。
我们对癌症中心组织库中入组的患者进行了回顾性分析。在入组期间,询问患者是否愿意在未来被联系以提供医疗随访信息和/或参与其他临床研究。我们使用单变量分析和多变量逻辑回归分析了患者对这些问题的反应与同意过程因素之间的关联。
在评估的 922 名患者中,85%的患者同意在未来被联系以提供随访信息,83%的患者同意在未来被联系以参与其他研究。单变量分析表明,愿意在未来被联系进行研究与同意者的经验有关(P=0.01),且与入组时与诊断的时间有关(P=0.08)有趋势相关,但与患者性别、种族或诊断无关。在多变量分析中,反应仍与同意者的经验有关(P=0.02)。
与同意过程相关的因素,包括同意者的经验和研究入组的时间,与患者对临床研究兴趣的标志物显著相关或有趋势相关。这些研究较少且潜在可改变的变量值得进一步评估。