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同意的时机和体验:可能影响对临床研究兴趣的可改变因素。

Consent timing and experience: modifiable factors that may influence interest in clinical research.

机构信息

University of Texas Southwestern Medical Center, Dallas, TX.

出版信息

J Oncol Pract. 2012 Mar;8(2):91-6. doi: 10.1200/JOP.2011.000335. Epub 2011 Dec 6.

DOI:10.1200/JOP.2011.000335
PMID:23077435
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3457835/
Abstract

PURPOSE

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.

METHODS

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.

RESULTS

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).

CONCLUSION

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.

摘要

目的

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。

方法

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。

结果

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)。

结论

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。

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本文引用的文献

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The impact of consenter characteristics and experience on patient interest in clinical research.同意者的特征和经验对患者参与临床研究兴趣的影响。
Oncologist. 2009 May;14(5):468-75. doi: 10.1634/theoncologist.2008-0268. Epub 2009 Apr 28.
2
The length of consent documents in oncological trials is doubled in twenty years.肿瘤学试验中知情同意书的长度在二十年内增加了一倍。
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Influence of clinical communication on patients' decision making on participation in clinical trials.临床沟通对患者参与临床试验决策的影响。
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Cancer. 2008 Jan 1;112(1):212-9. doi: 10.1002/cncr.23170.
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A short communication course for physicians improves the quality of patient information in a clinical trial.一门面向医生的短期沟通课程提高了临床试验中患者信息的质量。
Acta Oncol. 2007;46(1):42-8. doi: 10.1080/02841860600849067.
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Who enrolls onto clinical oncology trials? A radiation Patterns Of Care Study analysis.哪些人会参加临床肿瘤学试验?一项放射治疗模式护理研究分析。
Int J Radiat Oncol Biol Phys. 2007 Jul 15;68(4):1145-50. doi: 10.1016/j.ijrobp.2007.01.051. Epub 2007 Apr 9.
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Efficacy of communication skills training for giving bad news and discussing transitions to palliative care.沟通技巧培训在传达坏消息及讨论向姑息治疗过渡方面的效果。
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Provider roles in the recruitment of underrepresented populations to cancer clinical trials.医疗服务提供者在招募代表性不足人群参与癌症临床试验中的角色。
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Factors influencing inclusion of patients with malignancies in clinical trials.影响恶性肿瘤患者纳入临床试验的因素。
Cancer. 2006 Jan 15;106(2):258-70. doi: 10.1002/cncr.21613.