Simons-Morton Denise G, Chan Jeffrey C, Kimel Angela R, Linz Peter E, Stowe Cynthia L, Summerson John, Ambrosius Walter T
Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, 2701 Rockledge Drive, Bethesda, MD 20892, USA.
Division of Public Health Sciences, Wake Forest School of Medicine, Medical Center Blvd., Winston-Salem, NC 27157, USA.
Contemp Clin Trials. 2014 Jan;37(1):155-64. doi: 10.1016/j.cct.2013.12.002. Epub 2013 Dec 17.
Prior studies found that some groups have lower genetic consent rates than others. Participant consent for genetic studies enables randomized trials to examine effects of interventions compared to control in participants with different genotypes.
Unadjusted and multivariate associations between genetic consent rates and participant, study, and consent characteristics in 9573 participants approached for genetics consent in the multicenter Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial, which used a layered genetics consent.
Eighty-nine percent of eligible participants consented to genetic studies ("Any Consent") and 64.7% consented to studies of any genes by any investigator ("Full Consent"), with similar rates in randomized groups. Controlling for multiple characteristics, African-Americans had lower consent rates than others (Any Consent Odds Ratio, OR = 0.62, p = 0.0004; Full Consent OR = 0.67, p < 0.0001). Those with high school or higher education level had higher rates than less than high school graduates (Full Consent ORs 1.41-1.69, p-values < 0.0001). Consent rates were lower when genetics consent was separate from the main trial consent on the same day (Any Consent OR 0.30; Full Consent OR 0.52, p values < 0.0001) or on a subsequent day (Any Consent OR 0.70, p = 0.0022; Full Consent OR 0.76, p = 0.0002).
High rates of consent for genetic studies can be obtained in complex randomized trials, with lower consent rates in African-Americans, in participants with less than high-school education, and for sharing samples with other investigators. A genetics consent separated from the main trial consent was associated with lower consent rates.
先前的研究发现,某些群体的基因研究同意率低于其他群体。参与者对基因研究的同意使得随机试验能够在不同基因型的参与者中检验干预措施与对照相比的效果。
在多中心糖尿病心血管风险控制行动(ACCORD)试验中,对9573名被邀请进行基因同意的参与者,分析基因同意率与参与者、研究及同意特征之间的未调整和多变量关联,该试验采用分层基因同意。
89%的符合条件的参与者同意进行基因研究(“任何同意”),64.7%的参与者同意任何研究者对任何基因进行研究(“完全同意”),随机分组中的同意率相似。在控制多种特征后,非裔美国人的同意率低于其他群体(任何同意的优势比,OR = 0.62,p = 0.0004;完全同意OR = 0.67,p < 0.000)。高中或更高教育水平的参与者同意率高于高中以下学历者(完全同意的OR为1.41 - 1.69,p值 < 0.0001)。当基因同意与同一天的主要试验同意分开(任何同意OR 0.30;完全同意OR 0.52,p值 < 0.0001)或在随后一天(任何同意OR 0.70,p = 0.0022;完全同意OR 0.76,p = 0.0002)时,同意率较低。
在复杂的随机试验中可以获得较高的基因研究同意率,非裔美国人、高中以下学历的参与者以及与其他研究者共享样本的同意率较低。与主要试验同意分开的基因同意与较低的同意率相关。