Division of Pharmaceutical Outcomes and Policy, UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
Department of Biostatistics, Virginia Commonwealth University, Richmond, Virginia, USA.
J Am Med Inform Assoc. 2019 Dec 1;26(12):1637-1644. doi: 10.1093/jamia/ocz157.
We describe the use of an online patient portal to recruit and enroll primary care patients in a randomized trial testing the effectiveness of a colorectal cancer (CRC) screening decision support program. We use multiple logistic regression to identify patient characteristics associated with trial recruitment, enrollment, and engagement. We found that compared to Whites, Blacks had lower odds of viewing the portal message (OR = 0.46, 95% CI = 0.37-0.57), opening the attached link containing the study material (OR = 0.75, 95% CI = 0.62-0.92), and consenting to participate in the trial (OR = 0.85, 95% CI = 0.67-0.93). We also found that compared to Whites, Asians had lower odds of viewing the portal message (OR = 0.53, 95% CI = 0.33-0.64), opening the attached link containing the study material (OR = 0.76, 95% CI = 0.54-0.97), consenting to participate in the trial (OR = 0.68, 95% CI = 0.53-0.95), and completing the trial's baseline questionnaire (OR = 0.59, 95% CI = 0.36-0.90). While portals offer an opportunity to mitigate human bias in trial invitations, because of racial disparities-not only in who has a portal account, but in how they interact with trial recruitment and enrollment material within the portal-using portals alone for trial recruitment may generate study samples that are not racially diverse.
我们描述了一种使用在线患者门户来招募和纳入初级保健患者参加一项随机试验的方法，该试验测试了一种结直肠癌（CRC）筛查决策支持计划的有效性。我们使用多项逻辑回归来确定与试验招募、纳入和参与相关的患者特征。我们发现，与白人相比，黑人查看门户消息的可能性较低（OR=0.46，95%CI=0.37-0.57），打开包含研究材料的附件链接的可能性较低（OR=0.75，95%CI=0.62-0.92），以及同意参与试验的可能性较低（OR=0.85，95%CI=0.67-0.93）。我们还发现，与白人相比，亚洲人查看门户消息的可能性较低（OR=0.53，95%CI=0.33-0.64），打开包含研究材料的附件链接的可能性较低（OR=0.76，95%CI=0.54-0.97），同意参与试验的可能性较低（OR=0.68，95%CI=0.53-0.95），以及完成试验基线问卷的可能性较低（OR=0.59，95%CI=0.36-0.90）。虽然门户提供了一个机会，可以减轻试验邀请中的人为偏见，但由于种族差异——不仅表现在谁拥有门户账户，还表现在他们如何在门户内与试验招募和纳入材料互动——仅使用门户进行试验招募可能会产生种族多样性不足的研究样本。
