Institute of Cancer Research, London, UK
Drug Development Unit, Royal Marsden Hospital Sutton, London, UK.
BMJ Open. 2021 Sep 6;11(9):e049217. doi: 10.1136/bmjopen-2021-049217.
Early phase cancer clinical trials have become increasingly complicated in terms of patient selection and trial procedures-this is reflected in the increasing length of participant information sheets (PIS). Informed consent for early phase clinical trials has been contentious due to the potential ethical issues associated with performing experimental research on a terminally ill population which has exhausted standard treatment options. Empirical studies have demonstrated significant gaps in patient understanding regarding the nature and intent of these trials. This study aims to test whether enhanced informed consent for patient education can improve patient scores on a validated questionnaire testing clinical trial comprehension.
This is a randomised controlled trial that will allocate patients who are eligible to participate in one of four investigator-initiated clinical trials at the Royal Marsden Drug Development Unit to either a standard arm or an experimental arm, stratified by age and educational level. The standard arm will involve the full length trial PIS, followed by electronic or paper administration of the Quality of Informed Consent Questionnaire Parts A and B (QuIC-A and QuIC-B). The experimental arm will involve the full length trial PIS, exposure to a two-page study aid and 10 online educational videos, followed by administration of the QuIC-A and QuIC-B. The primary endpoint will be the difference (using a one-sided two-sample t-test) in the QuIC-A score, which measures objective understanding, between the standard and experimental arm. Accrual target is at least 17 patients per arm to detect an 8 point difference (80% power, alpha 0.05).
Ethics approval was granted by the National Health Service Health Research Authority on 15 June 2020-IRAS Project ID 277065, Protocol Number CCR5165, REC Reference 20/EE/0155. Results will be disseminated via publication in a relevant journal.
NCT04407676; Pre-results.
在患者选择和试验程序方面,早期癌症临床试验变得越来越复杂——这反映在参与者信息表(PIS)的长度不断增加上。由于对已经用尽标准治疗方案的晚期绝症患者进行实验性研究可能涉及到潜在的伦理问题,因此早期临床试验的知情同意一直存在争议。实证研究表明,患者在理解这些试验的性质和目的方面存在明显差距。本研究旨在检验增强患者教育的知情同意是否能提高患者在测试临床试验理解的有效问卷上的得分。
这是一项随机对照试验,将符合条件的患者分配到皇家马斯登药物开发单位的四项研究者发起的临床试验中的任意一项,分为标准组或实验组,根据年龄和教育水平分层。标准组将涉及完整的试验 PIS,随后进行电子或纸质的知情同意问卷 A 部分和 B 部分(QuIC-A 和 QuIC-B)的管理。实验组将涉及完整的试验 PIS,接触两页的研究辅助材料和 10 个在线教育视频,然后进行 QuIC-A 和 QuIC-B 的管理。主要终点将是标准组和实验组之间 QuIC-A 评分(使用单侧两样本 t 检验)的差异,该评分衡量客观理解。预计每个臂至少有 17 名患者,以检测 8 分的差异(80%的功效,alpha 0.05)。
2020 年 6 月 15 日,英国国家医疗服务体系健康研究管理局批准了该研究的伦理——IRAS 项目 ID 277065,方案编号 CCR5165,REC 参考 20/EE/0155。结果将通过在相关期刊上发表来传播。
NCT04407676;预结果。