Mogensen Nina, Kreicbergs Ulrika, Albertsen Birgitte Klug, Lähteenmäki Päivi, Heyman Mats, Harila Arja
Department of Women's and Children's Health, Childhood Cancer Research Unit, Karolinska Institute, Stockholm, Sweden.
Department of Pediatric Oncology, Karolinska University Hospital, Stockholm, Sweden.
Pediatr Blood Cancer. 2023 Dec;70(12):e30684. doi: 10.1002/pbc.30684. Epub 2023 Sep 20.
Randomized clinical trials (RCTs) are an essential part of improving acute lymphoblastic leukemia (ALL) treatment. This population-based questionnaire study investigated parents' experiences of the informed consent process in the RCTs within the Nordic NOPHO (Nordic Society of Paediatric Haematology and Oncology) ALL2008 trial.
Parents in Sweden, Denmark, and Finland whose child was alive and in first remission after end of therapy and who were asked to participate in any RCT in the ALL2008 protocol, were asked to complete 15 questions/items regarding their experience of the RCT consent process.
A total of 483 parents of 279 children met the inclusion criteria and answered the study questionnaire. Most (91%) agreed/strongly agreed to having received sufficient information to make a well-informed decision, felt confidence in the study design (86%), and thought that the process was satisfactory (86%). Those who did not consent reported a generally more negative experience of the process. More than a third of all parents and over half of parents who had refused participation felt that it was burdensome to decide. Most parents (66%) in general, and one-third of those with children 8 years or older, reported that their child was not involved in the process.
Parents were in general satisfied with the informed consent process, although many parents, particularly those who refused participation, reported it as burdensome to make the decision concerning RCT. Fewer than expected of the school-aged children were involved in the decision process, which calls for attention on how children are included in the consent procedure in clinical trials.
随机临床试验(RCT)是改善急性淋巴细胞白血病(ALL)治疗的重要组成部分。这项基于人群的问卷调查研究调查了北欧儿科血液学和肿瘤学会(NOPHO)ALL2008试验中家长在RCT知情同意过程中的经历。
瑞典、丹麦和芬兰的家长,其孩子在治疗结束后存活且处于首次缓解期,并被要求参与ALL2008方案中的任何RCT,被要求完成15个关于他们对RCT同意过程经历的问题/条目。
共有279名儿童的483名家长符合纳入标准并回答了研究问卷。大多数(91%)家长同意/强烈同意已获得足够信息以做出明智决定,对研究设计有信心(86%),并认为该过程令人满意(86%)。那些不同意的家长对该过程的总体体验通常更负面。超过三分之一的家长以及超过一半拒绝参与的家长认为做决定很麻烦。总体而言,大多数家长(66%),以及三分之一有8岁及以上孩子的家长表示他们的孩子未参与该过程。
家长总体上对知情同意过程感到满意,尽管许多家长,特别是那些拒绝参与的家长,称做出关于RCT的决定很麻烦。参与决策过程的学龄儿童数量少于预期,这需要关注如何在临床试验中将儿童纳入同意程序。