Cleveland Clinic, Cleveland, Ohio, USA
Cleveland Clinic, Cleveland, Ohio, USA.
BMJ Open. 2024 Aug 24;14(8):e089242. doi: 10.1136/bmjopen-2024-089242.
Informed decisions to enrol in the clinical investigations of Alzheimer's disease and related dementias (ADRD) require careful consideration of complex risks and uncertain benefits. Decisions regarding whether to receive information about biomarker status are complicated by lack of scientific consensus regarding biomarkers as surrogate endpoints for Alzheimer's disease and how information about individual risk should be evaluated and shared with research participants. This study aims to establish stakeholder consensus regarding ethically optimal approaches to sharing individual results with ADRD research participants.
This Delphi consensus-building study consists of multiple online surveys conducted with Alzheimer's disease research experts, including neurologists, neuropsychologists, ethicists, research oversight specialists and clinical trialists. Panellists will be administered questionnaires developed from a synthesis of researcher- and participant-endorsed considerations and decisional needs identified in published literature and a decisional needs assessment conducted with support from an Alzheimer's Association Research Grant. Panellists will also be asked their views on the content and implementation of processes for sharing individual research results. ≥75% agreement will be required to achieve consensus. Response rates, level of agreement, medians, interquartile ranges and group rankings will be analysed. Following each round of data collection, our research team will undertake qualitative content analysis of open-ended responses.
Ethical approval will be obtained from the Cleveland Clinic Institutional Review Board (Study Number 22-766). Delphi panellists will receive participant information sheets describing the study before agreeing to participate in the Delphi process. Results from the data we anticipate will be generated through this research and will be submitted for peer-reviewed journal publication and presentation at international conferences.
参与阿尔茨海默病及相关痴呆症(ADRD)的临床研究需要做出明智的决策,这需要仔细考虑复杂的风险和不确定的获益。关于是否要获取生物标志物状态信息的决策变得复杂,因为缺乏将生物标志物作为阿尔茨海默病替代终点的科学共识,以及如何评估和与研究参与者共享个体风险信息。本研究旨在就与 ADRD 研究参与者分享个体结果相关的伦理最优方法达成利益相关者共识。
这项德尔菲共识建立研究由多项在线调查组成,对象为阿尔茨海默病研究专家,包括神经科医生、神经心理学家、伦理学家、研究监督专家和临床试验人员。将向小组成员发放调查问卷,这些问卷是从已发表文献中研究人员和参与者认可的考虑因素以及决策需求综合以及在阿尔茨海默病协会研究资助支持下进行的决策需求评估中开发而来的。小组成员还将被要求就分享个体研究结果的内容和实施过程发表意见。需要达到 ≥75%的一致性才能达成共识。将分析应答率、一致性水平、中位数、四分位距和小组排名。在每轮数据收集后,我们的研究团队将对开放式回答进行定性内容分析。
克利夫兰诊所机构审查委员会(研究编号 22-766)将批准这项伦理。德尔菲小组成员在同意参与德尔菲流程之前,将收到描述这项研究的参与者信息表。我们预计通过这项研究产生的数据的结果将提交给同行评审期刊发表,并在国际会议上展示。