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临床试验参与中的差异:中西部学术医疗中心癌症患者的横断面调查。

Disparities in Clinical Trial Participation: A Cross-Sectional Survey of Cancer Patients at a Midwest Academic Medical Center.

机构信息

Department of Internal Medicine, College of Medicine, University of Cincinnati, Cincinnati, OH 45229, USA.

University of Cincinnati Cancer Center, The University of Cincinnati College of Medicine, Cincinnati, OH 45267, USA.

出版信息

Curr Oncol. 2024 Sep 11;31(9):5367-5373. doi: 10.3390/curroncol31090396.

Abstract

Research conducted on homogenous populations can lead to biased and misleading findings, impeding the development of effective interventions and treatments for diverse populations. Low participation among minority groups further leads to disparities in access to innovative cancer care and treatment outcomes associated with trial participation. To better understand cancer patients' attitudes and willingness to participate in clinical trials, solid tumor patients attending their clinic visits were invited to complete a survey. The survey included questions on demographics, previous trial participation, and future trial interest. Responses were analyzed with frequency tables and chi-square tests. Of 300 participants, only 96 (32%) were asked to participate in a clinical trial. Of these, 81 (84%) chose to participate and 15 (16%) did not. There were notable differences by race but not gender or education level. Of the 204 who had never been asked to participate, 70% indicated that they would be willing to participate in future, and there was a strong sex-race interaction. Non-White males were the most hesitant group. Of 204, 99% indicated that they would participate to access new treatments, and 57% would participate to contribute to research overall. This study shows that many solid tumor patients undergoing treatment are not offered clinical trials. Racial differences in attitudes toward trial participation are evident. Nonetheless, many patients are willing to participate in trials to access innovative treatments and to support research. Culturally relevant outreach to build trust with minority groups is needed to increase overall participation in clinical trials.

摘要

针对同质人群进行的研究可能会导致有偏差和误导性的发现,从而阻碍针对不同人群的有效干预和治疗方法的发展。少数群体参与率低进一步导致他们在获得创新癌症护理和与试验参与相关的治疗结果方面存在差异。为了更好地了解癌症患者对参与临床试验的态度和意愿,邀请正在就诊的实体瘤患者完成一项调查。该调查包括人口统计学、以前的试验参与情况和未来的试验兴趣等问题。使用频率表和卡方检验对回答进行了分析。在 300 名参与者中,只有 96 人(32%)被要求参加临床试验。其中,81 人(84%)选择参加,15 人(16%)不参加。种族之间存在显著差异,但性别或教育水平没有差异。在从未被要求参加的 204 人中,有 70%表示他们将来愿意参加,而且存在强烈的性别-种族相互作用。非白人男性是最犹豫不决的群体。在 204 人中,有 99%表示他们会为了获得新的治疗方法而参加,有 57%会为了总体上对研究做出贡献而参加。这项研究表明,许多正在接受治疗的实体瘤患者没有被提供临床试验。对试验参与的态度存在明显的种族差异。尽管如此,许多患者还是愿意参加试验,以获得创新治疗方法并支持研究。需要进行文化相关的外联活动,以与少数群体建立信任,从而提高临床试验的总体参与度。

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Overcoming Barriers to Clinical Trial Enrollment.克服临床试验入组障碍。
Am Soc Clin Oncol Educ Book. 2019 Jan;39:105-114. doi: 10.1200/EDBK_243729. Epub 2019 May 17.

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