Morrow G R, Hickok J T, Burish T G
Cancer Center, University of Rochester School of Medicine and Dentistry, New York 14642.
Cancer. 1994 Nov 1;74(9 Suppl):2676-82. doi: 10.1002/cncr.1994.2820740918.
A less-than-optimal proportion of patients with cancer are entered into National Cancer Institute-sponsored clinical trials. This article reviews the literature on accrual in oncology clinical trials to characterize the extent of the problem, identify reasons for low accrual, and suggest ways to promote accrual. Four well known theories of health behavior (the Health Belief Model, Subjective Expected Utility Theory, Protection Motivation Theory, and the Theory of Reasoned Action) point to central concepts involved in understanding patient health-related behavior: (1) the probability that an unwelcomed health event will happen to a patient, (2) the severity of that event if it does occur, (3) the effectiveness of a particular behavior (such as taking part in a clinical trial) to modify the severity, and (4) the cost of adopting that behavior. These concepts form a framework for integrating the available information about accrual to clinical oncology trials. Patient and physician factors previously related to clinical trials suggest specific recommendations for increasing accrual to clinical oncology trials.
参与美国国立癌症研究所资助的临床试验的癌症患者比例并不理想。本文回顾了肿瘤学临床试验中关于患者入组情况的文献，以描述该问题的严重程度，找出入组率低的原因，并提出提高入组率的方法。四种著名的健康行为理论（健康信念模型、主观期望效用理论、保护动机理论和理性行动理论）指出了理解患者健康相关行为所涉及的核心概念：（1）不良健康事件发生在患者身上的概率；（2）如果该事件发生，其严重程度；（3）特定行为（如参加临床试验）改变严重程度的有效性；（4）采取该行为的成本。这些概念构成了一个框架，用于整合有关肿瘤学临床试验入组情况的现有信息。先前与临床试验相关的患者和医生因素为提高肿瘤学临床试验入组率提出了具体建议。
