Literature DB >> 2390587

Recruitment to a prospective breast conservation trial: why are so few patients randomised?

W J Jack1, U Chetty, A Rodger.   

Abstract

OBJECTIVE: To investigate the rate of recruitment to early breast cancer trials and elucidate the reasons for ineligibility and refusal to participate among patients otherwise suitable for these trials.
DESIGN: Prospective study of one year's cohort of patients referred to a breast unit with special reference to the subgroup suitable for conservation management and to the proportion eligible for and (after informed consent) ultimately randomised within the Scottish early breast cancer trials.
SETTING: The breast unit, Longmore Hospital, Edinburgh, during 1988. PATIENTS: All 3054 patients referred to the breast unit during the year. 324 Found to have invasive breast cancer and 147 initially thought suitable for conservation management.
RESULTS: 63 Patients were treated by mastectomy, 19 of whom requested mastectomy rather than conservation management. 84 Patients were excluded from trials, and of the 63 eligible patients, 40 gave informed consent. Most of the 23 patients who refused the trials requested a specific adjuvant treatment after discussion of their management and the trials.
CONCLUSIONS: Recruitment to prospective trials in which informed consent is required before randomisation may be slower than predicted because of a high proportion of exclusions and also refusal by patients. Trials may therefore take longer to complete and give distorted results by virtue of the unpredictable nature of the selection of patients.

Entities:  

Keywords:  Biomedical and Behavioral Research; Empirical Approach

Mesh:

Year:  1990        PMID: 2390587      PMCID: PMC1663425          DOI: 10.1136/bmj.301.6743.83

Source DB:  PubMed          Journal:  BMJ        ISSN: 0959-8138


  6 in total

1.  Conservation therapy of breast cancer.

Authors:  H J Stewart; R J Prescott; P A Forrest
Journal:  Lancet       Date:  1989-07-15       Impact factor: 79.321

2.  Ethics of clinical research: lessons for the future.

Authors:  M Baum; K Zilkha; J Houghton
Journal:  BMJ       Date:  1989-07-22

3.  Patient preferences and randomised clinical trials.

Authors:  C R Brewin; C Bradley
Journal:  BMJ       Date:  1989-07-29

4.  Randomised trials and informed consent.

Authors:  D Brahams
Journal:  Lancet       Date:  1988-10-29       Impact factor: 79.321

5.  Breast cancer therapy: exercising all our options.

Authors:  V T De Vita
Journal:  N Engl J Med       Date:  1989-02-23       Impact factor: 91.245

6.  Mastectomy or conservation: the patient's choice.

Authors:  R G Wilson; A Hart; P J Dawes
Journal:  BMJ       Date:  1988-11-05
  6 in total
  11 in total

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Review 2.  Recruiting underserved populations to dermatologic research: a systematic review.

Authors:  Chaya R Spears; Bridgit V Nolan; Jenna L O'Neill; Thomas A Arcury; Joseph G Grzywacz; Steven R Feldman
Journal:  Int J Dermatol       Date:  2011-04       Impact factor: 2.736

3.  Recruitment of patients with lung cancer into a randomised clinical trial: experience at two centres. On behalf of the Big Lung Trial Steering Committee.

Authors:  S G Spiro; N H Gower; M T Evans; F M Facchini; R M Rudd
Journal:  Thorax       Date:  2000-06       Impact factor: 9.139

4.  Recruiting older people to a randomised controlled dietary intervention trial--how hard can it be?

Authors:  Sarah E Forster; Laura Jones; John M Saxton; Daniel J Flower; Gemma Foulds; Hilary J Powers; Stuart G Parker; A Graham Pockley; Elizabeth A Williams
Journal:  BMC Med Res Methodol       Date:  2010-02-22       Impact factor: 4.615

5.  Unexpected difficulties in randomizing patients in a surgical trial: a prospective study comparing extracorporeal shock wave lithotripsy with open cholecystectomy.

Authors:  P W Plaisier; M Y Berger; R L van der Hul; H G Nijs; R den Toom; O T Terpstra; H A Bruining
Journal:  World J Surg       Date:  1994 Sep-Oct       Impact factor: 3.352

6.  Why don't women participate? A qualitative study on non-participation in a surgical randomised controlled trial.

Authors:  D Gopinath; A R B Smith; C Holland; F M Reid
Journal:  Int Urogynecol J       Date:  2012-11-01       Impact factor: 2.894

7.  Physician participation in clinical research and trials: issues and approaches.

Authors:  Sayeeda Rahman; Md Anwarul Azim Majumder; Sami F Shaban; Nuzhat Rahman; Moslehuddin Ahmed; Khalid Bin Abdulrahman; Urban Ja D'Souza
Journal:  Adv Med Educ Pract       Date:  2011-03-07

Review 8.  Paying clinicians to join clinical trials: a review of guidelines and interview study of trialists.

Authors:  James Raftery; Christine Kerr; Sheila Hawker; John Powell
Journal:  Trials       Date:  2009-03-10       Impact factor: 2.279

Review 9.  Outcomes of patients who participate in randomized controlled trials compared to similar patients receiving similar interventions who do not participate.

Authors:  Gunn Elisabeth Vist; Dianne Bryant; Lyndsay Somerville; Trevor Birminghem; Andrew D Oxman
Journal:  Cochrane Database Syst Rev       Date:  2008-07-16

10.  Effects of patient selection on the applicability of results from a randomised clinical trial (EORTC 10853) investigating breast-conserving therapy for DCIS.

Authors:  N Bijker; J L Peterse; I S Fentiman; J-P Julien; A A M Hart; A Avril; L Cataliotti; E J T Rutgers
Journal:  Br J Cancer       Date:  2002-09-09       Impact factor: 7.640

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