Connie M Ulrich1, Sarah J Ratcliffe2, Gwenyth R Wallen3, Qiuping Pearl Zhou4, Kathleen Knafl5, Christine Grady6. 1. Department of Biobehavioral Health Sciences and Department of Medical Ethics and Health Policy, University of Pennsylvania School of Nursing and Perelman School of Medicine. 2. Department of Biostatistics & Epidemiology, University of Pennsylvania Perelman School of Medicine. 3. National Institutes of Health Clinical Center. 4. Department of Nursing, George Washington University. 5. Division of Family Health, University of North Carolina School of Nursing Chapel Hill. 6. Department of Bioethics, National Institutes of Health.
Abstract
BACKGROUND: The purpose of this article is to examine the extent to which cancer clinical trial participants assess the benefits and risks of research participation before enrollment. METHODS: One hundred and ten oncology research participants enrolled in cancer clinical research in a large Northeastern cancer center responded to a self-administered questionnaire on perceptions about cancer clinical trials. RESULTS: Of the participants, 51.6% reported they did not directly assess the benefits or risks. Educational level, age, employment, treatment options, insurance, and spiritual-religious beliefs were significantly associated with whether participants assessed risk and benefits. Those who felt well informed were more likely to have assessed the benefits and risks at enrollment than those who did not feel well informed (odds ratio [OR] = 3.92, p = .014); of those who did not assess the risks and benefits, 21% did not feel well informed at enrollment (p = .001). Those who agreed that the clinical trial helped pay the costs of the care had nearly three times the odds of not assessing risks and benefits compared to those who disagreed. CONCLUSION: Our findings have important implications for understanding the role of assessing risks and benefits in the research participation decisions of patients with cancer and call for further understanding of why participants are not assessing information believed to be essential for autonomous informed decisions.
BACKGROUND: The purpose of this article is to examine the extent to which cancer clinical trial participants assess the benefits and risks of research participation before enrollment. METHODS: One hundred and ten oncology research participants enrolled in cancer clinical research in a large Northeastern cancer center responded to a self-administered questionnaire on perceptions about cancer clinical trials. RESULTS: Of the participants, 51.6% reported they did not directly assess the benefits or risks. Educational level, age, employment, treatment options, insurance, and spiritual-religious beliefs were significantly associated with whether participants assessed risk and benefits. Those who felt well informed were more likely to have assessed the benefits and risks at enrollment than those who did not feel well informed (odds ratio [OR] = 3.92, p = .014); of those who did not assess the risks and benefits, 21% did not feel well informed at enrollment (p = .001). Those who agreed that the clinical trial helped pay the costs of the care had nearly three times the odds of not assessing risks and benefits compared to those who disagreed. CONCLUSION: Our findings have important implications for understanding the role of assessing risks and benefits in the research participation decisions of patients with cancer and call for further understanding of why participants are not assessing information believed to be essential for autonomous informed decisions.
Entities:
Keywords:
cancer; clinical trials; informed consent; risks and benefits
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