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Tan SH, King TL, Tan SSN, Lai WH, Bujang MA, Voon PJ. Development and validation of Join Clinical Trial Questionnaire (JoinCT). Asia Pac J Clin Oncol 2023. [PMID: 37943536 DOI: 10.1111/ajco.14034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 10/30/2023] [Indexed: 11/10/2023]
Abstract
AIM Participant recruitment has always been a major challenge in clinical trials. This study aimed to develop and validate the Join Clinical Trial Questionnaire (JoinCT), exploring the willingness to join a clinical trial and associated factors in patients. METHODS This questionnaire development study involved four phases: (i) exploring and understanding the subject matter, (ii) questionnaire development, (iii) content validity testing, and lastly, (iv) field-testing of the questionnaire. For the field-testing phase, a cross-sectional self-administered survey of JoinCT was conducted among cancer patients with various socio-demographic backgrounds and medical conditions. Besides content validity, Cronbach's alpha was used to evaluate the internal consistency of domains, and confirmatory factor analysis was used to evaluate the model fit of the JoinCT framework. RESULTS A total of 389 respondents participated in the survey. Based on the results obtained from a field data collection phase, JoinCT consisted of four independent variables domains, namely "knowledge", "perception of benefits", "perception of risks", and "confidence". The only dependent variable was the willingness to participate in a clinical trial. The minimum Cronbach's alpha was 0.937, and the model fit for the overall framework of JoinCT is also excellent with Comparative Fit Index (> 0.90), root mean square error approximation (< 0.08), and Standardized Root Mean Square Residual (< 0.08). CONCLUSIONS The Join Clinical Trial Questionnaire (JoinCT) was successfully validated with excellent reliability and validity, and a good model fit. The main factors that contribute to willingness to participate in clinical trials are knowledge, perception of benefits, perception of risks, and confidence.
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Affiliation(s)
- Shirin Hui Tan
- Clinical Research Centre, Sarawak General Hospital, Ministry of Health, Kuching, Sarawak, Malaysia
| | - Teck Long King
- Clinical Research Centre, Sarawak General Hospital, Ministry of Health, Kuching, Sarawak, Malaysia
| | - Shirley Siang Ning Tan
- Clinical Research Centre, Sarawak General Hospital, Ministry of Health, Kuching, Sarawak, Malaysia
- Department of Pharmacy, Sarawak General Hospital, Ministry of Health, Kuching, Sarawak, Malaysia
| | - Wei Hong Lai
- Clinical Research Centre, Sarawak General Hospital, Ministry of Health, Kuching, Sarawak, Malaysia
| | - Mohamad Adam Bujang
- Clinical Research Centre, Sarawak General Hospital, Ministry of Health, Kuching, Sarawak, Malaysia
| | - Pei Jye Voon
- Department of Radiotherapy and Oncology, Sarawak General Hospital, Ministry of Health, Kuching, Sarawak, Malaysia
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Thakur N, Lovinsky-Desir S, Appell D, Bime C, Castro L, Celedón JC, Ferreira J, George M, Mageto Y, Mainous III AG, Pakhale S, Riekert KA, Roman J, Ruvalcaba E, Sharma S, Shete P, Wisnivesky JP, Holguin F. Enhancing Recruitment and Retention of Minority Populations for Clinical Research in Pulmonary, Critical Care, and Sleep Medicine: An Official American Thoracic Society Research Statement. Am J Respir Crit Care Med 2021; 204:e26-e50. [PMID: 34347574 PMCID: PMC8513588 DOI: 10.1164/rccm.202105-1210st] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: Well-designed clinical research needs to obtain information that is applicable to the general population. However, most current studies fail to include substantial cohorts of racial/ethnic minority populations. Such underrepresentation may lead to delayed diagnosis or misdiagnosis of disease, wide application of approved interventions without appropriate knowledge of their usefulness in certain populations, and development of recommendations that are not broadly applicable.Goals: To develop best practices for recruitment and retention of racial/ethnic minorities for clinical research in pulmonary, critical care, and sleep medicine.Methods: The American Thoracic Society convened a workshop in May of 2019. This included an international interprofessional group from academia, industry, the NIH, and the U.S. Food and Drug Administration, with expertise ranging from clinical and biomedical research to community-based participatory research methods and patient advocacy. Workshop participants addressed historical and current mistrust of scientific research, systemic bias, and social and structural barriers to minority participation in clinical research. A literature search of PubMed and Google Scholar was performed to support conclusions. The search was not a systematic review of the literature.Results: Barriers at the individual, interpersonal, institutional, and federal/policy levels were identified as limiting to minority participation in clinical research. Through the use of a multilevel framework, workshop participants proposed evidence-based solutions to the identified barriers.Conclusions: To date, minority participation in clinical research is not representative of the U.S. and global populations. This American Thoracic Society research statement identifies potential evidence-based solutions by applying a multilevel framework that is anchored in community engagement methods and patient advocacy.
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Milosevic S, Joseph-Williams N, Pell B, Cain E, Hackett R, Murdoch F, Ahmed H, Allen AJ, Bray A, Clarke S, Drake MJ, Drinnan M, Hood K, Schatzberger T, Takwoingi Y, Thomas-Jones E, White R, Edwards A, Harding C. Conducting invasive urodynamics in primary care: qualitative interview study examining experiences of patients and healthcare professionals. Diagn Progn Res 2021; 5:10. [PMID: 34006320 PMCID: PMC8130146 DOI: 10.1186/s41512-021-00100-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 04/29/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Invasive urodynamics is used to investigate the causes of lower urinary tract symptoms; a procedure usually conducted in secondary care by specialist practitioners. No study has yet investigated the feasibility of carrying out this procedure in a non-specialist setting. Therefore, the aim of this study was to explore, using qualitative methodology, the feasibility and acceptability of conducting invasive urodynamic testing in primary care. METHODS Semi-structured interviews were conducted during the pilot phase of the PriMUS study, in which men experiencing bothersome lower urinary tract symptoms underwent invasive urodynamic testing along with a series of simple index tests in a primary care setting. Interviewees were 25 patients invited to take part in the PriMUS study and 18 healthcare professionals involved in study delivery. Interviews were audio-recorded, transcribed verbatim and analysed using a framework approach. RESULTS Patients generally found the urodynamic procedure acceptable and valued the primary care setting due to its increased accessibility and familiarity. Despite some logistical issues, facilitating invasive urodynamic testing in primary care was also a positive experience for urodynamic nurses. Initial issues with general practitioners receiving and utilising the results of urodynamic testing may have limited the potential benefit to some patients. Effective approaches to study recruitment included emphasising the benefits of the urodynamic test and maintaining contact with potential participants by telephone. Patients' relationship with their general practitioner was an important influence on study participation. CONCLUSIONS Conducting invasive urodynamics in primary care is feasible and acceptable and has the potential to benefit patients. Facilitating study procedures in a familiar primary care setting can impact positively on research recruitment. However, it is vital that there is a support network for urodynamic nurses and expertise available to help interpret urodynamic results.
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Affiliation(s)
- Sarah Milosevic
- Centre for Trials Research, Cardiff University, Cardiff, UK.
| | - Natalie Joseph-Williams
- PRIME Centre Wales, Division of Population Medicine, School of Medicine, Neuadd Meirionnydd, Cardiff University, Cardiff, UK
| | - Bethan Pell
- Centre for the Development and Evaluation of Complex Interventions for Public Health Improvement (DECIPHer), Cardiff University, Cardiff, UK
| | - Elizabeth Cain
- PRIME Centre Wales, Division of Population Medicine, School of Medicine, Neuadd Meirionnydd, Cardiff University, Cardiff, UK
| | - Robyn Hackett
- PRIME Centre Wales, Division of Population Medicine, School of Medicine, Neuadd Meirionnydd, Cardiff University, Cardiff, UK
| | - Ffion Murdoch
- PRIME Centre Wales, Division of Population Medicine, School of Medicine, Neuadd Meirionnydd, Cardiff University, Cardiff, UK
| | - Haroon Ahmed
- PRIME Centre Wales, Division of Population Medicine, School of Medicine, Neuadd Meirionnydd, Cardiff University, Cardiff, UK
| | - A Joy Allen
- NIHR Newcastle In Vitro Diagnostics Co-operative, Newcastle University, Newcastle upon Tyne, UK
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Alison Bray
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
- Northern Medical Physics and Clinical Engineering, The Newcastle upon Tyne Hospitals NHS Foundation Trust, Royal Victoria Infirmary, Newcastle upon Tyne, UK
| | - Samantha Clarke
- North Bristol NHS Trust, Southmead Hospital, Southmead Road, Westbury-on-Trym, Bristol, UK
| | - Marcus J Drake
- Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Michael Drinnan
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
- Northern Medical Physics and Clinical Engineering, The Newcastle upon Tyne Hospitals NHS Foundation Trust, Royal Victoria Infirmary, Newcastle upon Tyne, UK
| | - Kerenza Hood
- Centre for Trials Research, Cardiff University, Cardiff, UK
| | - Tom Schatzberger
- Corbridge Health Centre, NHS Northumberland Clinical Commissioning Group, Newcastle Road, Corbridge, Northumberland, UK
| | - Yemisi Takwoingi
- Test Evaluation Research Group, Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | | | - Raymond White
- PPI Representative, formerly of Grampian University Hospital Trust, Biomedical Physics and Bioengineering, Foresterhill, Aberdeen, UK
| | - Adrian Edwards
- PRIME Centre Wales, Division of Population Medicine, School of Medicine, Neuadd Meirionnydd, Cardiff University, Cardiff, UK
| | - Chris Harding
- Department of Urology, Newcastle upon Tyne NHS Hospital Trust, Newcastle Freeman Hospital, Freeman Road, High Heaton, Newcastle upon Tyne, UK
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Jaffe K, Nosova E, DeBeck K, Hayashi K, Milloy MJ, Richardson L. Trust in research physicians as a key dimension of randomized controlled trial participation in clinical addictions research. Subst Abus 2021; 42:927-934. [DOI: 10.1080/08897077.2021.1900987] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- Kaitlyn Jaffe
- British Columbia Centre on Substance Use, University of British Columbia, Vancouver, Canada
- Department of Sociology, University of British Columbia, Vancouver, Canada
| | - Ekaterina Nosova
- British Columbia Centre on Substance Use, University of British Columbia, Vancouver, Canada
| | - Kora DeBeck
- British Columbia Centre on Substance Use, University of British Columbia, Vancouver, Canada
- School of Public Policy, Simon Fraser University, Vancouver, Canada
| | - Kanna Hayashi
- British Columbia Centre on Substance Use, University of British Columbia, Vancouver, Canada
- Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada
| | - M.-J. Milloy
- British Columbia Centre on Substance Use, University of British Columbia, Vancouver, Canada
- Department of Medicine, University of British Columbia, Vancouver, Canada
| | - Lindsey Richardson
- British Columbia Centre on Substance Use, University of British Columbia, Vancouver, Canada
- Department of Sociology, University of British Columbia, Vancouver, Canada
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Mahmud A, Zalay O, Springer A, Arts K, Eisenhauer E. Barriers to participation in clinical trials: a physician survey. ACTA ACUST UNITED AC 2018; 25:119-125. [PMID: 29719427 DOI: 10.3747/co.25.3857] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background Clinical trials are vital for evidence-based cancer care. Oncologist engagement in clinical trials has an effect on patient recruitment, which in turn can affect trial success. Identifying barriers to clinical trial participation might enable interventions that could help to increase physician participation. Methods To assess factors affecting physician engagement in oncology trials, a national survey was conducted using the online SurveyMonkey tool (SurveyMonkey, San Mateo, CA, U.S.A.; http://www.surveymonkey.com). Physicians associated with the Canadian Cancer Clinical Trials Network and the Canadian Cancer Trials Group were asked about their specialty, years of experience, barriers to participation, and motivating interventions, which included an open-ended question inviting survey takers to suggest interventions. Results The survey collected 207 anonymous responses. Respondents were predominantly medical oncologists (46.4%), followed by radiation oncologists (24.6%). Almost 70% of the respondents had more than 10 years of experience. Significant time constraints included extra paperwork (77%), patient education (54%), and extended follow-up or clinic visits (53%). Timing of events within trials was also a barrier to participation (55%). Most respondents favoured clinical work credits (72%), academic credits (67%), a clinical trial alert system (75%), a regular meeting to review trial protocols (65%), and a screening log to aid in patient accrual (67%) as motivational strategies. Suggested interventions included increased support staff, streamlined regulatory burden, and provision of greater funding for trials and easier access to ancillary services. Conclusions The present study confirms that Canadian oncologists are willing to participate in clinical research, but face multiple barriers to trial participation. Those barriers could be mitigated by the implementation of several interventions identified in the study.
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Affiliation(s)
| | | | - A Springer
- Department of Health Sciences, Queen's University, Kingston, ON
| | - K Arts
- Canadian Cancer Clinical Trials Network, Toronto, ON
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Fanaroff AC, Li S, Webb LE, Miller V, Navar AM, Peterson ED, Wang TY. An Observational Study of the Association of Video- Versus Text-Based Informed Consent With Multicenter Trial Enrollment: Lessons From the PALM Study (Patient and Provider Assessment of Lipid Management). Circ Cardiovasc Qual Outcomes 2018; 11:e004675. [PMID: 29625993 PMCID: PMC5891825 DOI: 10.1161/circoutcomes.118.004675] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BACKGROUND Patient participation in clinical research is low, in part because of the length and complexity of the informed consent process. Video informed consent may enhance the appeal of research and help break down barriers to participation. METHODS AND RESULTS The PALM study (Patient and Provider Assessment of Lipid Management) enrolled 7904 patients at cardiology, endocrinology, and primary care clinics across the United States to evaluate cholesterol management practices. Of 153 participating clinics, 67 (43.8%) secured institutional review board approval to use a tablet-based video informed consent tool that patients could select to navigate through the informed consent process instead of traditional text-based informed consent. At sites without institutional review board approval of video consent, all patients read a text-based informed consent document. Site activation times and enrollment volumes, as well as characteristics of enrolled patients, were compared between sites with and without video consent capability. Sites with video consent capability more often used a central institutional review board (89.6% versus 73.3%), were more often rural (16.7% versus 3.8%), and tended to have fewer providers. Compared with sites without video consent capability, sites with video consent capability had shorter times from site approach to first patient enrollment (median 178 versus 207 days; P=0.02). Sites with video consent capability enrolled similar numbers of patients as sites without video consent capability (P=0.48) but enrolled a greater proportion of patients who were ≥75 years old (27.5% versus 23.6%; P<0.001) and nonwhite (17.7% versus 14.2%; P<0.001). CONCLUSIONS In this observational study of recruitment in a multicenter registry, sites approved for video consent use enrolled the same number of patients as sites with only traditional text-based informed consent but had faster speed to first patient enrolled and more often enrolled older and nonwhite patients. Future randomized trials are needed to assess the impact of video consent on enrollment mechanics and demographics. CLINICAL TRIAL REGISTRATION URL: https://www.clinicaltrials.gov. Unique identifier: NCT02341664.
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Affiliation(s)
- Alexander C Fanaroff
- Department of Medicine (A.C.F., A.M.N., E.D.P., T.Y.W.) and Duke Clinical Research Institute (A.C.F., A.M.N., E.D.P., T.Y.W., S.L., L.E.W., V.M.,), Duke University Medical Center, Durham, NC.
| | - Shuang Li
- Department of Medicine (A.C.F., A.M.N., E.D.P., T.Y.W.) and Duke Clinical Research Institute (A.C.F., A.M.N., E.D.P., T.Y.W., S.L., L.E.W., V.M.,), Duke University Medical Center, Durham, NC
| | - Laura E Webb
- Department of Medicine (A.C.F., A.M.N., E.D.P., T.Y.W.) and Duke Clinical Research Institute (A.C.F., A.M.N., E.D.P., T.Y.W., S.L., L.E.W., V.M.,), Duke University Medical Center, Durham, NC
| | - Vincent Miller
- Department of Medicine (A.C.F., A.M.N., E.D.P., T.Y.W.) and Duke Clinical Research Institute (A.C.F., A.M.N., E.D.P., T.Y.W., S.L., L.E.W., V.M.,), Duke University Medical Center, Durham, NC
| | - Ann Marie Navar
- Department of Medicine (A.C.F., A.M.N., E.D.P., T.Y.W.) and Duke Clinical Research Institute (A.C.F., A.M.N., E.D.P., T.Y.W., S.L., L.E.W., V.M.,), Duke University Medical Center, Durham, NC
| | - Eric D Peterson
- Department of Medicine (A.C.F., A.M.N., E.D.P., T.Y.W.) and Duke Clinical Research Institute (A.C.F., A.M.N., E.D.P., T.Y.W., S.L., L.E.W., V.M.,), Duke University Medical Center, Durham, NC
| | - Tracy Y Wang
- Department of Medicine (A.C.F., A.M.N., E.D.P., T.Y.W.) and Duke Clinical Research Institute (A.C.F., A.M.N., E.D.P., T.Y.W., S.L., L.E.W., V.M.,), Duke University Medical Center, Durham, NC
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O’Connor CM, Psotka MA, Fiuzat M, Lindenfeld J, Abraham WT, Bristow MR, Canos D, Harrington RA, Hillebrenner M, Jessup M, Malik FI, Solomon SD, Stockbridge N, Tcheng JE, Unger EF, Whellan DJ, Zuckerman B, Califf RM. Improving Heart Failure Therapeutics Development in the United States. J Am Coll Cardiol 2018; 71:443-453. [DOI: 10.1016/j.jacc.2017.11.048] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Revised: 10/30/2017] [Accepted: 11/27/2017] [Indexed: 01/24/2023]
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Jackson JD, Moy B, Evans MK. The Elimination of Cancer Health Disparities: Are We Ready to Do the Heavy Lifting? Oncologist 2016; 21:1411-1413. [PMID: 27821795 PMCID: PMC5153347 DOI: 10.1634/theoncologist.2016-0327] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Accepted: 10/21/2016] [Indexed: 11/23/2022] Open
Abstract
Black Americans are under-represented in cancer clinical trials because of myriad factors. Minority under-representation in clinical trials likely contributes to the disparate cancer outcomes among minorities and the poor. This Commentary, in light of a clinical trial that was prematurely terminated because of poor accrual of black men, discusses strategies to identify and overcome barriers to enrollment for this particularly vulnerable population.
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Affiliation(s)
- Jonathan D Jackson
- Massachusetts General Hospital Cancer Center, Boston, Massachusetts, USA
| | - Beverly Moy
- Massachusetts General Hospital Cancer Center, Boston, Massachusetts, USA
| | - Michele K Evans
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, National Institutes of Health, Baltimore, Maryland, USA
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Giménez N, Pedrazas D, Redondo S, Quintana S. [Informed consent process in clinical trials: Insights of researchers, patients and general practitioners]. Aten Primaria 2016; 48:518-526. [PMID: 26777978 PMCID: PMC6877861 DOI: 10.1016/j.aprim.2015.10.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Revised: 10/27/2015] [Accepted: 10/28/2015] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE Adequate information for patients and respect for their autonomy are mandatory in research. This article examined insights of researchers, patients and general practitioners (GPs) on the informed consent process in clinical trials, and the role of the GP. DESIGN A cross-sectional study using three questionnaires, informed consent reviews, medical records, and hospital discharge reports. SETTING GPs, researchers and patients involved in clinical trials. PARTICIPANTS Included, 504 GPs, 108 researchers, and 71 patients. RESULTS Consulting the GP was recommended in 50% of the informed consents. Participation in clinical trials was shown in 33% of the medical records and 3% of the hospital discharge reports. GPs scored 3.54 points (on a 1-10 scale) on the assessment of the information received by the principal investigator. The readability of the informed consent sheet was rated 8.03 points by researchers, and the understanding was rated 7.68 points by patients. Patient satisfaction was positively associated with more time for reflection. CONCLUSIONS GPs were not satisfied with the information received on the participation of patients under their in clinical trials. Researchers were satisfied with the information they offered to patients, and were aware of the need to improve the information GPs received. Patients collaborated greatly towards biomedical research, expressed satisfaction with the overall process, and minimised the difficulties associated with participation.
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Affiliation(s)
- Nuria Giménez
- Unidad de Investigación, Fundación para la Investigación Mútua Terrassa, Universitat de Barcelona, Barcelona, España; Comité Ético de Investigación Clínica, Hospital Universitari Mútua Terrassa, Universitat de Barcelona, Barcelona, España; Laboratorio de Toxicología, Universitat Autònoma de Barcelona, España.
| | - David Pedrazas
- Unidad de Investigación, Fundación para la Investigación Mútua Terrassa, Universitat de Barcelona, Barcelona, España; ABS Abrera, Direcció d'Atenció Primària Costa de Ponent, Institut Català de la Salut, Barcelona, España; Departamento de Medicina, Universitat Autònoma de Barcelona, Barcelona, España
| | - Susana Redondo
- Comité Ético de Investigación Clínica, Hospital Universitari Mútua Terrassa, Universitat de Barcelona, Barcelona, España; Servicio de Farmacia, Hospital Universitari Mútua Terrassa, Fundación para la Investigación Mútua Terrassa, Universitat de Barcelona, Barcelona, España
| | - Salvador Quintana
- Comité Ético de Investigación Clínica, Hospital Universitari Mútua Terrassa, Universitat de Barcelona, Barcelona, España
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Dal-Ré R, Morell F, Tejedor J, Gracia D. Therapeutic misconception in clinical trials: Fighting against it and living with it. Rev Clin Esp 2014. [DOI: 10.1016/j.rceng.2014.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Dal-Ré R, Morell F, Tejedor J, Gracia D. El equívoco terapéutico en los ensayos clínicos: combatirlo y convivir con él. Rev Clin Esp 2014; 214:470-4. [DOI: 10.1016/j.rce.2014.03.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2014] [Revised: 03/20/2014] [Accepted: 03/24/2014] [Indexed: 10/25/2022]
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Mainous AG. Physicians should declare financial incentives for recruiting minority ethnic patients into clinical trials. BMJ 2014; 348:g2985. [PMID: 24806316 PMCID: PMC4707709 DOI: 10.1136/bmj.g2985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Mistrust may explain why non-white people are under-represented in clinical trials despite apparent willingness. Arch G Mainous III suggests doctors who recruit such patients should
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Affiliation(s)
- Arch G Mainous
- Department of Health Services Research, Management and Policy and Department of Community Health and Family Medicine, University of Florida, PO Box 100195, Gainesville, FL 32610, USA
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Pelayo-Alvarez M, Perez-Hoyos S, Agra-Varela Y. Clinical effectiveness of online training in palliative care of primary care physicians. J Palliat Med 2013; 16:1188-96. [PMID: 23987657 DOI: 10.1089/jpm.2013.0005] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Primary care physicians (PCPs) have a major responsibility in the management of palliative patients. Online palliative care (PC) education has not been shown to have a clinical impact on patients that is equal or different to traditional training. OBJECTIVE This study tested the clinical effectiveness of online PC education of physicians through impact on symptom control, quality of life (QOL), caregiver satisfaction, and knowledge-attitude of physicians at 18 months of the intervention. METHODS We conducted a randomized clinical trial. Subjects were 169 physicians randomly assigned to receive the online model or traditional training. Consecutive patients with advanced cancer requiring PC were included. Physicians and patients completed the Palliative Care Outcome Scale (POS), and patients the Brief Pain Inventory (BPI) and the Rotterdam Symptom Checklist (RSCL) twice, 7 to 10 days apart. Caregivers completed the SERVQUAL. Physicians' level of knowledge-attitude was measured at 18 months. RESULTS Sixty-seven physicians enrolled 117 patients. The intervention group had reduced scores for pain, symptoms, and family anxiety. The global RSCL scale showed a difference between groups. There was no significant difference in the questionnaires used. Caregiver satisfaction was comparable between groups. Physicians in the intervention group significantly increased their knowledge without any differences in attitude. Online training was completed by 86.6% in the intervention group, whereas 13.4% in the control group accessed traditional training. CONCLUSIONS Participation in an online PC education program by PCPs improved patient scores for some symptoms and family anxiety on the POS and also showed improved global QOL. Significant differences were found in physicians' knowledge at short and long term.
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A questionnaire-based survey of participants' decisions regarding recruitment and retention in a randomised controlled trial - lessons learnt from the SCoRD trial. Contemp Clin Trials 2011; 32:363-8. [PMID: 21300178 DOI: 10.1016/j.cct.2011.01.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2010] [Revised: 01/24/2011] [Accepted: 01/31/2011] [Indexed: 11/22/2022]
Abstract
Successful recruitment and retention on trials is critical to ensuring that adequate power is conferred, results are generalisable and trials are completed within the allocated time and resources. Nested within an existing pragmatic randomised controlled trial a process evaluation was conducted to explore the reasons for a much higher than anticipated recruitment (120% of required sample size) and retention rate (96% completed follow-up). A questionnaire was designed to ascertain patient's views on reasons affecting consent and retention. 148 patients still enrolled in the trial at their final follow-up were either given or mailed a questionnaire of which 102 were returned (69%). 96% rated the written information as very or somewhat important in their decision to consent. Verbal information given to them by the operating surgeon was considered very or somewhat important by 86% and the relative inconvenience was rated as important by 79% of patients. Reasons for consenting for a large proportion of patents were the wish to help in research which may benefit others in the future and the perception that this was an important and relevant study. There was also some evidence that patients weighed up the demands with the potential benefits to them. High levels of satisfaction were expressed with trial personnel and trial procedures. The inclusion of a trial process evaluation such as the one presented here is an efficient method for gathering information of participants' decisions regarding recruitment and retention in a trial and can help to inform the successful planning of future trials.
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