دورية أكاديمية

Physician-Investigator, Research Coordinator, and Patient Perspectives on Dual-Role Consent in Oncology: A Qualitative Study.

التفاصيل البيبلوغرافية
العنوان: Physician-Investigator, Research Coordinator, and Patient Perspectives on Dual-Role Consent in Oncology: A Qualitative Study.
المؤلفون: Morain SR; Johns Hopkins Berman Institute of Bioethics and the Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland., Barlevy D; Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, Texas., Joffe S; Department of Medical Ethics and Health Policy, University of Pennsylvania Perelman School of Medicine, Philadelphia., Largent EA; Department of Medical Ethics and Health Policy, University of Pennsylvania Perelman School of Medicine, Philadelphia.; Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia.
المصدر: JAMA network open [JAMA Netw Open] 2023 Jul 03; Vol. 6 (7), pp. e2325477. Date of Electronic Publication: 2023 Jul 03.
نوع المنشور: Journal Article; Research Support, N.I.H., Extramural
اللغة: English
بيانات الدورية: Publisher: American Medical Association Country of Publication: United States NLM ID: 101729235 Publication Model: Electronic Cited Medium: Internet ISSN: 2574-3805 (Electronic) Linking ISSN: 25743805 NLM ISO Abbreviation: JAMA Netw Open Subsets: MEDLINE
أسماء مطبوعة: Original Publication: Chicago, IL : American Medical Association, [2018]-
مواضيع طبية MeSH: Neoplasms* , Physicians*, Humans ; Female ; Male ; Prospective Studies ; Medical Oncology ; Informed Consent
مستخلص: Importance: Classic statements of research ethics generally advise against dual-role consent in which physician-investigators seek consent for research participation from patients with whom they have preexisting treatment relationships. Yet dual-role consent is common in clinical oncology research, as studies are often conducted in close relationship with clinical care.
Objective: To explore key stakeholders' perspectives on dual-role consent in clinical oncology trials.
Design, Setting, and Participants: This qualitative study with 43 participants was conducted at a National Cancer Institute-designated comprehensive cancer center from 2018 to 2022. Semistructured qualitative interviews of physician-investigators, research coordinators, and patients were performed. Respondents were recruited from 3 populations: (1) physician-investigators engaged in clinical oncology research; (2) research coordinators engaged in clinical oncology research; and (3) patients, with and without prior clinical trial experience, who had received a new cancer diagnosis at least 2 months prior to enrollment in this study.
Main Outcomes and Measures: Interviews were audio recorded and professionally transcribed. A thematic analysis approach was used to develop a codebook that included both theory-driven, a priori codes and emergent, inductive codes. Two authors double-coded all transcripts and met regularly to compare coding, discuss discrepancies, refine the codebook, and draft memos describing relevant themes and their frequency.
Results: Among the 43 respondents, 28 (65.1%) were female; 9 (20.9%) were African American, 8 (18.6%) were Asian, 6 (14.0%) were Hispanic, and 21 (48.8%) were White; 15 were physician-investigators (6 [40.0%] with 6-10 years of experience, 4 [26.7%] with at least 20 years of experience), 13 were research coordinators (5 [38.5%] with 0-5 years of experience, 5 [38.5%] with 6-10 years of experience), and 15 were patients (9 [60.0%] aged 46-64 years). Four main themes were found: interviewees (1) perceived greater potential for role synergy than for role conflict; (2) reported dual-role consent as having mixed effects on the consent process, increasing prospective participants' understanding and likelihood of agreement while also challenging voluntariness; (3) preferred a team-based approach to the consent process in which physician-investigators and research coordinators share responsibility for communicating with prospective participants and safeguarding voluntariness; and (4) offered strategies for managing tensions in dual-role consent.
Conclusions and Relevance: This qualitative study found that concerns about dual-role consent in clinical oncology, while valid, may be outweighed by corresponding advantages, particularly if appropriate mitigation strategies are in place. These findings support a team-based approach to informed consent, in which physician-investigators and research coordinators promote both the understanding and voluntariness of prospective participants.
References: Am J Bioeth. 2019 Apr;19(4):33-35. (PMID: 31544669)
J Perinatol. 2018 Jul;38(7):865-872. (PMID: 29795451)
Ann Intern Med. 2015 May 19;162(10):690-6. (PMID: 25868119)
Am J Bioeth. 2019 Apr;19(4):28-30. (PMID: 31544674)
Pediatrics. 2007 Apr;119(4):e849-59. (PMID: 17403829)
Am J Bioeth. 2019 Apr;19(4):23-25. (PMID: 31544683)
Am J Bioeth. 2020 Oct;20(10):90-91. (PMID: 32945746)
Am J Bioeth. 2019 Apr;19(4):22-23. (PMID: 31544676)
J Clin Oncol. 2004 Jul 1;22(13):2708-17. (PMID: 15226338)
N Engl J Med. 2018 Jun 21;378(25):2433-2438. (PMID: 29924950)
J Clin Oncol. 1984 Jul;2(7):849-55. (PMID: 6737023)
J Oncol Pract. 2018 Jan;14(1):e1-e10. (PMID: 29099678)
Clin Trials. 2016 Oct;13(5):555-65. (PMID: 27257125)
Yale J Biol Med. 1992 Mar-Apr;65(2):65-74. (PMID: 1519378)
JAMA. 2000 May 24-31;283(20):2701-11. (PMID: 10819955)
Am J Bioeth. 2021 Apr;21(4):85-88. (PMID: 33825652)
AJOB Neurosci. 2021 Jan;12(1):68-70. (PMID: 33528327)
Am J Bioeth. 2019 Apr;19(4):11-18. (PMID: 30994425)
Am J Bioeth. 2020 Jun;20(5):28-30. (PMID: 32364472)
AJOB Neurosci. 2021 Jan;12(1):57-67. (PMID: 33528320)
Am J Bioeth. 2019 Apr;19(4):26-28. (PMID: 31544673)
Am J Bioeth. 2019 May;19(5):W3-W4. (PMID: 31068108)
Paediatr Drugs. 2016 Apr;18(2):145-56. (PMID: 26755349)
Contemp Clin Trials Commun. 2017 Nov 23;9:33-39. (PMID: 29696222)
BMC Med. 2014 Mar 24;12:52. (PMID: 24655604)
BMC Pediatr. 2020 Jul 24;20(1):353. (PMID: 32709229)
Pediatr Blood Cancer. 2011 Dec 1;57(6):998-1004. (PMID: 21280199)
Health Technol Assess. 2011 Mar;15(15):1-116. (PMID: 21443838)
Am J Bioeth. 2019 Apr;19(4):30-32. (PMID: 31544670)
Bioethics. 2016 Jul;30(6):440-50. (PMID: 26686529)
BMC Med Ethics. 2011 Sep 27;12:18. (PMID: 21943406)
Acad Med. 2014 Sep;89(9):1245-51. (PMID: 24979285)
Am J Bioeth. 2019 Apr;19(4):44-46. (PMID: 31544678)
Am J Bioeth. 2015;15(9):4-17. (PMID: 26305741)
معلومات مُعتمدة: P30 CA125123 United States CA NCI NIH HHS
تواريخ الأحداث: Date Created: 20230725 Date Completed: 20230726 Latest Revision: 20230728
رمز التحديث: 20230729
مُعرف محوري في PubMed: PMC10369198
DOI: 10.1001/jamanetworkopen.2023.25477
PMID: 37490290
قاعدة البيانات: MEDLINE
الوصف
تدمد:2574-3805
DOI:10.1001/jamanetworkopen.2023.25477