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| Research article summary (published 10 May 2009): |
Who will participate in acute stroke trials?
Full Abstract
BACKGROUND: Despite the high incidence of acute stroke, only a minority of patients are enrolled in acute stroke treatment trials. We aimed to identify factors associated with participation in clinical trials of novel therapeutic agents for acute stroke. METHODS: Prospective survey of patients with acute stroke <72 hours from onset. A structured interview was administered to the patient or primary decision-maker. If offered participation in an actual acute treatment trial, questions focused on decisions about that trial; otherwise a similar mock trial was proposed. The primary outcome was whether the subject agreed to participate in the proposed trial. RESULTS: A total of 200 subjects (47% patients, 53% proxies) completed the survey: mean age 63 +/- 14 years, 47% women, 44% white, 50% black. A real acute trial was offered to 22%; others were offered a mock trial. Overall, 57% (95% confidence interval: 50%-64%) of respondents stated they would participate in the proposed acute treatment trial. There were no differences with respect to age, sex, race, educational level, self-assessed stroke severity or stroke type, vascular risk factors, or comorbidities. Misconceptions about key research concepts were found in 50% but did not impact participation. Participation was associated with the perceived risk of the proposed trial intervention (p < 0.001), prior general attitudes about research (p < 0.001), and influences attributed to family, religion, and other personal beliefs (p < 0.001). Patients were more likely to participate than proxy decision-makers (p = 0.04). CONCLUSIONS: Demographic factors, clinical factors, and prior knowledge about research have little impact on the decision to participate in acute stroke clinical trials. Preexisting negative attitudes and external influences about research strongly inhibit participation. Patients are more inclined to participate than their proxy decision-makers.
Author information
Author/s: Kasner, S E (SE); Del Giudice, A (A); Rosenberg, S (S); Sheen, M (M); Luciano, J M (JM); Cucchiara, B L (BL); Messé, S R (SR); Sansing, L H (LH); Baren, J M (JM);
Affiliation: Department of Neurology, University of Pennsylvania Medical Center, 3 West Gates Building, 3400 Spruce Street, Philadelphia, PA 19104, USA. kasner(-atsign-)mail.med.upenn.edu
Journal and publication information
Publication Type: Journal Article; Research Support, Non-U.S. Gov't
Journal: Neurology (Neurology), published in United States. (Language: eng)
Reference: 2009-May; vol 72 (issue 19) : pp 1682-8
Dates: Created 2009/05/12; Completed 2009/06/30;
PMID: 19433742, status: MEDLINE (last retrieval date: 6/30/2009, IMS Date: 30 Jun 2009 00:00:00)
Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.
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