Investigating patient recruitment to radiotherapy clinical trials

2016 ◽  
Vol 15 (3) ◽  
pp. 232-238 ◽  
Author(s):  
Emma Thompson ◽  
Melanie Clarkson
Keyword(s):  
Decision Making ◽  
Clinical Trials ◽  
Expert Knowledge ◽  
Dose Fractionation ◽  
Trial Participation ◽  
Decision Making Process ◽  
Patient Interviews ◽  
Main Factors ◽  
Randomised Controlled ◽  
Lack Of Commitment

AbstractBackgroundRadiotherapy randomised controlled trials provide evidence to support the development of new techniques and dose/fractionation regimens. Some radiotherapy trials have previously had to close early or revise targets due to low recruitment rates. Many authors have recommended research into recruitment strategies for many areas of medicine, however little work has been carried out in the specific field of radiotherapy.MethodUsing a survey of research radiographers followed by radiotherapy patient interviews, this project provides perspectives on motives for patient participation in radiotherapy clinical trials, and how to best support people through this decision-making process.FindingsThe main factors influencing participation identified by the radiographers were altruism, treatment fatigue and concerns about the trial arms, lack of resources and lack of commitment from some medical colleagues. For patients the main factors were mainly emotional; altruism, and fears for efficacy of different trial arms featured, with requests for timely communication of trial information.ConclusionWe recommend that strategies should be offered proactively to support patients through the decision-making process when considering trial participation. Research radiographers are ideally qualified to offer support and expert knowledge to these patients.

scholarly journals Participation in a randomised controlled trial (RCT) of metformin in gestational diabetes mellitus (GDM): pregnant women’s perceptions and experiences of the decision-making process

2021 ◽  
Vol 4 ◽  
pp. 65
Author(s):  
Sinead Wallace ◽  
Catherine Houghton ◽  
Fidelma Dunne
Keyword(s):  
Diabetes Mellitus ◽  
Clinical Trial ◽  
Decision Making ◽  
Clinical Trials ◽  
Gestational Diabetes ◽  
Pregnant Women ◽  
Controlled Trial ◽  
Decision Making Process ◽  
Randomised Controlled ◽  
In Pregnancy

Background: Research in pregnancy and childbirth is required to advance healthcare needs for this population. Fears around potential fetal risk and the history of drug scandals renders it an area of research that is somewhat neglected. Due to the growing medical complexities facing pregnant women, efforts have been made in recent times to recognise the ethical importance of including this population in clinical research. Although clinical trials are becoming more common in pregnancy, recruitment of this population remains difficult with a common assumption that pregnant women would be reluctant to participate in clinical trials. This study set out to explore pregnant women’s perspectives and experiences of the decision-making process to participate in a randomised controlled trial of metformin in gestational diabetes mellitus (the EMERGE clinical trial). Methods: This study employed a qualitative descriptive design with thematic analysis. Data were collected by conducting individual semi-structured interviews (n=11) with participants (n=9) and decliners (n=2) of the EMERGE clinical trial.  Results: The main findings reveal that a significant perception of personal benefit from participation was the biggest influence on women’s decisions to participate. Concerns about the impact of gestational diabetes on their pregnancies, the option of a favourable intervention treatment, a low perception of risk associated with the trial and the opportunity to help medical research appeared to have significantly influenced their decision. Receiving detailed information, personal interactions with the study team, a perception of voluntariness in participation and accessibility of the trial positively impacted on women’s decisions to participate.  Conclusions: Personal contact during recruitment, presenting clear and thorough trial information, providing previous participant testimonials, and facilitating women to participate in clinical trials are all important strategies when trying to enhance recruitment in pregnancy trials. Further research on pregnant women declining participation in clinical trials is needed.

A Decision Methodology for Determining Suitable Post-Disaster Accommodations: Reconsidering Effective Indicators for Decision-making Processes

2020 ◽  
Vol 17 (3) ◽  
Author(s):  
S. M. Amin Hosseini ◽  
Albert de la Fuente ◽  
Oriol Pons ◽  
Carmen Mendoza Arroyo
Keyword(s):  
Decision Making ◽  
Case Studies ◽  
Natural Hazard ◽  
Recovery Process ◽  
Decision Making Process ◽  
Temporary Housing ◽  
Universal Approach ◽  
Decision Making Processes ◽  
Main Factors ◽  
Post Disaster

AbstractOne of the main challenges in assisting displaced persons who have lost their homes as a result of a natural hazard is the provision of adequate post-disaster accommodations, such as temporary housing. Although the need for temporary housing has increased around the world in recent years, it has been criticized on economic, environmental, and social grounds. A universal approach to post-disaster accommodations cannot successfully deal with this issue because each recovery process involves a unique set of conditions. Therefore, rather than defining a specific strategy, this study aims to present an approach capable of producing customized strategies based on contextual and social conditions. To this end, first, the main factors influencing the choice of post-disaster accommodations are identified through five case studies. It is concluded that all of the factors can be organized into three main vertices to simplify the highly complex issues involved in post-disaster accommodations. The case studies also show that the decision-making process consists of two main parts. To date, a recurring failure to distinguish between these two parts has led to unsuitable outcomes. Thus, this paper presents a new decision-making methodology, consisting of multiple steps, phases, and indicators based on the main vertices.

TO STANDARDISE OR TO PATENT? DEVELOPMENT OF A DECISION MAKING TOOL AND RECOMMENDATIONS FOR YOUNG COMPANIES

2016 ◽  
Vol 20 (08) ◽  
pp. 1640020 ◽  
Author(s):  
NIZAR ABDELKAFI ◽  
SERGIY MAKHOTIN ◽  
MARINA THUNS ◽  
ANNA POHLE ◽  
KNUT BLIND
Keyword(s):  
Decision Making ◽  
Influencing Factors ◽  
Knowledge Diffusion ◽  
Decision Making Process ◽  
Need Support ◽  
Knowledge Protection ◽  
Main Factors ◽  
Intellectual Properties ◽  
Technology Resources ◽  
Decision Making Tool

Young companies need support concerning decisions related to intellectual properties. Entrepreneurs can resort to a menu of strategies, not only patenting. First, we explore the literature on standardisation and patenting and relate it to entrepreneurship to identify the internal and external influencing factors as well as the motives and risks related to decision making. Then, we conduct five case studies to explore these influencing factors, while trying to reconstruct the decision making process. We find five main factors: technology, resources, knowledge protection vs. knowledge diffusion, need for partnerships, and pace of innovation. Companies should use patents when their technology is patentable and knowledge protection is perceived essential. Standardisation is suitable when knowledge diffusion is more important than protection, and companies look for establishing new partnerships. These insights are integrated into a decision tree that provides guidance to young entrepreneurs to make an informed decision regarding intellectual properties.

scholarly journals Realizing better doctor-patient dialogue about choices in palliative care and early phase clinical trial participation: towards an online value clarification tool (OnVaCT)

2019 ◽  
Vol 18 (1) ◽  
Author(s):  
Liza G. G. van Lent ◽  
Nicole K. Stoel ◽  
Julia C. M. van Weert ◽  
Jelle van Gurp ◽  
Maja J. A. de Jonge ◽  
...  
Keyword(s):  
Decision Making ◽  
Clinical Trials ◽  
Advanced Cancer ◽  
Early Phase ◽  
Decisional Conflict ◽  
Decision Making Process ◽  
Medical Oncologists ◽  
Post Test ◽  
Patient Values ◽  
Early Phase Clinical Trials

Abstract Background Patients with advanced cancer for whom standard systemic treatment is no longer available may be offered participation in early phase clinical trials. In the decision making process, both medical-technical information and patient values and preferences are important. Since patients report decisional conflict after deciding on participation in these trials, improving the decision making process is essential. We aim to develop and evaluate an Online Value Clarification Tool (OnVaCT) to assist patients in clarifying their values around this end-of-life decision. This improved sharing of values is hypothesized to support medical oncologists in tailoring their information to individual patients’ needs and, consequently, to support patients in taking decisions in line with their values and reduce decisional conflict. Methods In the first part, patients’ values and preferences and medical oncologists’ views hereupon will be explored in interviews and focus groups to build a first prototype OnVaCT using digital communication (serious gaming). Next, we will test feasibility during think aloud sessions, to deliver a ready-to-implement OnVaCT. In the second part, the OnVaCT, with accompanied training module, will be evaluated in a pre-test (12–18 months before implementation) post-test (12–18 months after implementation) study in three major Dutch cancer centres. We will include 276 patients (> 18 years) with advanced cancer for whom standard systemic therapy is no longer available, and who are referred for participation in early phase clinical trials. The first consultation will be recorded to analyse patient-physician communication regarding the discussion of patients’ values and the decision making process. Three weeks afterwards, decisional conflict will be measured. Discussion This project aims to support the discussion of patient values when considering participation in early phase clinical trials. By including patients before their first appointment with the medical oncologist and recording that consultation, we are able to link decisional conflict to the decision making process, e.g. the communication during consultation. The study faces challenges such as timely including patients within the short period between referral and first consultation. Furthermore, with new treatments being developed rapidly, molecular stratification may affect the patient populations included in the pre-test and post-test periods. Trial registration Netherlands Trial Registry number: NTR7551 (prospective; July 17, 2018).

“When offered to participate”: A systematic review and meta-analysis of patient agreement to participate in cancer clinical trials.

2020 ◽  
Vol 38 (29_suppl) ◽  
pp. 92-92
Author(s):  
Joseph M. Unger ◽  
Dawn L. Hershman ◽  
Cathee Till ◽  
Lori M. Minasian ◽  
Raymond U Osarogiagbon ◽  
...  
Keyword(s):  
Systematic Review ◽  
Decision Making ◽  
Clinical Trials ◽  
Meta Analysis ◽  
Trial Participation ◽  
Participation Rates ◽  
Patient Decision Making ◽  
Asian Patients ◽  
Patient Decision ◽  
Black Patients

92 Background: Patient participation in clinical trials (CTs) is vital for knowledge advancement and outcomes improvement. The rate of CT participation for adult cancer patients is between 5%-8%; many CTs fail due to poor accrual. Although patient decision-making is a common focus of studies examining barriers to CT participation, the rate of trial participation for patients actually offered a CT is unknown. Methods: We conducted a systematic review and meta-analysis using PubMed, Web of Science, and Ovid Medline search engines to identify studies over 20 years (1/1/2000-1/1/2020) that examined CT participation. Studies must have been conducted in the United States and specified the number of patients offered a CT and the number enrolled. We conducted a meta-analysis of single proportions using random effects. Rates were examined for both treatment trials and cancer control (CC) studies. We also compared the rates of enrollment between Black, Hispanic, and Asian patients versus White patients. Clinical care setting (academic vs community) was examined as a potential moderator. Results: We screened 3,241 unique citations and identified 35 (30 treatment and 5 CC) studies among which n = 9,759 patients were offered CT participation. Overall, 55.0% (95% CI: 49.4%-60.5%) of patients offered a CT agreed to enroll. Trial participation rates did not differ between treatment (55.0%, 95% CI: 48.9%-60.9%) and CC trials (55.3%, 95% CI: 38.9%-71.1%, p = .98); however, participation rates were significantly higher at academic centers (58.4%, 95% CI: 52.2%-64.5%) versus community centers (45.0%, 95% CI: 34.5%-55.7%, p = .04). In common studies, Black patients agreed to participate at similar rates (58.4%, 95% CI: 46.8%-69.7%) compared to White patients (55.1%, 95% CI: 44.3%-65.6%, p = .88). Results were also similar comparing White versus Hispanic or Asian patients. The main reasons for non-participation were treatment choice or lack of interest. Conclusions: More than half of all cancer patients who are offered CTs do participate; results were consistent between major race/ethnicity groups. This finding upends several conventional beliefs about cancer clinical trial participation, including that Black patients are less likely to agree to participate and that patient decision-making is the primary barrier to participation. Policies and interventions to improve CT participation should focus more on modifiable systemic structural and clinical barriers, such as improving access to existing trials and broadening trial eligibility.

Why Cancer Patients Enter Randomized Clinical Trials: Exploring the Factors That Influence Their Decision

2004 ◽  
Vol 22 (21) ◽  
pp. 4312-4318 ◽  
Author(s):  
James R. Wright ◽  
Timothy J. Whelan ◽  
Susan Schiff ◽  
Sacha Dubois ◽  
Dauna Crooks ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Decision Making ◽  
Clinical Trials ◽  
Logistic Regression ◽  
Cancer Patients ◽  
Randomized Clinical Trials ◽  
Univariate Analysis ◽  
Multivariate Logistic Regression Model ◽  
Decision Making Process ◽  
Trial Entry

Purpose Few interventions have been designed and tested to improve recruitment to clinical trials in oncology. The multiple factors influencing patients' decisions have made the prioritization of specific interventions challenging. The present study was undertaken to identify the independent predictors of a cancer patient's decision to enter a randomized clinical trial. Methods A list of factors from the medical literature was augmented with a series of focus groups involving cancer patients, physicians, and clinical research associates (CRAs). A series of questionnaires was developed with items based on these factors and were administered concurrently to 189 cancer patients, their physicians, and CRAs following the patient's decision regarding trial entry. Forward logistic regression modeling was performed using the items significantly correlated (by univariate analysis) with the decision to enter a clinical trial. Results A number of items were significantly correlated with the patient's decision. In the multivariate logistic regression model, the patient's perception of personal benefit was the most important, with an odds ratio (OR) of 3.08 (P < .05). CRA-related items involving supportive aspects of the decision-making process were also important. These included whether the CRA helped with the decision (OR = 1.71; P < .05), and whether the decision was hard for the patient to make (OR = 0.52; P < .05). Conclusion Strategies that better address the potential benefits of trial entry may result in improved accrual. Interventions or aids that focus on the supportive aspects of the decision-making process while respecting the need for information and patient autonomy may also lead to meaningful improvements in accrual.

scholarly journals Living Conditions of Sub-Saharan Immigrants in Belgium: A Socio-Economic Approach of Eating Habits

2019 ◽  
Vol 6 (9) ◽  
Author(s):  
Dr BALLE Guy-Romaric Ségbé
Keyword(s):  
Decision Making ◽  
Eating Habits ◽  
Living Environment ◽  
Decision Making Process ◽  
Economic Approach ◽  
Economic Relationships ◽  
Financial Condition ◽  
Main Factors ◽  
Sub Saharan ◽  
Qualitative Part

The objective of this study is to understand the socio-economic relationships in  habits among sub-Saharan immigrants in Belgium. The interactions between the new living environment and pre-immigration habits were also a focus of the study. The quantitative survey was carried out in seven Belgian cities on a sample of 180 persons. The qualitative part consisted of interviews with twelve sub-Saharan immigrants. The results showed that the main factors explaining the consumption of African food are: the presence of a spouse in the household, children's interest in African products, household size and the availability (supply) of products from the country of origin. Moreover, it appears that the length of stay on Belgian territory does not significantly affect the consumption of African products. Relationships to African food are variously perceived and expressed by sub-Saharan Africans. Basically, their consumption seems to respond to a need to reinvent the socio-emotional microcosm necessary to preserve sacred links with the land of origin. However, in this new and constraining environment, the economic and financial condition of these immigrants does not represent a major factor in the decision-making process for purchasing exotic products.

scholarly journals A Case Study on the Factors of Biometric Counterterrorism Policies as a Result of September 11, 2001

2020 ◽  
Vol 9 (2) ◽  
Author(s):  
Sharon Liu ◽  
Robert Hodgson
Keyword(s):  
Decision Making ◽  
Thematic Analysis ◽  
September 11 ◽  
Decision Making Process ◽  
Safety Measures ◽  
Terrorist Incident ◽  
Public Sentiment ◽  
Qualitative Thematic Analysis ◽  
Main Factors

Biometrics has emerged as a rapidly moving technology that has been continuously evolving and improving. It has even been incorporated as a form of counterterrorism, preventing incidents of terrorism as well as providing safety measures. While various researchers have analyzed the effectiveness of biometric counterterrorism measures, the factors behind the reasonings of those decision making process of implementation have been untouched. This paper looks to analyze the factors through a case study on the events of September 11, 2001, using a qualitative thematic analysis to identify the factors. It is important to note that rather than analyzing secondhand sources, this study will analyze first hand sources throughout the study. Through this study, it can be concluded that there are five main factors behind implementation of biometric counterterrorism policies: ensuring safety if a terrorist incident were to happen, increasing security to prevent the incident from occurring, public sentiment, potential to become in the future, and current effectivity.

scholarly journals A Literature Review of Factors Influencing Implementation of Management Information Systems in Organizations

2017 ◽  
Vol 12 (8) ◽  
pp. 72
Author(s):  
Shuddha Chowdhury ◽  
K. M. Salahuddin
Keyword(s):  
Decision Making ◽  
Information Systems ◽  
Management Information Systems ◽  
Vital Role ◽  
Decision Making Process ◽  
Successful Implementation ◽  
Management Information ◽  
Successful Execution ◽  
Main Factors ◽  
Process Managers

A proper implementation of Management Information Systems (MIS) can improve an organization's performance, productivity, and work efficiently. Three factors are vital in the successful implementation of MIS. These are organization factors, technology factors and management factors. There are several other factors but these three are the most important ones according to observation. All other factors can be incorporated into these three factors. These three main factors work in an integrated and coordinated way. There are several other important sub-factors in each of these three areas. These are also discussed in this paper. Management Information Systems (MIS) play a vital role in decision-making process. Managers can improve their decision-making process with the successful execution of Information Systems. Our main goal in this paper is to determine the factors and make discussions on them. How they affect in the successful implementation of MIS is also discussed here.

Project Management in Russian Companies: State of Affairs and Statistical Analysis of Characteristics� Correlation

2015 ◽  
Vol 4 (1) ◽  
pp. 3-12
Author(s):  
������ ◽  
O. Bykova
Keyword(s):  
Decision Making ◽  
Project Management ◽  
Statistical Analysis ◽  
System Organization ◽  
Current Situation ◽  
Decision Making Process ◽  
Russian Market ◽  
Main Factors ◽  
State Of Affairs

The research objective is to analyze the current situation in the field of project management in Russian market and to determine the main factors and depended variables, that influence the decision-making process in the field of project system organization. The research demonstrates the result of surveying 57 companies in the Russian market.

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