scholarly journals The Role of Clinical Trial Participation in Cancer Research: Barriers, Evidence, and Strategies

2016 ◽  
pp. 185-198 ◽  
Author(s):  
Joseph M. Unger ◽  
Elise Cook ◽  
Eric Tai ◽  
Archie Bleyer
Keyword(s):  
Clinical Trial ◽  
Age Groups ◽  
Treatment Decision ◽  
Cancer Clinical Trial ◽  
Trial Participation ◽  
Treatment Decision Making ◽  
Patients With Cancer ◽  
Global And Local ◽  
To Receive

Fewer than one in 20 adult patients with cancer enroll in cancer clinical trials. Although barriers to trial participation have been the subject of frequent study, the rate of trial participation has not changed substantially over time. Barriers to trial participation are structural, clinical, and attitudinal, and they differ according to demographic and socioeconomic factors. In this article, we characterize the nature of cancer clinical trial barriers, and we consider global and local strategies for reducing barriers. We also consider the specific case of adolescents with cancer and show that the low rate of trial enrollment in this age group strongly correlates with limited improvements in cancer population outcomes compared with other age groups. Our analysis suggests that a clinical trial system that enrolls patients at a higher rate produces treatment advances at a faster rate and corresponding improvements in cancer population outcomes. Viewed in this light, the issue of clinical trial enrollment is foundational, lying at the heart of the cancer clinical trial endeavor. Fewer barriers to trial participation would enable trials to be completed more quickly and would improve the generalizability of trial results. Moreover, increased accrual to trials is important for patients, because trials provide patients the opportunity to receive the newest treatments. In an era of increasing emphasis on a treatment decision-making process that incorporates the patient perspective, the opportunity for patients to choose trial participation for their care is vital.

scholarly journals Insurance denials for cancer clinical trial participation after the Affordable Care Act mandate

Cancer ◽  
2017 ◽  
Vol 123 (15) ◽  
pp. 2893-2900 ◽  
Author(s):  
Christine B. Mackay ◽  
Kaitlyn R. Antonelli ◽  
Suanna S. Bruinooge ◽  
Jarron M. Saint Onge ◽  
Shellie D. Ellis
Keyword(s):  
Clinical Trial ◽  
Affordable Care Act ◽  
Cancer Clinical Trial ◽  
Trial Participation ◽  
Clinical Trial Participation ◽  
The Affordable Care Act

scholarly journals Healthcare Interpreting and Informed Consent: What is the Interpreter’s Role in Treatment Decision-Making?

2007 ◽  
Vol 18 (2) ◽  
pp. 225-247 ◽  
Author(s):  
Andrew Clifford
Keyword(s):  
Decision Making ◽  
Informed Consent ◽  
Medical Ethics ◽  
Treatment Decision ◽  
Cross Cultural ◽  
Professional Relationships ◽  
Case Scenario ◽  
Treatment Decision Making ◽  
General Communication

This article examines the part that healthcare interpreters play in cross-cultural medical ethics, and it argues that there are instances when the interpreter needs to assume an interventionist role. However, the interpreter cannot take on this role without developing expertise in the tendencies that distinguish general communication from culture to culture, in the ethical principles that govern medical communication in different communities, and in the development of professional relationships in healthcare. The article describes each of these three variables with reference to a case scenario, and it outlines a number of interventionist strategies that could be potentially open to the interpreter. It concludes with a note about the importance of the three variables for community interpreter training. Keywords: community interpreting, informed consent, role of the interpreter, healthcare.

scholarly journals Effect of Red Wine Intake on Serum and Salivary Melatonin Levels: A Randomized, Placebo-Controlled Clinical Trial

Molecules ◽  
2018 ◽  
Vol 23 (10) ◽  
pp. 2474 ◽  
Author(s):  
Elena Varoni ◽  
Rita Paroni ◽  
Jacopo Antognetti ◽  
Giovanni Lodi ◽  
Andrea Sardella ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Healthy Volunteers ◽  
Red Wine ◽  
Statistical Significance ◽  
Serum Levels ◽  
Controlled Clinical Trial ◽  
Salivary Melatonin ◽  
The One ◽  
To Receive

Melatonin (MLT) is a recently discovered phytochemical in wine, but its influence on physiological MLT levels is still unknown. This study aimed at evaluating variations, in serum and saliva, of MLT concentrations after the intake of MLT-enriched red wine. Twelve healthy volunteers were recruited to receive 125 mL of red wine naturally lacking of MLT (placebo, PLC), or the same wine enriched with MLT (MLT+). A physiological steady decline of serum MLT was observed from baseline up to 90 min, for both wines. After PLC intake, the decrease was significantly faster than the one occurring after MLT+ wine, which thus delayed the drop down of serum MLT with a plateau at 30–60 min. Salivary MLT levels slightly peaked at 45 min after MLT+ wine intake, without statistical significance. Therefore, the intake of a glass of MLT-enriched red wine changed serum levels of the indoleamine, supporting the role of wine MLT in counteracting the physiological decline of the hormone into the bloodstream.

Patient perception of gynecologic cancer clinical trial participation in the Deep South

2020 ◽  
Vol 159 ◽  
pp. 293-294
Author(s):  
N.L. Rezvani ◽  
O.E. Gilbert ◽  
C. Smith ◽  
A.G. Chapple ◽  
N. Nair ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Gynecologic Cancer ◽  
Patient Perception ◽  
Cancer Clinical Trial ◽  
Trial Participation ◽  
Deep South ◽  
Clinical Trial Participation

scholarly journals Patient Income Level and Cancer Clinical Trial Participation

2013 ◽  
Vol 31 (5) ◽  
pp. 536-542 ◽  
Author(s):  
Joseph M. Unger ◽  
Dawn L. Hershman ◽  
Kathy S. Albain ◽  
Carol M. Moinpour ◽  
Judith A. Petersen ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Clinical Trials ◽  
Universal Access ◽  
Participation Rate ◽  
Treatment Decision ◽  
Trial Participation ◽  
Lower Income ◽  
Clinical Trial Participation ◽  
Clinical Trial Results ◽  
The Impact

Purpose Studies have shown an association between socioeconomic status (SES) and quality of oncology care, but less is known about the impact of patient SES on clinical trial participation. Patients and Methods We assessed clinical trial participation patterns according to important SES (income, education) and demographic factors in a large sample of patients surveyed via an Internet-based treatment decision tool. Logistic regression, conditioning on type of cancer, was used. Attitudes toward clinical trials were assessed using prespecified items about treatment, treatment tolerability, convenience, and cost. Results From 2007 to 2011, 5,499 patients were successfully surveyed. Forty percent discussed clinical trials with their physician, 45% of discussions led to physician offers of clinical trial participation, and 51% of offers led to clinical trial participation. The overall clinical trial participation rate was 9%. In univariate models, older patients (P = .002) and patients with lower income (P = .001) and education (P = .02) were less likely to participate in clinical trials. In a multivariable model, income remained a statistically significant predictor of clinical trial participation (odds ratio, 0.73; 95% CI, 0.57 to 0.94; P = .01). Even in patients age ≥ 65 years, who have universal access to Medicare, lower income predicted lower trial participation. Cost concerns were much more evident among lower-income patients (P < .001). Conclusion Lower-income patients were less likely to participate in clinical trials, even when considering age group. A better understanding of why income is a barrier may help identify ways to make clinical trials better available to all patients and would increase the generalizability of clinical trial results across all income levels.

Treatment decision-making in cancer care: the role of the carer

2010 ◽  
Vol 19 (13-14) ◽  
pp. 2023-2031 ◽  
Author(s):  
Gill Hubbard ◽  
Nicola Illingworth ◽  
Neneh Rowa-Dewar ◽  
Liz Forbat ◽  
Nora Kearney
Keyword(s):  
Decision Making ◽  
Cancer Care ◽  
Treatment Decision ◽  
Treatment Decision Making
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