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Informed consent in randomised controlled trials: further development and evaluation of the participatory and informed consent (PIC) measure

BACKGROUND: Informed consent is an accepted ethical and legal prerequisite for trial participation, yet there is no standardised method of assessing patient understanding for informed consent. The participatory and informed consent (PIC) measure was developed for application to recruitment discussio...

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Autores principales: Wade, Julia, Humphrys, Elka, Realpe, Alba X, Gaunt, Daisy M, Burt, Jenni
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10155434/
https://www.ncbi.nlm.nih.gov/pubmed/37131255
http://dx.doi.org/10.1186/s13063-023-07296-y
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author Wade, Julia
Humphrys, Elka
Realpe, Alba X
Gaunt, Daisy M
Burt, Jenni
author_facet Wade, Julia
Humphrys, Elka
Realpe, Alba X
Gaunt, Daisy M
Burt, Jenni
author_sort Wade, Julia
collection PubMed
description BACKGROUND: Informed consent is an accepted ethical and legal prerequisite for trial participation, yet there is no standardised method of assessing patient understanding for informed consent. The participatory and informed consent (PIC) measure was developed for application to recruitment discussions to evaluate recruiter information provision and evidence of patient understanding. Preliminary evaluation of the PIC indicated the need to improve inter-rater and intra-rater reliability ratings and conduct further psychometric evaluation. This paper describes the assessment, revision and evaluation of the PIC within the context of OPTiMISE, a pragmatic primary care-based trial. METHODS: This study used multiple methods across two phases. In phase one, one researcher applied the existing PIC measure to 18 audio-recorded recruitment discussions from the OPTiMISE study and made detailed observational notes about any uncertainties in application. Appointments were sampled to be maximally diverse for patient gender, study centre, recruiter and before and after an intervention to optimise information provision. Application uncertainties were reviewed by the study team, revisions made and a coding manual developed and agreed. In phase two, the coding manual was used to develop tailored guidelines for applying the PIC to appointments within the OPTiMISE trial. Two researchers then assessed 27 further appointments, purposively sampled as above, to evaluate inter-rater and intra-rater reliability, content validity and feasibility. RESULTS: Application of the PIC to 18 audio-recorded OPTiMISE recruitment discussions resulted in harmonisation of the scales rating recruiter information provision and evidence of patient understanding, minor amendments to clarify wording and the development of detailed generic coding guidelines for applying the measure within any trial. Application of the revised measure using these guidelines to 27 further recruitment discussions showed good feasibility (time to complete), content validity (completion rate) and reliability (inter- and intra-rater) of the measure. CONCLUSION: The PIC provides a means to evaluate the content of information provided by recruiters, patient participation in recruitment discussions and, to some extent, evidence of patient understanding. Future work will use the measure to evaluate recruiter information provision and evidence of patient understanding both across and within trials. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13063-023-07296-y.
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spelling pubmed-101554342023-05-04 Informed consent in randomised controlled trials: further development and evaluation of the participatory and informed consent (PIC) measure Wade, Julia Humphrys, Elka Realpe, Alba X Gaunt, Daisy M Burt, Jenni Trials Methodology BACKGROUND: Informed consent is an accepted ethical and legal prerequisite for trial participation, yet there is no standardised method of assessing patient understanding for informed consent. The participatory and informed consent (PIC) measure was developed for application to recruitment discussions to evaluate recruiter information provision and evidence of patient understanding. Preliminary evaluation of the PIC indicated the need to improve inter-rater and intra-rater reliability ratings and conduct further psychometric evaluation. This paper describes the assessment, revision and evaluation of the PIC within the context of OPTiMISE, a pragmatic primary care-based trial. METHODS: This study used multiple methods across two phases. In phase one, one researcher applied the existing PIC measure to 18 audio-recorded recruitment discussions from the OPTiMISE study and made detailed observational notes about any uncertainties in application. Appointments were sampled to be maximally diverse for patient gender, study centre, recruiter and before and after an intervention to optimise information provision. Application uncertainties were reviewed by the study team, revisions made and a coding manual developed and agreed. In phase two, the coding manual was used to develop tailored guidelines for applying the PIC to appointments within the OPTiMISE trial. Two researchers then assessed 27 further appointments, purposively sampled as above, to evaluate inter-rater and intra-rater reliability, content validity and feasibility. RESULTS: Application of the PIC to 18 audio-recorded OPTiMISE recruitment discussions resulted in harmonisation of the scales rating recruiter information provision and evidence of patient understanding, minor amendments to clarify wording and the development of detailed generic coding guidelines for applying the measure within any trial. Application of the revised measure using these guidelines to 27 further recruitment discussions showed good feasibility (time to complete), content validity (completion rate) and reliability (inter- and intra-rater) of the measure. CONCLUSION: The PIC provides a means to evaluate the content of information provided by recruiters, patient participation in recruitment discussions and, to some extent, evidence of patient understanding. Future work will use the measure to evaluate recruiter information provision and evidence of patient understanding both across and within trials. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13063-023-07296-y. BioMed Central 2023-05-02 /pmc/articles/PMC10155434/ /pubmed/37131255 http://dx.doi.org/10.1186/s13063-023-07296-y Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Methodology
Wade, Julia
Humphrys, Elka
Realpe, Alba X
Gaunt, Daisy M
Burt, Jenni
Informed consent in randomised controlled trials: further development and evaluation of the participatory and informed consent (PIC) measure
title Informed consent in randomised controlled trials: further development and evaluation of the participatory and informed consent (PIC) measure
title_full Informed consent in randomised controlled trials: further development and evaluation of the participatory and informed consent (PIC) measure
title_fullStr Informed consent in randomised controlled trials: further development and evaluation of the participatory and informed consent (PIC) measure
title_full_unstemmed Informed consent in randomised controlled trials: further development and evaluation of the participatory and informed consent (PIC) measure
title_short Informed consent in randomised controlled trials: further development and evaluation of the participatory and informed consent (PIC) measure
title_sort informed consent in randomised controlled trials: further development and evaluation of the participatory and informed consent (pic) measure
topic Methodology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10155434/
https://www.ncbi.nlm.nih.gov/pubmed/37131255
http://dx.doi.org/10.1186/s13063-023-07296-y
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