본문 바로가기
KERD
논문KCI 등재

임상연구에서 피험자 서면동의의 질 평가

Evaluating the Quality of Informed Consent in Clinical Research

2

조회

0

다운로드

12

인용

0

참고문헌

키워드

주제분류의학일반

초록

This study was designed to assess the quality of the informed consent process in clinical research by measuring subjects’ understanding of informed consent. A convenience sample of 188 subjects aged 20 and above participated in bioequivalence studies at the Inje regional clinical trial center in Busan (South Korea). The study instruments were self-reported questionnaires, which were modified versions of the Quality of IC (QuIC) questionnaire developed by Joffe et al. (2001) and the Informed Consent Questionnaire-4 items (ICQ-4) developed by Guarino et al. (2006). The data were collected from February to May, 2007 and analyzed with descriptive statistics to assess the quality of the informed consent process and also with a t-test, X2 test, and paired t-test to identify correlates of increased understanding of informed consent. Prior to the subjects’ participation in these clinical trials, the mean QuIC objective knowledge score (QuIC-A) was 68.7 points (maximum: 100 points) and the perceived (subjective) understanding score (QuIC-B) was 78.7; after the clinical trials were completed, the mean scores for (QuIC-A) and (QuIC-B) were 68.7 and 80.4 respectively. The general quality of informed consent (ICQ-4) was measured after the clinical trials were completed; the score was 78.3 points (maximum: 100 points). Higher objective knowledge (QuIC-A) scores were associated with age (25 years old and above, p=0.043), and education (college and above, p=0.001). Higher QuIC-B scores were associated with previous experience with clinical trials (p=0.028) and memorization of the date of the signed consent (p=0.037). The quality of informed consent measured in this study is significantly lower than that reported in similar studies conducted in the US and Australia. Thus, this study suggests that it is there is a need to develop strategies to improve subjects’ understanding of informed consent.

Abstract

This study was designed to assess the quality of the informed consent process in clinical research by measuring subjects’ understanding of informed consent. A convenience sample of 188 subjects aged 20 and above participated in bioequivalence studies at the Inje regional clinical trial center in Busan (South Korea). The study instruments were self-reported questionnaires, which were modified versions of the Quality of IC (QuIC) questionnaire developed by Joffe et al. (2001) and the Informed Consent Questionnaire-4 items (ICQ-4) developed by Guarino et al. (2006). The data were collected from February to May, 2007 and analyzed with descriptive statistics to assess the quality of the informed consent process and also with a t-test, X2 test, and paired t-test to identify correlates of increased understanding of informed consent. Prior to the subjects’ participation in these clinical trials, the mean QuIC objective knowledge score (QuIC-A) was 68.7 points (maximum: 100 points) and the perceived (subjective) understanding score (QuIC-B) was 78.7; after the clinical trials were completed, the mean scores for (QuIC-A) and (QuIC-B) were 68.7 and 80.4 respectively. The general quality of informed consent (ICQ-4) was measured after the clinical trials were completed; the score was 78.3 points (maximum: 100 points). Higher objective knowledge (QuIC-A) scores were associated with age (25 years old and above, p=0.043), and education (college and above, p=0.001). Higher QuIC-B scores were associated with previous experience with clinical trials (p=0.028) and memorization of the date of the signed consent (p=0.037). The quality of informed consent measured in this study is significantly lower than that reported in similar studies conducted in the US and Australia. Thus, this study suggests that it is there is a need to develop strategies to improve subjects’ understanding of informed consent.

참고문헌 (24)

  1. Sugarman J, "The Nuremberg Code in Ethics of research with human subjects", pp.12~13 (1998), University Publishing Group
  2. Ethical principles and guidelines for the protection of human subjects of research, , National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research, ~ (1979)
  3. "U.S Department of Health and Human Services", 45 Code of Federal Regulations 46. Fed Reg 1991, ~ (1991)
  4. Priestley KA, "Are patient consent forms for research protocols easy to read?", BMJ, 305(6864), pp.1263~1264 (1992)
  5. Barnett K, "Randomized study of the impact of different styles of patient information leaflets for randomized controlled trials on children’s understanding", Arch Dis Child, 90(4), pp.364~366 (2005)
  6. Williams MV, "Inadequate functional health literacy among patients at two public hospitals", JAMA, 274(21), pp.1677~1682 (1995)
  7. Riecken HW, "Informed consent to biomedical research in veterans administration hospitals", JAMA, 248(3), pp.344~348 (1982)
  8. Joffe S, "Quality of informed consent in cancer clinical trials: a cross-sectional survey", Lancet, 358(9295), pp.1772~1777 (2001)
  9. Schaeffer MH, "The impact of disease severity on the informed consent process in clinical research", Am J Med, 100(3), pp.261~268 (1996)
  10. "Advisory Committee on Human Radiation Experiments" (1996), Oxford University Press
  11. Daugherty C, "Perceptions of cancer patients and their physicians involved in phase I trials", J Clin Oncol, 13(5), pp.1062~1072 (1995)
  12. Appelbaum PS, "False hopes and best data: consent to research and the therapeutic misconception", Hastings Cent Rep, 17(2), pp.20~24 (1987)
  13. Appelbaum PS, "Therapeutic misconception in clinical research: frequency and risk factors", IRB, 26(2), pp.1~8 (2004)
  14. 김양희, "암 임상연구에 참여하는 환자들의 피험자 동의서에 관한 인식조사", 석사, pp.2008
  15. Joffe S, "Quality of informed consent: a new measure of understanding among research subjects", J Natl Cancer Inst, 93(2), pp.139~147 (2001)
  16. Guarino P, "A brief measure of perceived understanding of informed consent in a clinical trial was validated", J Clin Epidemiol, 59(6), pp.608~614 (2006)
  17. Flory J, "Interventions to improve research participants’understanding in informed consent for research : A systematic review", JAMA, 292(13), pp.1593~1601 (2004)
  18. Ferguson PR, "Patients’perceptions of information provided in clinical trials", J Med Ethics, 28(1), pp.45~48 (2002)
  19. Moseley TH, "Effects of presentation method on the understanding of informed consent", Br J Ophthalmol, 90(8), pp.990~993 (2006)
  20. Paris A, "French adaptation and preliminary validation of a questionnaire to evaluate understanding of informed consent documents in phase I biomedical research", Fundam Clin Pharmacol, 20(1), pp.97~104 (2006)
  21. Jefford M, "Satisfaction with the decision to participate in cancer clinical trials (CCT) is high, but understanding is a problem", J Clin Oncol, 23(16S), pp.6067~ (2005)
  22. Brauer LH, "Informed consent in clinical trials: From process to paper", Res Pract, 9(1), pp.11~16 (2008)
  23. Cohn E, "Improving participant comprehension in the informed consent process", J Nurs Scholarsh, 39(3), pp.273~280 (2007)
  24. Dunn CM, "Protecting study volunteers in research: a manual for investigative sites", pp.33~ (2004), CenterWatch

관련 논문AI추천

이 간행물의 다른 논문 (4건)