Patients lured to CT trials by promise of free health info, benefit to society

Participants enlisted in research studies using coronary CT imaging cited additional health information, free imaging, and the altruistic benefit to society as motivating participation factors, according to a study published in the January issue of Academic Radiology.

Clinical research trials are crucial for the evolution of medicine and clinical practice and patient participation is necessary for their success. Recruitment strategies must be refined for optimal participation, which is affected by numerous factors.

Specialized factors can make recruitment even more challenging, as explained by the study’s lead author, Jacqueline Hallada, of the David Geffen School of Medicine in Los Angeles, and colleagues. “Unique attributes of computed tomographic (CT) imaging could present additional concerns in these clinical trials involving coronary CT angiography (CCTA)," they wrote. "CCTA continues to raise attention because of its radiation levels and potential for harmful effects over time.”

Hallada and colleagues analyzed influential factors in patient participation in research studies that involve coronary CT imaging by surveying patients interested in participating in CCTA imaging trials to determine factors that contributed to their decisions. Eighty participants were given a 12-point survey with a questionnaire. Forty of them agreed to participate in a cardiovascular CT imaging research study and the other forty declined.

Potential factors surveyed amongst the participants included additional health information, free imaging, altruistic benefit to society, monetary compensation, radiation exposure, role as an experimental subject, possible loss of confidentiality, contrast or investigational drug use, premedication use, blood draw or intravenous placement, time commitment, and personal medical opinion. These aspects were evaluated with a five-point Likert scale and were then compared between the enrolling and non-enrolling groups.

The researchers found that the enrolling subjects submitted significantly higher ratings than their non-enrolling counterparts for additional health information (average rating 4.5 out of 5 for enrolling patients), free imaging (4.1 out of 5), and the altruistic benefit to society (4.5 out of 5). Non-enrolling subjects were most concerned about possible drug use or contrast injection (average rating 3.1 out of 5 for non-enrolling patients), possible premedication (2.9 out of 5), and the time commitment (3.7 out of 5). Radiation exposure and personal medical opinion were rated significantly high as influential factors amongst both participant groups but did not differ between the two.

“This information can be used to develop a more conscientious approach to explain these research studies and lead to the modification of recruitment strategies, consent forms, and clinical procedures to meet the expectations of participants,” wrote the study’s authors. “Furthermore, the results from this study may provide insights into the typical concerns of patients undergoing CT imaging or other imaging procedures that use ionizing radiation in a clinical, non-research based setting.”