TY - JOUR
T1 - A randomised controlled trial of consent procedures for the use of residual tissues for medical research
T2 - Preferences of and implications for patients, research and clinical practice
AU - Rebers, S.
AU - Vermeulen, E.
AU - Brandenburg, A. P.
AU - Stoof, T. J.
AU - Zupan-Kajcovski, B.
AU - Bos, W. J.W.
AU - Jonker, M. J.
AU - Bax, C. J.
AU - Van Driel, W. J.
AU - Verwaal, V. J.
AU - Van Den Brekel, M. W.
AU - Grutters, J. C.
AU - Tupker, R. A.
AU - Plusjé, L.
AU - De Bree, R.
AU - Van Leeuwen, J. H.Schagen
AU - Vermeulen, E. G.J.
AU - De Leeuw, R. A.
AU - Brohet, R. M.
AU - Aaronson, N. K.
AU - Van Leeuwen, F. E.
AU - Schmidt, M. K.
N1 - Dutch Trial Register NTR2982
PY - 2016/3/30
Y1 - 2016/3/30
N2 - Background: Despite much debate, there is little evidence on consequences of consent procedures for residual tissue use. Here, we investigated these consequences for the availability of residual tissue for medical research, clinical practice, and patient informedness. Methods: We conducted a randomised clinical trial with three arms in six hospitals. Participants, patients from whom tissue had been removed for diagnosis or treatment, were randomised to one of three arms: informed consent, an opt-out procedure with active information provision (opt-out plus), and an opt-out procedure without active information provision. Participants received a questionnaire six weeks post-intervention; a subsample of respondents was interviewed. Health care providers completed a pre- and post-intervention questionnaire. We assessed percentage of residual tissue samples available for medical research, and patient and health care provider satisfaction and preference. Health care providers and outcome assessors could not be blinded. Results: We randomised 1,319 patients, 440 in the informed consent, 434 in the opt-out plus, and 445 in the opt-out arm; respectively 60.7%, 100%, and 99.8% of patients' tissue samples could be used for medical research. Of the questionnaire respondents (N = 224, 207, and 214 in the informed consent, opt-out plus, and opt-out arms), 71%, 69%, and 31%, respectively, indicated being (very) well informed. By questionnaire, the majority (53%) indicated a preference for informed consent, whereas by interview, most indicated a preference for optout plus (37%). Health care providers (N = 35) were more likely to be (very) satisfied with opt-out plus than with informed consent (p = 0.002) or opt-out (p = 0.039); the majority (66%) preferred opt-out plus. Conclusion: We conclude that opt-out with information (opt-out plus) is the best choice to balance the consequences for medical research, patients, and clinical practice, and is therefore the most optimal consent procedure for residual tissue use in Dutch hospitals.
AB - Background: Despite much debate, there is little evidence on consequences of consent procedures for residual tissue use. Here, we investigated these consequences for the availability of residual tissue for medical research, clinical practice, and patient informedness. Methods: We conducted a randomised clinical trial with three arms in six hospitals. Participants, patients from whom tissue had been removed for diagnosis or treatment, were randomised to one of three arms: informed consent, an opt-out procedure with active information provision (opt-out plus), and an opt-out procedure without active information provision. Participants received a questionnaire six weeks post-intervention; a subsample of respondents was interviewed. Health care providers completed a pre- and post-intervention questionnaire. We assessed percentage of residual tissue samples available for medical research, and patient and health care provider satisfaction and preference. Health care providers and outcome assessors could not be blinded. Results: We randomised 1,319 patients, 440 in the informed consent, 434 in the opt-out plus, and 445 in the opt-out arm; respectively 60.7%, 100%, and 99.8% of patients' tissue samples could be used for medical research. Of the questionnaire respondents (N = 224, 207, and 214 in the informed consent, opt-out plus, and opt-out arms), 71%, 69%, and 31%, respectively, indicated being (very) well informed. By questionnaire, the majority (53%) indicated a preference for informed consent, whereas by interview, most indicated a preference for optout plus (37%). Health care providers (N = 35) were more likely to be (very) satisfied with opt-out plus than with informed consent (p = 0.002) or opt-out (p = 0.039); the majority (66%) preferred opt-out plus. Conclusion: We conclude that opt-out with information (opt-out plus) is the best choice to balance the consequences for medical research, patients, and clinical practice, and is therefore the most optimal consent procedure for residual tissue use in Dutch hospitals.
UR - http://www.scopus.com/inward/record.url?scp=84962713412&partnerID=8YFLogxK
U2 - https://doi.org/10.1371/journal.pone.0152509
DO - https://doi.org/10.1371/journal.pone.0152509
M3 - Article
C2 - 27028128
SN - 1932-6203
VL - 11
JO - PLOS ONE
JF - PLOS ONE
IS - 3
M1 - e0152509
ER -