BMJ 1994;309:539-540 (20 August)

Letters

Patients are unwilling to enter clinical trials

EDITOR, - T C B Dehn is right to draw attention to the problems of obtaining informed consent from patients entering randomised trials, particularly when one option entails additional, potentially toxic treatment, such as chemotherapy.1 But Dehn's letter also illustrates the problem of avoiding bias when describing a trial: Dehn admits that five of six patients refused to enter a trial comparing preoperative chemotherapy with surgery alone for oesophageal cancer because of anxiety that they might get chemotherapy. I wonder if, had the patients been seen by an oncologist, a similar number might not have refused because they did not want to miss out on the "beneficial" effects of the chemotherapy.

A colleague and I are both committed to a particular trial testing the value of prophylactic cranial irradiation in small cell lung cancer. We both think that we are honest in our description of the hazards and benefits, and, . . . [Full text of this article]


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Relevant Article

Patients are unwilling to enter randomised trials
T C B Dehn
BMJ 1994 309: 126. [Extract] [Full Text]

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