Factors Influencing Participation in Clinical Trials: Emergency Medicine vs. Other Specialties.

Anita Kurt PhD, RN, Lehigh Valley Health Network
Hope Kincaid MPH, CPH, Lehigh Valley Health Network
Charity Curtis MPH, Lehigh Valley Health Network
Lauren Semler, Lehigh Valley Health Network
Matthew Meyers BS, Lehigh Valley Health Network
Melanie B. Johnson MPA, Lehigh Valley Health Network
Beth Careyva M.D., Lehigh Valley Health Network
Brian Stello MD, Lehigh Valley Health Network
Timothy J. Friel MD, Lehigh Valley Health Network
Mark Knouse MD, Lehigh Valley Health Network
John C. Smulian MD, MPH, Lehigh Valley Health Network
Jeanne L. Jacoby MD, Lehigh Valley Health Network


Introduction: This study investigated factors that influence emergency medicine (EM) patients' decisions to participate in clinical trials and whether the impact of these factors differs from those of other medical specialties. Methods: A survey was distributed in EM, family medicine (FM), infectious disease (ID), and obstetrics/gynecology (OB/GYN) outpatient waiting areas. Eligibility criteria included those who were 18 years of age or older, active patients on the day of the survey, and able to complete the survey without assistance. We used the Kruskal-Wallis test and ordinal logistic regression analyses to identify differences in participants' responses. Results: A total of 2,893 eligible subjects were approached, and we included 1,841 surveys in the final analysis. Statistically significant differences (p=0.009) were found for eight of the ten motivating factors between EM and one or more of the other specialties. Regardless of a patient's gender, race, and education, the relationship with their doctor was more motivating to patients seen in other specialties than to EM patients (FM [odds ratio {OR}:1.752, 95% confidence interval {CI}{1.285-2.389}], ID [OR:3.281, 95% CI{2.293-4.695}], and OB/GYN [OR:2.408, 95% CI{1.741-3.330}]). EM's rankings of "how well the research was explained" and whether "the knowledge learned would benefit others" as their top two motivating factors were similar across other specialties. All nine barriers showed statistically significant differences (p=0.008) between EM and one or more other specialties. Participants from all specialties indicated "risk of unknown side effects" as their strongest barrier. Regardless of the patients' race, "time commitment" was considered to be more of a barrier to other specialties when compared to EM (FM [OR:1.613, 95% CI{1.218-2.136}], ID [OR:1.340, 95% CI{1.006-1.784}], or OB/GYN [OR:1.901, 95% CI{1.431-2.526}]). Among the six resources assessed that help patients decide whether to participate in a clinical trial, only one scored statistically significantly different for EM (p