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Disparity Among Races In Regards to Clinical Trial Discussions

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Study data may account for underenrollment of black patients in cancer clinical trials

A new study further confirms racial disparities in the quality of communication between physicians and patients. When comparing how physicians discuss clinical trials with patients, researchers discovered that oncologists provided black patients with less information overall compared with white patients, according to data presented at the Fifth American Association for Cancer Research Conference on The Science of Cancer Health Disparities.

“Minority patients tend to receive less information, which could, in part, explain underenrollment by minorities in clinical cancer trials,” said Susan Eggly, PhD, associate professor of oncology in the Population Studies and Disparities Program at Wayne State University School of Medicine and the Barbara Ann Karmanos Cancer Institute in Detroit, Michigan. “These disparities could also lead to minority patients being enrolled in trials without fully understanding the purpose of the trial and the potential risks of participation.”

For the study, 22 video-recorded interactions between oncologists and patients during which a clinical trial was offered were analyzed. Half of the video-recorded interactions were with black patients, half were with white patients, and the patients were matched by cancer type and sociodemographic characteristics. Eggly and colleagues used linguistic discourse analytical methods to assess several features of the interactions. Overall discussion of clinical trials and the 5 basic elements of consent: purpose, risks, benefits, alternatives to participating, and the voluntary nature of trial participation were examined.

Researchers discovered that when compared with interactions with white patients, the clinical trial interactions with black patients were shorter in length and included less discussion of clinical trials. Key aspects of consent were also discussed less with black patients than with white patients, particularly the objective of the trial and risks of participation. On the other hand, data showed that oncologists spoke more about voluntary participation with black patients than with white patients.

Previous research by Eggly and colleagues showed that black patients trusted their doctors less than white patients did, and they tended to ask fewer questions. Furthermore, physician biases affected the quality of communication, and Eggly believes this may also explain the differences found in this study.

“Taking a close look at interactions and the language used can help us to identify patterns of behavior and make the necessary improvements that may ultimately lead to decisions that are in the best interest of each patient,” she said.

Source: AACR