Evidence map›Paper›PMID 37403311›Full record

Trial reportClinical trials (London, England)2023

A randomized comparison of two-stage versus traditional one-stage consent for a low-stakes randomized trial.

Andrew J Vickers, Emily A Vertosick, Mia Austria, Christopher D Gaffney, Sigrid V Carlsson, Scott Yh Kim, Behfar Ehdaie

Abstract readRandomized Controlled Trial
In one paragraph

Trial report in Clinical trials (London, England), 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Andrew J VickersDepartment of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA.ORCID 0000-0003-1525-6503
Emily A VertosickDepartment of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Mia AustriaDepartment of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Christopher D GaffneyDepartment of Surgery (Urology Service), Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Sigrid V CarlssonDepartment of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Scott Yh KimDepartment of Bioethics, Clinical Center, National Institutes of Health, Bethesda, MD, USA.ORCID 0000-0002-9444-4627
Behfar EhdaieDepartment of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA.

Funding

X-RAY CRYSTALLOGRAPHYP30CA008748 · NCI · SLOAN-KETTERING INSTITUTE FOR CANCER RES · PI Hongbiao Carl Lekaye · 1985 to 2026
$347.4M
SPORE In Prostate CancerP50CA092629 · NCI · SLOAN-KETTERING INSTITUTE FOR CANCER RES · PI JAMES A EASTHAM · 2001 to 2026
$63.0M
Improving shared decision making in cancer screeningK22CA234400 · NCI · SLOAN-KETTERING INST CAN RESEARCH · PI CARLSSON, SIGRID · 2019 to 2021
$621k
Ethics of Standards of Care ResearchZIACL010538 · CLC · CLINICAL CENTER · PI KIM, SCOTT · 2015 to 2025
$0k
NCI NIH HHS K22 CA234400NCI NIH HHS P30 CA008748NCI NIH HHS P50 CA092629
6 · The paper itself

Abstract

BACKGROUND/

aimsIt has been proposed that informed consent for randomized trials should be split into two stages, with the purported advantage of decreased information overload and patient anxiety. We compared patient understanding, anxiety and decisional quality between two-stage and traditional one-stage consent.

methodsWe approached patients at an academic cancer center for a low-stakes trial of a mind-body intervention for procedural distress during prostate biopsy. Patients were randomized to hear about the trial by either one- or two-stage consent (n = 66 vs n = 59). Patient-reported outcomes included Quality of Informed Consent (0-100); general and consent-specific anxiety and decisional conflict, burden, and regret.

resultsQuality of Informed Consent scores were non-significantly superior for two-stage consent, by 0.9 points (95% confidence interval = -2.3, 4.2, p = 0.6) for objective and 1.1 points (95% CI = -4.8, 7.0, p = 0.7) for subjective understanding. Differences between groups for anxiety and decisional outcomes were similarly small. In a post hoc analysis, consent-related anxiety was lower among two-stage control patients, likely because scores were measured close to the time of biopsy in the two-stage patients receiving the experimental intervention.

conclusionTwo-stage consent maintains patient understanding of randomized trials, with some evidence of lowered patient anxiety. Further research is warranted on two-stage consent in higher-stakes settings.

Indexed as

AnxietyEmotionsHumansInformed ConsentMaleanxietyclinical protocolsInformed consentrandomized controlled trialsresearch designsurveys and questionnaires

Identifiers

PMID37403311
PMCPMC10764653

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.