Obstacles to participation in randomised cancer clinical trials: a systematic review of the literature

Journal of Medical Imaging and Radiation Oncology
Melissa M Grand, Peter C O'Brien

Abstract

Accrual to clinical trials continues to be a problem in many countries including Australia despite its fundamental importance to the progress of evidence-based medicine. This paper reviews the current literature addressing the obstacles to accrual excluding those related to protocol design. An electronic search of the literature identified publications in oncology specifically addressing the obstacles to participation in clinical trials. This search was supplemented by searches of key oncology journals. Obstacles fall into three main categories - clinician, patient and system; however, there are overlaps between categories. Clinician behaviour is the most important of these. Exclusion of patients for reasons other than defined eligibility criteria, concerns about increased time requirements, and suboptimal communication with patients all affect accrual. Risk management strategies for clinical trials need to be individualised to address the obstacles most likely to negatively impact on accrual. Communication between clinician and patient appears to be a greater issue than previously recognised. Time concerns need to be addressed as generational change affects the expectations of the medical workforce.

References

Nov 1, 1991·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·A B BensonK Anderson
Jan 1, 1991·Medical and Pediatric Oncology·W B FisherP J Loehrer
Sep 15, 1983·Cancer·J Y Lee, S R Breaux
Aug 1, 1994·British Journal of Cancer·C A Stiller
Sep 1, 1994·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·K M TaylorP P Carbone
Oct 1, 1994·Cancer·E L TrimbleM A Friedman
Jun 19, 1996·Journal of the National Cancer Institute·H A TejedaO W Brawley
Feb 21, 1998·European Journal of Cancer : Official Journal for European Organization for Research and Treatment of Cancer (EORTC) [and] European Association for Cancer Research (EACR)·L FallowfieldR Souhami
Dec 16, 1998·European Journal of Cancer : Official Journal for European Organization for Research and Treatment of Cancer (EORTC) [and] European Association for Cancer Research (EACR)·C J TwelvesA Gould
Aug 12, 1999·The Australian and New Zealand Journal of Surgery·P M EllisS M Dunn
Oct 3, 1999·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·T L AlbrechtR Strongbow
Dec 30, 1999·The New England Journal of Medicine·L F HutchinsK S Albain
Jan 7, 2000·Southern Medical Journal·C N KlabundeJ Atkins
Mar 15, 2000·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·L A SiminoffQ Shen
Feb 27, 2001·Journal of Clinical Epidemiology·D A BraunholtzR J Lilford
Mar 10, 2001·European Journal of Cancer : Official Journal for European Organization for Research and Treatment of Cancer (EORTC) [and] European Association for Cancer Research (EACR)·A FleissigL Fallowfield
Mar 17, 2001·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·P N LaraK S Lam
Apr 17, 2002·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Warren B SaterenMichaele C Christian
Apr 18, 2002·Japanese Journal of Clinical Oncology·Robert C Burton
Mar 1, 2003·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Robert L ComisEllen Stoval
Apr 17, 2003·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Karen W L YeeLillian L Siu
Apr 26, 2003·American Journal of Clinical Oncology·Robert S MannelMichael A Gold
May 8, 2003·Journal of the National Cancer Institute·Vicki Burkitt
Jun 14, 2003·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·M Margaret KemenyHarvey J Cohen
Jan 9, 2004·Cancer Nursing·Mary E CooleyLeda Layo Danao
Apr 15, 2004·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Michael S SimonDiane R Brown
May 28, 2004·BMJ : British Medical Journal·Steven JoffeJane C Weeks
Jul 31, 2004·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Todd L DemmyStephen L George
Oct 30, 2004·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·James R WrightMark N Levine
Jan 18, 2005·The Medical Journal of Australia·Patrina H Y CaldwellPhyllis N Butow
Mar 22, 2005·ANZ Journal of Surgery·Neil R WetzigUNKNOWN RACS SNAC Group
Apr 1, 2005·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Gretchen G KimmickHyman B Muss
Apr 30, 2005·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Carol A TownsleyLillian L Siu
Dec 20, 2005·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Primo N LaraMoon S Chen
Jul 4, 2006·The Medical Journal of Australia·Clare A Skinner
Dec 7, 2006·American Journal of Clinical Oncology·Charles G WoodJames M Metz
Apr 6, 2007·Journal of Thoracic Oncology : Official Publication of the International Association for the Study of Lung Cancer·Gwendolyn P QuinnGerold Bepler

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Citations

Apr 2, 2014·Clinical Oncology : a Journal of the Royal College of Radiologists·P SundaresanH H Woo
Jan 18, 2016·Advanced Drug Delivery Reviews·Philippe LambinSean Walsh
Aug 16, 2014·Journal of Medical Imaging and Radiation Oncology·Verity Ahern
Feb 18, 2015·Clinical Journal of Oncology Nursing·Yasemin E TurkmanM Tish Knobf
Dec 7, 2013·Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology·Erik RoelofsPhilippe Lambin
Sep 3, 2013·Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology·Philippe LambinAndre Dekker
Sep 23, 2014·Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology·Andre DekkerDavid Thwaites
Feb 12, 2013·Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology·Erik RoelofsPhilippe Lambin
Aug 24, 2006·Surgery for Obesity and Related Diseases : Official Journal of the American Society for Bariatric Surgery·Craig A TernovitsAtul K Madan
Jun 21, 2013·Clinical Trials : Journal of the Society for Clinical Trials·Iain C SandersonJay Moskowitz
Sep 27, 2014·International Journal of Medical Informatics·Lawrence B AfrinDiane L Kamen
Apr 5, 2011·International Journal of Medical Informatics·Marc CuggiaDavid Glasspool
Mar 3, 2009·Mayo Clinic Proceedings·Amit SoodDietlind L Wahner-Roedler
Oct 30, 2016·Journal of the National Cancer Institute·Janice L KriegerMelanie A Sarge
Aug 21, 2013·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·James H Doroshow
Oct 24, 2013·Journal of Oncology Practice·Carol P SomkinLouis Fehrenbacher
Jan 12, 2017·World Journal of Methodology·Francesca ValdoraAlberto Tagliafico
Apr 26, 2017·International Journal of Gynecological Cancer : Official Journal of the International Gynecological Cancer Society·Gavin C E StuartMonica Bacon
May 1, 2017·International Journal of Gynecological Cancer : Official Journal of the International Gynecological Cancer Society·Gavin C E StuartMonica Bacon
Nov 6, 2020·Journal of Multidisciplinary Healthcare·Bianca ViljoenSonja March
Feb 20, 2021·Cancer·Diane C St Germain, Worta McCaskill-Stevens
Aug 18, 2021·Contemporary Clinical Trials Communications·Edgardo Rodríguez-TorresClemente Díaz-Pérez

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