title: Conventional consent with opting in versus simplified consent with opting out: an exploratory trial for studies that do not increase patient risk.
abstract: OBJECTIVE
  The objective of this study was to assess a modified consent procedure allowed under federal regulations and developed for studies, particularly clinical trials, that are judged by the Institutional Review Board to reduce or have no effect on patient risk.
  
  
  METHODS
  This was a randomized trial of a conventional consent procedure that required parental signature to give consent (opting in) after a comprehensive disclosure of the rights of participants in research versus a modified consent procedure that required parental signature to refuse consent (opting out) after specific disclosures appropriate when risk is not increased. Consent was sought for a trial of primary follow-up care for disadvantaged infants at high risk, a trial judged by our Institutional Review Board to increase access to care for both groups. A blinded assessor interviewed mothers within 24 hours of the consent decision.
  
  
  RESULTS
  Among the 44 mothers interviewed, the modified consent group scored higher than the conventional consent group in recall and understanding of study purpose and methods (47% vs 30%; p < 0.02). Other comparisons provided no evidence that the modified consent procedure was less desirable. Virtually all mothers reported satisfaction.
  
  
  CONCLUSIONS
  The modified approach may improve communication and facilitate studies judged by the Institutional Review Board to be risk-neutral or risk-reducing. Further evaluation of a modified consent procedure for such studies is warranted.
authors.affiliation: Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, USA.
authors.forename: C G
authors.initials: CG
authors.lastname: Rogers
authors.forename: J E
authors.initials: JE
authors.lastname: Tyson
authors.forename: K A
authors.initials: KA
authors.lastname: Kennedy
authors.forename: R S
authors.initials: RS
authors.lastname: Broyles
authors.forename: J F
authors.initials: JF
authors.lastname: Hickman
mesh_terms: D000328:Adult; D032882:Comprehension; D032962:Consent Forms; D030881:Disclosure; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007224:Infant Care; D007231:Infant, Newborn; D007258:Informed Consent / Q000331:legislation & jurisprudence; D009035:Mothers; D033282:Parental Consent; D010358:Patient Participation; D018570:Risk Assessment; D012307:Risk Factors; D035862:Vulnerable Populations