title: Attitudes, understanding, and concerns regarding medical research amongst Egyptians: a qualitative pilot study.
abstract: BACKGROUND
  Medical research must involve the participation of human subjects. Knowledge of patients' perspectives and concerns with their involvement in research would enhance recruitment efforts, improve the informed consent process, and enhance the overall trust between patients and investigators. Several studies have examined the views of patients from Western countries. There is limited empirical research involving the perspectives of individuals from developing countries. The purpose of this study is to examine the attitudes of Egyptian individuals toward medical research. Such information would help clarify the type and extent of concerns regarding research participation of individuals from cultural, economic, and political backgrounds that differ from those in developed countries.
  
  
  METHODS
  We conducted semi-structured interviews with 15 Egyptian individuals recruited from the outpatient settings (public and private) at Ain Shams University in Cairo, Egypt. Interviews were taped, transcribed, and translated. Thematic analysis followed.
  
  
  RESULTS
  All individuals valued the importance of medical research; however most would not participate in research that involved more than minimal risk. Individuals were comfortable with studies involving surveys and blood sampling, but many viewed drug trials as being too risky. All participants valued the concept of informed consent, as they thought that their permission to be in a research study was paramount. Many participants had discomfort with or difficulty in the understanding several research concepts: randomization, double-blind, and clinical equipoise. Trust in the physicians performing research was important in deciding to participate in clinical research. The small sample size and the selection bias associated with obtaining information from only those who agreed to participate in a research study represent limitations in this study.
  
  
  CONCLUSIONS
  Overall, individuals in our sample recognize the value of medical research and have a great deal of trust regarding medical research and their participation in research. There were, however, concerns with the level of research risks associated with several types of medical research. Many also demonstrated confusion with certain research methodologies. We recommend 1) enhanced educational efforts regarding general research concepts to enhance the validity of informed consent and 2) further survey studies in other areas of Egypt to determine the generalizability of our results.
authors.affiliation: Ain Shams University, Cairo, Egypt. susan00@gmail.com
authors.forename: Susan S
authors.initials: SS
authors.lastname: Khalil
authors.forename: Henry J
authors.initials: HJ
authors.lastname: Silverman
authors.forename: May
authors.initials: M
authors.lastname: Raafat
authors.forename: Samer
authors.initials: S
authors.lastname: El-Kamary
authors.forename: Maged
authors.initials: M
authors.lastname: El-Setouhy
mesh_terms: D000328:Adult; D000368:Aged; D001290:Attitude / Q000208:ethnology; D035843:Biomedical Research / Q000941:ethics / Q000379:methods; D032882:Comprehension; D015986:Confounding Factors, Epidemiologic; D003466:Cultural Characteristics; D004534:Egypt; D005260:Female; D006801:Humans; D007258:Informed Consent; D008297:Male; D008875:Middle Aged; D010045:Outpatients / Q000706:statistics & numerical data; D018579:Patient Selection; D010865:Pilot Projects; D012107:Research Design; D012108:Research Personnel; D035842:Research Subjects / Q000523:psychology; D012309:Risk-Taking; D018401:Sample Size; D015983:Selection Bias; D011795:Surveys and Questionnaires; D035502:Trust