title: Factors influencing patient willingness to participate in genetic research after a myocardial infarction.
abstract: BACKGROUND
  Achieving 'personalized medicine' requires enrolling representative cohorts into genetic studies, but patient self-selection may introduce bias. We sought to identify characteristics associated with genetic consent in a myocardial infarction (MI) registry.
  
  
  METHODS
  We assessed correlates of participation in the genetic sub-study of TRIUMPH, a prospective MI registry (n = 4,340) from 24 US hospitals between April 2005 and December 2008. Factors examined included extensive socio-demographics factors, clinical variables, and study site. Predictors of consent were identified using hierarchical modified Poisson regression, adjusting for study site. Variation in consent rates across hospitals were quantified by the median rate ratio (MRR).
  
  
  RESULTS
  Most subjects consented to donation of their genetic material (n = 3,484; 80%). Participation rates varied greatly between sites, from 40% to 100%. After adjustment for confounding factors, the MRR for hospital was 1.22 (95% confidence interval (CI) 1.11 to 1.29). The only patient-level factors associated with consent were race (RR 0.93 for African Americans versus whites, 95% CI 0.88 to 0.99) and body mass index (RR 1.03 for BMI ≥ 25, 95% CI 1.01 to 1.06).
  
  
  CONCLUSIONS
  Among patients with an MI there were notable differences in genetic consent by study site, but little association with patient-level factors. This suggests that variation in the way information is presented during recruitment, or other site factors, strongly influence patients' decision to participate in genetic studies.
authors.affiliation: Henry Ford Hospital, Heart and Vascular Institute, Detroit, Michigan, 48202, USA. dlanfea1@hfhs.org.
authors.forename: David E
authors.initials: DE
authors.lastname: Lanfear
authors.forename: Philip G
authors.initials: PG
authors.lastname: Jones
authors.forename: Sharon
authors.initials: S
authors.lastname: Cresci
authors.forename: Fengming
authors.initials: F
authors.lastname: Tang
authors.forename: Saif S
authors.initials: SS
authors.lastname: Rathore
authors.forename: John A
authors.initials: JA
authors.lastname: Spertus