title: Prospective preference assessment of patients' willingness to participate in a randomized controlled trial of intensity-modulated radiotherapy versus proton therapy for localized prostate cancer.
abstract: OBJECTIVE
  To investigate patients' willingness to participate (WTP) in a randomized controlled trial (RCT) comparing intensity-modulated radiotherapy (IMRT) with proton beam therapy (PBT) for prostate cancer (PCa).
  
  
  METHODS
  We undertook a qualitative research study in which we prospectively enrolled patients with clinically localized PCa. We used purposive sampling to ensure a diverse sample based on age, race, travel distance, and physician. Patients participated in a semi-structured interview in which they reviewed a description of a hypothetical RCT, were asked open-ended and focused follow-up questions regarding their motivations for and concerns about enrollment, and completed a questionnaire assessing characteristics such as demographics and prior knowledge of IMRT or PBT. Patients' stated WTP was assessed using a 6-point Likert scale.
  
  
  RESULTS
  Forty-six eligible patients (33 white, 13 black) were enrolled from the practices of eight physicians. We identified 21 factors that impacted patients' WTP, which largely centered on five major themes: altruism/desire to compare treatments, randomization, deference to physician opinion, financial incentives, and time demands/scheduling. Most patients (27 of 46, 59%) stated they would either "definitely" or "probably" participate. Seventeen percent (8 of 46) stated they would "definitely not" or "probably not" enroll, most of whom (6 of 8) preferred PBT before their physician visit.
  
  
  CONCLUSIONS
  A substantial proportion of patients indicated high WTP in a RCT comparing IMRT and PBT for PCa.
authors.affiliation: Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Anand
authors.initials: A
authors.lastname: Shah
authors.forename: Jason A
authors.initials: JA
authors.lastname: Efstathiou
authors.forename: Jonathan J
authors.initials: JJ
authors.lastname: Paly
authors.forename: Scott D
authors.initials: SD
authors.lastname: Halpern
authors.forename: Deborah W
authors.initials: DW
authors.lastname: Bruner
authors.forename: John P
authors.initials: JP
authors.lastname: Christodouleas
authors.forename: John J
authors.initials: JJ
authors.lastname: Coen
authors.forename: Curtiland
authors.initials: C
authors.lastname: Deville
authors.forename: Neha
authors.initials: N
authors.lastname: Vapiwala
authors.forename: William U
authors.initials: WU
authors.lastname: Shipley
authors.forename: Anthony L
authors.initials: AL
authors.lastname: Zietman
authors.forename: Stephen M
authors.initials: SM
authors.lastname: Hahn
authors.forename: Justin E
authors.initials: JE
authors.lastname: Bekelman
mesh_terms: D000368:Aged; D000533:Altruism; D044383:Black People / Q000523:psychology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009042:Motivation; D010349:Patient Compliance / Q000523:psychology*; D010353:Patient Education as Topic; D010358:Patient Participation / Q000523:psychology*; D057240:Patient Preference / Q000523:psychology; D011446:Prospective Studies; D011471:Prostatic Neoplasms / Q000523:psychology* / Q000532:radiotherapy*; D061766:Proton Therapy; D036301:Qualitative Research; D050397:Radiotherapy, Intensity-Modulated / Q000523:psychology*; D016032:Randomized Controlled Trials as Topic / Q000523:psychology*; D012052:Reimbursement, Incentive; D013997:Time Factors; D044465:White People / Q000523:psychology