title: Cancer clinical trial participants' assessment of risk and benefit.
abstract: BACKGROUND
  The purpose of this article is to examine the extent to which cancer clinical trial participants assess the benefits and risks of research participation before enrollment.
  
  
  METHODS
  One hundred and ten oncology research participants enrolled in cancer clinical research in a large Northeastern cancer center responded to a self-administered questionnaire on perceptions about cancer clinical trials.
  
  
  RESULTS
  Of the participants, 51.6% reported they did not directly assess the benefits or risks. Educational level, age, employment, treatment options, insurance, and spiritual-religious beliefs were significantly associated with whether participants assessed risk and benefits. Those who felt well informed were more likely to have assessed the benefits and risks at enrollment than those who did not feel well informed (odds ratio [OR] = 3.92,p= .014); of those who did not assess the risks and benefits, 21% did not feel well informed at enrollment (p= .001). Those who agreed that the clinical trial helped pay the costs of the care had nearly three times the odds of not assessing risks and benefits compared to those who disagreed.
  
  
  CONCLUSIONS
  Our findings have important implications for understanding the role of assessing risks and benefits in the research participation decisions of patients with cancer and call for further understanding of why participants are not assessing information believed to be essential for autonomous informed decisions.
authors.affiliation: Department of Biobehavioral Health Sciences and Department of Medical Ethics and Health Policy, University of Pennsylvania School of Nursing and Perelman School of Medicine.
authors.forename: Connie M
authors.initials: CM
authors.lastname: Ulrich
authors.affiliation: Department of Biostatistics & Epidemiology, University of Pennsylvania Perelman School of Medicine.
authors.forename: Sarah J
authors.initials: SJ
authors.lastname: Ratcliffe
authors.affiliation: National Institutes of Health Clinical Center.
authors.forename: Gwenyth R
authors.initials: GR
authors.lastname: Wallen
authors.affiliation: Department of Nursing, George Washington University.
authors.forename: Qiuping Pearl
authors.initials: QP
authors.lastname: Zhou
authors.affiliation: Division of Family Health, University of North Carolina School of Nursing Chapel Hill.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Knafl
authors.affiliation: Department of Bioethics, National Institutes of Health.
authors.forename: Christine
authors.initials: C
authors.lastname: Grady
keywords: cancer; clinical trials; informed consent; risks and benefits