Catalogo Articoli (Spogli Riviste)


Ethical approach to informed consent for participants in clinical trials on acute phase stroke
Ducrocq, X; Taillandier, L; Anxionnat, R; Lacour, JC; Debouverie, M; Lanotte, L; Vespignani, H; Weber, M;
Hop Cent, Neurol Serv, F-54035 Nancy, France Hop Cent Nancy France F-54035 p Cent, Neurol Serv, F-54035 Nancy, France Hop Cent, Serv Neuroradiol, F-54035 Nancy, France Hop Cent Nancy France F-54035 t, Serv Neuroradiol, F-54035 Nancy, France
Titolo Testata:
fascicolo: 24, volume: 29, anno: 2000,
pagine: 1335 - 1340
Tipo documento:
Settore Disciplinare:
Clinical Medicine
Life Sciences
Indirizzi per estratti:
Indirizzo: Ducrocq, X Hop Cent, Neurol Serv, Ave Lattre Tassigny,CO 34, F-54035 Nancy, France Hop Cent Ave Lattre Tassigny,CO 34 Nancy France F-54035 France
X. Ducrocq et al., "Ethical approach to informed consent for participants in clinical trials on acute phase stroke", PRESSE MED, 29(24), 2000, pp. 1335-1340


OBJECTIVE: We sought to evaluate the application of the French law for theprotection of persons participating in research studies in biology and medicine. Specifically, we examined comprehension and consequences of informedconsent procedures in the field of stroke, characterized by an emergency setting cognitive impairment and poor prognosis. PATIENTS AND METHODS: Patients (or proxies) included in recent years in clinical studies conducted in our Neurology Department for evaluating treatment of acute phase cerebral ischemia were interviewed to determine their knowledge of the disease, its treatment the study protocol and the legal regulations, and the affective and psychological consequences of the informed consent procedure. RESULTS: Among 72 patients included in 7 studies ([fibrinolytic agent: 3 (n = 43), anticoagulant agent: 1 (n = 4), neuroprotective drugs (n = 25)], [7 randomized studies, 6 double-blind versus placebo, 5 with a 6-hour inclusion time interval]), 15 died during the acute phase, 5 were lost to follow-up, 4 refused to participate and 7 gave very partial answers. Consent was signed by the patient in 15% of cases, the spouse in 50%, a descendant in 23%. These persons were aware of the spontaneous risk of death (85%) or definitive functional impairment (95%). Half of them thought a specific treatment existed, 11% had some idea of the mechanism of action of the proposed treatment while 67% learned about this mechanism from the information provided. Although they had received information, only 25% of the patients had knowledge of placebo and 7% of therapeutic risk 37% expected complete recovery from the treatment, 44% partial recovery, and 13% were very disappointed bythe outcome. 81% felt they were free to make their own decision. Although 86% did not know there was a law protecting them, 82% were in agreement with the requirement for their consent while 17% would have preferred to delayconsent Most wished to be given the opportunity to discuss the study again, after the acute phase, and to receive the results of the study. CONCLUSION: This study shows that most French stroke victims and their closest relatives are unaware of the law protecting persons in biomedical research and have poor knowledge of medical data after being given appropriate information. Even so, the quality of information increases the quality of the patient-physician relationship Patients want to be free to make their own decision to consent to biomedical research, but their desire was more forgood information than for the power to make their decision alone. Being asked to give informed consent in order to participate in a clinical study accentuates the affective and psychological consequences of stroke, a factor which should be taken into consideration during follow-up.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 04/07/20 alle ore 11:52:18