About this item:

466 Views | 717 Downloads

Author Notes:

Correspondence to: Neal W. Dickert, MD, PhD, Emory University School of Medicine, 1462 Clifton Rd, #508, Atlanta, GA 30322. E‐mail: njr@emory.edu

The authors are grateful to Ayman Tahhan in particular for assembling the primary database within which this analysis was performed.

Dr Dickert receives salary support from the Greenwall Foundation Faculty Scholars Program and research funding from the Patient‐Centered Outcomes Research Institute and National Institutes of Health.

Dr Butler reports receiving research support from the National Institutes of Health, and European Union and serves as a consultant to Amgen, Bayer, Boehringer Ingelheim, Cardiocell, Celladon, Novartis, Trevena, Pharmain, Relypsa, StealthPeptide, Z Pharma, and Zensun.

No authors report any significant financial conflicts of interest.


Research Funding:

Support for this project was provided by the Robert W. Woodruff Foundation.


  • clinical trial
  • informed consent
  • recruitment
  • research ethics
  • trials

Trends in Consent for Clinical Trials in Cardiovascular Disease.


Journal Title:

Journal of the American Heart Association


Volume 5, Number 6


, Pages e003582-e003582

Type of Work:

Article | Final Publisher PDF


BACKGROUND: Cardiovascular clinical trials depend on patient enrollment. Enrollment rates appear inadequate, but little is known about how frequently patients accept or decline offers of enrollment. The objective of this study was to assess trends and predictors of patient acceptance of offers to enroll in clinical trials for cardiovascular disease. METHODS AND RESULTS: We utilized an established database containing all randomized, controlled trials (n=1224) in cardiovascular disease published between 2001 and 2012 in the 8 highest-impact general medical and cardiology journals. Studies were eligible if the number of patients approached and number of patients declining enrollment could be ascertained from published materials. All studies were screened for eligibility. Each eligible study was reviewed by 3 co-authors. All discrepancies were resolved by the group. The main outcome was acceptance rate, defined as the number of patients enrolled divided by the number patients who were eligible and approached. Only 21.7% (n=266) of studies provided information sufficient to assess patient enrollment and refusals. The median acceptance rate across trials was 83.2%. Significant predictors of higher enrollment included: enrollment in the acute setting (P=0.031); geographical region (P<0.001 for group); and trial sponsorship (P=0.006 for group). CONCLUSIONS: Rates of reporting data sufficient to calculate acceptance rates are low. This compromises the ability to identify drivers of low enrollment and assess trial generalizability. However, the high rates of acceptance observed suggest that factors other than patients' decisions may be the primary drivers of declining rates of trial enrollment.

Copyright information:

© 2016 The Authors.

This is an Open Access work distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/).

Creative Commons License

Export to EndNote