Voluntariness of Same-Day Consent for Participation in Low-Risk Clinical Anesthesia Research Trials: A Prospective, Randomized Trial
Trial Snapshot
- Phase
- Not Applicable
- Status
- Completed
- Sponsor
- University of Toronto
- Enrollment
- 114
- Locations
- 1
- Primary Endpoint
- Average score on combined modified coercion scales
Study Overview
Brief Summary
As a result of their unique practice patterns, many specialist physicians typically only meet patients on the date of an intervention such as surgery. However, some of the world's most prestigious academic centers do not allow research participants to be recruited on the same day as surgery. This is because of concerns, shared by researchers and research ethics boards, that patients may be too anxious or rushed to provide informed, voluntary consent immediately before an operation. This is not supported by evidence, and leads to potential inequities by restricting patients' opportunities to contribute to and benefit from research. The investigators undertook a randomized controlled trial incorporating deception to study the voluntariness of research consent provided by patients invited to enroll in a fabricated anesthesia research study at Women's College Hospital in Toronto, Ontario, Canada. Patients undergoing day surgery were randomized to receive research recruitment opportunities either days before surgery in the pre-operative assessment clinic, or on the surgical date. Post-operatively, patient's perceptions of undue influence or coercion in the consent process were examined with questionnaires and compared between these groups. This trial will help to design future perioperative studies, and will answer the important question of whether truly voluntary and informed same-day consent can be provided for participation in perioperative research.
Study Design
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Parallel
- Primary Purpose
- Other
- Masking
- Triple (Participant, Care Provider, Outcomes Assessor)
Eligibility Criteria
- Ages
- 18 Years to — (Adult, Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •Patient scheduled to undergo ambulatory anterior cruciate ligament repair under general anesthesia with an adductor canal nerve block at Women's Colege Hospital
Exclusion Criteria
- •Inability to provide informed consent
Arms & Interventions
Advance Consent
Patients in this group were presented with the opportunity for trial participation in advance of surgery, during preoperative assessment approximately one week prior in the Pre-Anesthesia Clinic. Recruitment took place via telephone during this pre-operative assessment, and followed all standard procedures for trial recruitment at Women's College Hospital.
Intervention: Invitation to Consent to Trial Participation (Other)
Day of Surgery Consent
Patients in this group were presented with the opportunity for trial participation on the day of surgery, immediately before proceeding to their operation at Women's College Hospital. Recruitment took place in person at the bedside, and otherwise followed all standard procedures for trial recruitment at Women's College Hospital.
Intervention: Invitation to Consent to Trial Participation (Other)
Outcomes
Primary Outcomes
Average score on combined modified coercion scales
Time Frame: Measured on postoperative day one.
Minimum average score of 1 and maximum average score of 4, with higher scores corresponding to a greater degree of coercion.
Average Score on modified Iowa Coercion Questionnaire
Time Frame: Measured on postoperative day one.
Minimum average score of 1 and maximum average score of 4, with higher scores corresponding to a greater degree of coercion.
Average Score on Modified Coercion Assessment Scale
Time Frame: Measured on postoperative day one.
Minimum average score of 1 and maximum average score of 4, with higher scores corresponding to a greater degree of coercion.
Secondary Outcomes
- Rate of enrollment into the fictitious trial(Measured when patients were approached with an invitation to participate in the trial. For patients in the Advance Consent Group this was, on average, preoperative day seven. For patients in the Day of Surgery Group this was postoperative day zero.)
- Responses to individual items on the combined modified coercion scales(Measured on postoperative day one.)
Investigators
Connor Brenna
Resident Physician
University of Toronto
