Hello and welcome to another edition of Riding in Cars With Researchers. I’m Dr. Jeff Kingsley and today we are going to talk about the fact that physicians and patients aren’t communicating. That’s a problem and it’s impacting clinical research. I read a wonderful research article this morning on non-small cell lung cancer. Here is the link: HERE
The article is on non-small cell lung cancer and the authors looked at two things: the survival rates of patients that entered clinical trials vs patients who didn’t. They then looked at the what the physicians and the research staff believed as to the reasons why some patients didn’t go into research trials vs what the patients actually said.
Survival Rates – Patients in Research Trials
First, let’s talk about the difference in survival rates. Patients that entered clinical research trials for non-small cell lung cancer Phase I, II, and III, they randomized on a full breadth of different types of research trials. As such, the patients that entered research trials for non-small cell lung cancer had two times the survival rates of the patients that didn’t enter research trials. Massive difference!! And now they’re doing follow-up research to look at the WHY. One of the things that you’ve heard me say many times in the past is that patients get far more healthcare in a research trial than they get outside of one. They get more labs, CT scans, MRIs or PET scans, and more genetic analyses. They’re looked at much more closely and they get more robust healthcare as a result. Is that the reason possibly? Possibly it could be other things – could be the fact that it was the cutting edge of medicine, but regardless, clearly twice improved survival rates in patients that entered research trials vs patients who did not.
Survival Rates – Patients Not in Trials
Then they looked at the patients who didn’t and they asked the physicians and research coordinators, the staff that were dealing with those patients: Why didn’t they enter the trials?
They asked a multitude of different questions:
- What percent influence do you think racial bias has in a patient’s desire to go into a research trial?
- What about patient’s beliefs?
- What about the safety of research trials?
- What about the riskiness of research trials?
- Do the patients believe that research is only a last resort? That once you’re out of all other options, that’s the only time you should go into a research trial?
The results were a massive discrepancy between what the physicians thought and what the patients actually thought. I don’t have the numbers in front of me because I am driving a car, but there were questions where the physician said 61% of patients would believe X, and they asked the patients the question and it was like 8%. Not even a remotely close.
Why Are the Results Important?
Now why do I find this fascinating? Well, because the biases we harbor influence our behavior. If you believe that your patient isn’t going to want to go into a research trial because your patient is of African descent, it’s going to come out in your words, your body language and, in fact, your patient is less likely to say yes because they sensed something in their physician. It’s just so critical that physicians and patients begin to talk to one another so we can be on the same page. If we can lower these biases that physicians have about why patients would say no to a research trial, we will, in fact, enhance patients saying yes to research and open doors to patients that, right now, are closed.
Thanks for riding along!
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