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Ischemic stroke survivors' opinion regarding research utilizing exception from informed consent.

Publication ,  Journal Article
Kleindorfer, D; Lindsell, CJ; Alwell, K; Woo, D; Flaherty, ML; Eilerman, J; Khatri, P; Adeoye, O; Ferioli, S; Kissela, BM
Published in: Cerebrovasc Dis
2011

INTRODUCTION: 'Exception from informed consent for research' (EFIC) is a rigorous procedure regulated by the FDA that requires community assent but allows enrollment without patient or family consent. Recently, several acute stroke trials have explored the use of EFIC to improve enrollment. We obtained ischemic stroke survivors' opinions regarding hypothetical enrollment into a clinical trial at the time of their stroke without personal or proxy consent. METHODS: During 2005, 460 ischemic stroke patients (or their proxy) who met case criteria were prospectively interviewed and followed. After 2 years, patients were asked to think back to the time of their stroke and indicate whether they would have wished to be enrolled in an acute stroke research study before individual or proxy consent could be obtained, understanding that consent would be sought as soon as possible thereafter, and they rated how agreeable they would have been to acute stroke research with different levels of invasiveness. Predictors of a positive opinion regarding the hypothetical research were analyzed using logistic regression. Variables included in the model were age, race, sex, education, initial NIHSS, modified Rankin Scale prior to stroke and 30 days after stroke, and proxy versus patient responder. RESULTS: At 2 years after stroke, after excluding patient deaths, missing data or refusals, there were 194 patient/proxy responses included in this analysis. Overall, 72-79% of responses were favorable for chart review or blood draw without consent. The proportions answering agreeably to questions about medications or invasive strategies were smaller (62.9 and 59.8%). Older subjects were less likely to offer an agreeable response regarding use of medications [OR 0.97 per year (95% CI 0.94-0.99)] and invasive procedures [OR 0.97 per year (95% CI 0.94-0.99)]. Nonblacks tended to be more agreeable than blacks to invasive procedures. Men had twice the odds of being agreeable to blood draws than women. CONCLUSIONS: We found that the majority of interviewed ischemic stroke patients were agreeable to being enrolled in acute stroke research with exception from informed consent, although the rates of agreement were lower than we expected among a cohort of patients who had already agreed to research. Older subjects, black race, and women were less likely to agree to blood draws or treatment strategies.

Duke Scholars

Published In

Cerebrovasc Dis

DOI

EISSN

1421-9786

Publication Date

2011

Volume

32

Issue

4

Start / End Page

321 / 326

Location

Switzerland

Related Subject Headings

  • Survivors
  • Stroke
  • Sex Factors
  • Retrospective Studies
  • Racial Groups
  • Prospective Studies
  • Neurology & Neurosurgery
  • Middle Aged
  • Male
  • Logistic Models
 

Citation

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Kleindorfer, D., Lindsell, C. J., Alwell, K., Woo, D., Flaherty, M. L., Eilerman, J., … Kissela, B. M. (2011). Ischemic stroke survivors' opinion regarding research utilizing exception from informed consent. Cerebrovasc Dis, 32(4), 321–326. https://doi.org/10.1159/000328815
Kleindorfer, Dawn, Christopher J. Lindsell, Kathleen Alwell, Daniel Woo, Matthew L. Flaherty, Jane Eilerman, Pooja Khatri, Opeolu Adeoye, Simona Ferioli, and Brett M. Kissela. “Ischemic stroke survivors' opinion regarding research utilizing exception from informed consent.Cerebrovasc Dis 32, no. 4 (2011): 321–26. https://doi.org/10.1159/000328815.
Kleindorfer D, Lindsell CJ, Alwell K, Woo D, Flaherty ML, Eilerman J, et al. Ischemic stroke survivors' opinion regarding research utilizing exception from informed consent. Cerebrovasc Dis. 2011;32(4):321–6.
Kleindorfer, Dawn, et al. “Ischemic stroke survivors' opinion regarding research utilizing exception from informed consent.Cerebrovasc Dis, vol. 32, no. 4, 2011, pp. 321–26. Pubmed, doi:10.1159/000328815.
Kleindorfer D, Lindsell CJ, Alwell K, Woo D, Flaherty ML, Eilerman J, Khatri P, Adeoye O, Ferioli S, Kissela BM. Ischemic stroke survivors' opinion regarding research utilizing exception from informed consent. Cerebrovasc Dis. 2011;32(4):321–326.
Journal cover image

Published In

Cerebrovasc Dis

DOI

EISSN

1421-9786

Publication Date

2011

Volume

32

Issue

4

Start / End Page

321 / 326

Location

Switzerland

Related Subject Headings

  • Survivors
  • Stroke
  • Sex Factors
  • Retrospective Studies
  • Racial Groups
  • Prospective Studies
  • Neurology & Neurosurgery
  • Middle Aged
  • Male
  • Logistic Models