A Population-Based Assessment of Specialty Physician Involvement in Cancer Clinical Trials
A Population-Based Assessment of Specialty Physician Involvement in Cancer Clinical Trials
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DOI：
10.1093/jnci/djq549
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发表时间：
2011-03-01
影响因子：
10.3
通讯作者：
Ganz, Patricia A.
中科院分区：
文献类型：
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作者：
Klabunde, Carrie N.;Keating, Nancy L.;Ganz, Patricia A.
临床试验对于评估新的癌症疗法至关重要，但很少有成年患者参与其中。医生在促进患者参与临床试验方面发挥着重要作用。我们研究了参与临床试验的专科医生的特点，通过招募或转诊患者，他们参与的试验类型，以及与医生报告更多参与临床试验的因素。该研究包括1533名治疗结直肠癌和肺癌患者的专科医生（496名内科肿瘤学家，228名放射肿瘤学家和809名外科医生），并在2005-2006年完成了一项调查（应答率= 61.0%）。描述性统计被用来描述医生的个人和实践特征，回归模型被用来检查这些特征和医生参与临床试验之间的关联。所有统计检验均为双侧。结果共有87.8%的内科肿瘤学家，66.1%的放射肿瘤学家和35.0%的外科医生报告在过去的12个月内转诊或招募一名或多名患者参加临床试验。内科肿瘤学家、放射肿瘤学家和外科医生转诊或入组的患者平均数分别为17.2（95%置信区间[CI] = 15.5 - 18.9）、9.5（95% CI = 7.7 - 11.3）和12.2（95% CI = 9.8 - 14.6）（P <0.001）。专业类型、参与教学、与社区临床肿瘤学项目（CCOP）和/或国家癌症研究所指定的癌症中心的关系与医生试验参与和招募更多患者相关（所有P <0.05）。三分之二的医生与CCOP或国家癌症研究所指定的癌症中心affiliation报告参加trials.Conclusions功能的专科医生的执业环境与他们的试验参与，但许多医生在CCOP和癌症中心不参加。
Background Clinical trials are critical for evaluating new cancer therapies, but few adult patients participate in them. Physicians have an important role in facilitating patient participation in clinical trials. We examined the characteristics of specialty physicians who participate in clinical trials by enrolling or referring patients, the types of trials in which they participate, and factors associated with physicians who report greater involvement in clinical trials.Methods We analyzed data from the Cancer Care Outcomes Research and Surveillance Consortium. The study included 1533 specialty physicians who cared for colorectal and lung cancer patients (496 medical oncologists, 228 radiation oncologists, and 809 surgeons) and completed a survey conducted during 2005-2006 (response rate = 61.0%). Descriptive statistics were used to characterize physicians' personal and practice characteristics, and regression models were used to examine associations between these characteristics and physician participation in clinical trials. All statistical tests were two-sided.Results A total of 87.8% of medical oncologists, 66.1% of radiation oncologists, and 35.0% of surgeons reported referring or enrolling one or more patients in clinical trials during the previous 12 months. The mean number of patients referred or enrolled by these physicians was 17.2 (95% confidence interval [CI] = 15.5 to 18.9) for medical oncologists, 9.5 (95% CI = 7.7 to 11.3) for radiation oncologists, and 12.2 (95% CI = 9.8 to 14.6) for surgeons (P < .001). Specialty type, involvement in teaching, and affiliation with a Community Clinical Oncology Program (CCOP) and/or a National Cancer Institute-designated cancer center were associated with physician trial participation and enrolling more patients (all Ps < .05). Two-thirds of physicians with a CCOP or National Cancer Institute-designated cancer center affiliation reported participating in trials.Conclusions Features of specialty physicians' practice environments are associated with their trial participation, but many physicians at CCOPs and cancer centers do not participate.