Racial disparities in the quality of communication between physicians and patients were further confirmed by a study comparing how physicians discuss clinical trials during clinical interactions with black patients versus white patients. Oncologists provided black patients with less information overall about cancer clinical trials compared with white patients.
“Minority patients tend to receive less information, which could, in part, explain under-enrollment by minorities in clinical cancer trials,” said Susan Eggly, PhD, associate professor of oncology at Wayne State University School of Medicine and the Barbara Ann Karmanos Cancer Institute in Detroit, Michigan. “These disparities could also lead to minority patients being enrolled in trials without fully understanding the purpose of the trial and the potential risks of participation.”
Eggly and her colleagues examined 22 video-recorded interactions between oncologists and patients during which a clinical trial was offered. The patients were matched by cancer type and sociodemographic characteristics. Half of the video-recorded interactions were with black patients and half were with white patients. The research team used linguistic discourse analytical methods to examine several aspects of the interactions, which included the overall discussion of clinical trials and the five basic elements of consent: purpose, risk, benefits, alternatives to participating, and the voluntary nature of trial participation.
The study revealed that clinical trial interactions with black patients were shorter overall and included less discussion of clinical trials compared with interactions with white patients. Also, less discussion about key aspects of consent occurred with the black patients than with white patients, especially regarding the purpose of the trial and the risks of participation. However, oncologists spoke more about voluntary participation with black patients than with white patients.
Previous research by Eggly and colleagues revealed that black patients had a tendency to ask fewer questions, and that they trusted their doctors less than white patients did. In addition, physician biases affected the quality of communication, which Eggly believes may also account for the differences found in this study.
“Taking a close look at interactions and the language used can help us to identify patterns of behavior and make the necessary improvements that may ultimately lead to decisions that are in the best interest of each patient,” she said.
This data was presented at the Fifth American Association for Cancer Research Conference on The Science of Cancer Health Disparities in San Diego, California.