Nursing

Psychological intervention

Intensive care medicine

Clinical decision making

Health care

Social psychology

Clinical trial

Medical physics

Economics

Psychology

Altruism (biology)

Political science

Quality of life (healthcare)

Family medicine

Internal medicine

Autonomy

Oncology

Medicine

Economic growth

Patient participation

Cancer

Pathology

Cancer Treatment Reviews

BackgroundFor many patients with advanced cancer, the decision whether to participate in early phase clinical trials or not is complex. The decision-making process requires an in-depth discussion of patient values. We therefore aimed to synthesize and describe patient values that may affect early phase clinical trial participation.MethodsWe conducted a systematic search in seven electronic databases on patient values in relation to patients' decisions to participate in early phase clinical cancer trials.ResultsFrom 3072 retrieved articles, eleven quantitative and five qualitative studies fulfilled our inclusion criteria. We extracted ten patient values that can contribute to patients' decisions. Overall, patients who seek trial participation usually report hope, trust, quantity of life, altruism, perseverance, faith and/or risk tolerance as important values. Quality of life and humanity are main values of patients who refuse trial participation. Autonomy and social adherence can be reported by both trial seekers or refusers, dependent upon how they are manifested in a patient.ConclusionsWe identified patient values that frequently play a role in the decision-making process. In the setting of discussing early phase clinical trial participation with patients, healthcare professionals need to be aware of these values. This analysis supports the importance of individual exploration of values. Patients that become aware of their values, e.g. by means of interventions focused on clarifying their values, could feel more empowered to choose. Subsequently, healthcare professionals could improve their support in a patients' decision-making process and reduce the chance of decisional conflict.

Identifying patient values impacting the decision whether to participate in early phase clinical cancer trials: A systematic review