David Casarett|Jason Karlawish|Karen B. Hirschman
Identifying ambulatory cancer patients at risk of impaired capacity to consent to research
Veterans Health Administration|University of Pennsylvania|University of Pennsylvania|Veterans Health Administration|Veterans Health Administration|University of Pennsylvania
ethicists others expressed concerns patients cancer might lack adequate decisionmaking capacity give consent research although concern plausible known patient characteristics might used identify patients risk therefore undergo formal assessment decisionmaking capacity fortyfive patients cancer presented description randomized controlled trial accompanied institutional review boardapproved consent form two raters blind patient characteristics assessed decisionmaking capacity using macarthur competency assessment tool clinical research scores summarized overall capacity judgments using criteria established panel experts subjects also completed symptom rating scale battery neuropsychiatric tests relationship observed symptom severity domain decisionmaking capacity understanding appreciation reasoning ability express choice summary judgments however several patient characteristics including age education selected neuropsychiatric test results found strongly associated capacity scores data suggest several patient characteristics age education tests cognitive functions may help investigators identify patients impaired capacity give consent research