Qualitative differences among cancer clinical trial explanations

This paper examines how medical oncologists present to breast cancer patients the option of participating in experimental treatment trials. The investigation takes a case study approach, comparing two contrasting presentations of the clinical trial option. One presentation constructs the experimental trial as a locally organized, joint physician–patient effort to determine “best” treatments, and minimizes uncertainty by oversimplification of the randomization process; the second presentation situates the clinical trial within the larger national research effort, underscores the uncertainty created by randomization, and casts non-enrollment as a reasonable option. These observations provide initial evidence that physician presentation of the clinical trial varies substantially and provides the first detailed look at actual discourse practices used in the United States to recruit patients to experimental protocols.