Impact of a cancer clinical trials web site on discussions about trial participation: A cluster randomized trial

Background: Cancer patients want access to reliable information about currently recruiting clinical trials. Patients and methods: Oncologists and their patients were randomly assigned to access a consumer-friendly cancer clinical trials web site [Australian Cancer Trials (ACT), . www.australiancancertrials.gov.au] or to usual care in a cluster randomized controlled trial. The primary outcome, measured from audio recordings of oncologist-patient consultations, was the proportion of patients with whom participation in any clinical trial was discussed. Analysis was by intention-to-treat accounting for clustering and stratification. Results: Thirty medical oncologists and 493 patients were recruited. Overall, 46% of consultations in the intervention group compared with 34% in the control group contained a discussion about clinical trials (P = 0.08). The mean consultation length in both groups was 29 min (P = 0.69). The proportion consenting to a trial was 10% in both groups (P = 0.65). Patients' knowledge about randomized trials was lower in the intervention than the control group (mean score 3.0 versus 3.3, P = 0.03) but decisional conflict scores were similar (mean score 42 versus 43, P = 0.83). Conclusions: Good communication between patients and physicians is essential. Within this context, a web site such as Australian Cancer Trials may be an important tool to encourage discussion about clinical trial participation.