Related Experiment Video
Updated: Jul 14, 2026

Combining Behavioral Endocrinology and Experimental Economics: Testosterone and Social Decision Making
Published on: March 2, 2011
Sex differences in perceived risks, distrust, and willingness to participate in clinical trials: a randomized study
Eric L Ding1, Neil R Powe, JoAnn E Manson
1Departments of Epidemiology, Harvard School of Public Health, Boston, MA 02115, USA. eding@jhu.edu
Background:
Multiple sex differences exist in cardiovascular disease burden and treatment efficacies; adequate participation of both sexes is crucial to clinical research.
Methods:
A multicenter, double-blind, randomized study evaluated sex and trial scenarios on willingness to participate (WTP) in cardiovascular prevention trials and examined sex differences in perceived risks and distrust. Hypothetical trial scenarios randomized multifactorial vignettes of adverse effects, trial durations, sponsors, financial incentives, and conflicts of interest.
Results:
With 783 participants across 13 clinical centers, women showed lower distrust of medical researchers, perceived greater risk of myocardial infarction, and perceived greater risk of harm from trial participation than men. Men had 15% greater WTP than women (33.1% vs 28.7%; relative risk [RR], 1.15; 95% confidence interval [CI], 1.02-1.31); adjusting for explanatory mediators, we found that sex differences in perceived risks and benefits explained the sex gap in WTP. Although greater perceived probability of harm (RR, 0.41; 95% CI, 0.23-0.72), health benefit (RR, 2.99; 95% CI, 1.63-5.46), and quality of care (RR, 1.71; 95% CI, 1.12-2.61) strongly predicted WTP (for perceived probabilities >or=80% vs <20%) similarly in both sexes, and perceptions of distrust and myocardial infarction risk predicted WTP differently between sexes (P
Conclusions:
In this multicenter study, women perceived greater risk of harm and myocardial infarction and showed lower WTP in cardiovascular prevention trials. Evidence underscores the importance of sex in influencing clinical trial enrollment.
Related Concept Videos
Types of Biopharmaceutical Studies: Controlled and Non-Controlled Approaches
Non-controlled studies, commonly employed for initial exploration, lack a control group, rendering them susceptible to biases and external influences. In contrast, controlled...
Clinical Trials: Overview
Bias in Epidemiological Studies
Clinical Trials
There are four phases in a clinical trial. A phase one...
Hazard Ratio
For example, in a clinical trial evaluating a...
Bioavailability Study Design: Healthy Subjects Versus Patients