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Oncologists' knowledge, practices and ethical opinions about therapeutic misconception: a French national survey
Thibaud Haaser1,2,3,4, S Clair5, S Marty5,6
1Health and Research Ethics Centre of Bordeaux, Bordeaux, France. thibaud.haaser@chu-bordeaux.fr.
Background:
Therapeutic misconception (TM) among research participants refers to the conflation of research goals (generating generalisable knowledge) with clinical care goals (making the best decisions for the participants). Considering the high volume of oncology research, oncologists frequently encounter TM.
Aim:
To evaluate the knowledge, practices, and ethical concerns of French oncologists regarding TM.
Materials And Methods:
A questionnaire was developed to assess oncologists' knowledge and practices concerning TM, then utilised in a national survey of French oncologists from 1 June to 14 July 2023. A descriptive statistical analysis of the responses (according to a Likert scale) was carried out.
Results:
In total, 288 oncologists from various specialties responded to the survey. Initial knowledge of TM was low (16%), but after the definition was provided, 84% reported having encountered TM. Respondents indicated that they paid attention to the information given during participant inclusion; however, approximately half (46%) actively investigated the presence of TM, and 22% admitted to having encouraged TM at least occasionally. Attention to TM significantly declined over the course of study protocols. Awareness of TM, along with ethics education or participation in a research ethics committee, were identified as significant factors influencing responses. The acceptability of TM was nuanced, particularly in protocols recommended to patients receiving last-line treatments. Although 64% of respondents acknowledged a link between TM and dual roles as both investigator and physician, 78% opposed transferring investigative responsibilities to a non-referent oncologist.
Conclusion:
TM is a widespread but still mostly unknown phenomenon which could easily be tackled for better outcomes for patients. This study revealed considerable variability in knowledge, practices, and ethical considerations related to TM among French oncologists. Enhanced education and ethical support are needed to improve awareness and foster appropriate behaviours concerning TM.
Clinical Trial Number:
Not applicable.
Insights
Therapeutic misconception (TM), the confusion between research and clinical care, is common among oncologists. Enhanced education and ethical support are crucial for improving awareness and patient outcomes in oncology research.
Area of Science:
- Oncology
- Clinical Research Ethics
- Medical Education
Background:
- Therapeutic misconception (TM) occurs when research participants confuse research goals with clinical care goals.
- Oncologists frequently encounter TM due to the high volume of oncology research.
Purpose of the Study:
- To evaluate French oncologists' knowledge, practices, and ethical concerns regarding therapeutic misconception.
- Assess the prevalence and management of TM in oncology clinical trials.
Main Methods:
- A national survey of 288 French oncologists was conducted using a questionnaire from June 1 to July 14, 2023.
- Descriptive statistical analysis was performed on Likert scale responses to assess knowledge and practices related to TM.
Main Results:
- Initial TM knowledge was low (16%), but 84% reported encountering it. Only 46% actively investigated TM, and 22% admitted to occasionally encouraging it.
- TM awareness declined during study protocols. Ethics education and research ethics committee participation were linked to better responses.
- Acceptability of TM varied, especially in last-line treatment protocols. Most oncologists recognized the link between TM and their dual roles but opposed transferring responsibilities.
Conclusions:
- Therapeutic misconception is widespread yet often unrecognized, impacting patient care in oncology research.
- Significant variability exists in French oncologists' knowledge, practices, and ethical considerations regarding TM.
- Improved education and ethical support are necessary to enhance TM awareness and promote appropriate oncologist behaviors.
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