Project Summary

This research project is in progress. PCORI will post the research findings on this page within 90 days after the results are final.

One of PCORI’s goals is to improve the methods that researchers use for patient-centered outcomes research. PCORI funds methods projects like this one to better understand and advance the use of research methods that improve the strength and quality of comparative effectiveness research.

What is the project about?

Clinical trials test treatments to find out if they are safe and effective for patients. Before patients take part in a trial, researchers ask patients for informed consent. During the informed consent process, a doctor or researcher explains the purpose of the trial, answers the patient’s questions, and asks if the patient wants to take part. But this process can be confusing. For example, some patients may not understand that being assigned to a treatment by chance means they might not get the treatment being studied. Also, informed consent often occurs shortly after diagnosis, when patients may feel overwhelmed.  

Two-stage informed consent can help reduce patient stress by splitting up the consent process. In the first stage, researchers ask patients if they will agree to be part of a pool of patients from which the researchers select some patients by chance to hear about a new treatment. Researchers then assign patients by chance to hear about the new treatment or receive usual medical care. In the second stage, researchers give information about the new treatment only to patients assigned to the new treatment.

In this study, the research team is comparing standard one-stage consent to two-stage consent to see how well each improves patients’ stress and understanding of the benefits and harms of treatment.

How can this project help improve research methods?

Results may help researchers when considering ways to obtain informed consent for clinical trials.

What is the research team doing?

This study includes patients at a cancer center who were previously asked to take part in a research study but who have not yet completed informed consent. The research team is assigning these patients by chance to receive either one- or two-stage informed consent. Shortly after the informed consent process, the team is contacting patients to ask about their experience with the process. The team is asking patients if they felt anxiety or stress and if they had difficulty deciding whether to take part in the trial. Also, the team is giving patients a survey to see how well they understand the trial.

The research team is comparing patients’ stress, understanding about the trial, and willingness to take part in the trial between those who receive one-stage consent and those who receive two-stage consent. The team also is looking to see how well one- versus two-stage informed consent works for different types of trials, such as trials with high stakes (such as a trial to study chemotherapy to improve survival) versus those with low stakes (such as a study of relaxation techniques to improve pain during biopsy).

Research methods at a glance

Design Element Description
  • Compare one-stage (standard) and two-stage informed consent process for clinical trials with respect to reducing anxiety and ensuring comprehension
  • Explore characteristics of trials that may make a two-stage approach appropriate or advantageous
Approach Randomized controlled trial

Journal Citations

Project Information

Andrew Vickers, DPhil
Sloan-Kettering Institute For Cancer Research
Comparing Just-in-Time to Conventional Consent for Randomized Trials with Usual Care Controls

Key Dates

April 2019
August 2024

Study Registration Information


Award Type
Health Conditions Health Conditions These are the broad terms we use to categorize our funded research studies; specific diseases or conditions are included within the appropriate larger category. Note: not all of our funded projects focus on a single disease or condition; some touch on multiple diseases or conditions, research methods, or broader health system interventions. Such projects won’t be listed by a primary disease/condition and so won’t appear if you use this filter tool to find them. View Glossary
Intervention Strategy Intervention Strategies PCORI funds comparative clinical effectiveness research (CER) studies that compare two or more options or approaches to health care, or that compare different ways of delivering or receiving care. View Glossary
State State The state where the project originates, or where the primary institution or organization is located. View Glossary
Last updated: August 23, 2022