• Ron Schellings, Alfons G Kessels, Gerben Ter Riet, Jos Kleijnen, Pieter Leffers, J André Knottnerus, and Ferd Sturmans.
• Public Health Supervisory Service of the Netherlands, the Inspectorate of Health Care, The Hague. Ron.schellings@worldonline.nl
• J Clin Epidemiol. 2005 Jun 1;58(6):589-94.

Background And ObjectiveThe use of randomized consent designs has been subject of methodologic and ethical controversy. In most Western countries, research ethics committees make the decision as to whether a randomized consent design can be applied. The purpose of the study is to assess to what extent a randomized consent design and a modification of this design is accepted by research ethics committees, in terms of ethics, health law, and methodology.MethodsA postal survey was conducted among members of research ethics committees in the United Kingdom, and in The Netherlands, with professional competence in ethics, (health) law, methodology, or clinical practice.ResultsIn both the UK and in The Netherlands, the modified randomized consent design appears to be statistically significantly more acceptable than the randomized consent design, with respect to ethical and judicial aspects. The overall rejection rate of the randomized consent design was 66% in the UK and 59% in The Netherlands. However, the modified randomized consent design was rejected by 47 and 41% in the two countries, respectively.Conclusionthe modified randomized consent design appears to be more acceptable than the randomized consent design. To increase consistency in the way research ethics committees handle study protocols, a discussion about the use of randomized consent designs appears necessary.

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