JAMA : the journal of the American Medical Association
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Available data suggest that prospective research participants may frequently not understand information disclosed to them in the informed consent process. Little is known about how understanding can be improved. ⋯ Efforts to improve understanding through the use of multimedia and enhanced consent forms have had only limited success. Having a study team member or a neutral educator spend more time talking one-on-one to study participants appears to be the most effective available way of improving research participants' understanding; however, further research is needed.
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Review
Accuracy of diagnostic tests read with and without clinical information: a systematic review.
Although it is common practice to read tests with clinical information, whether this improves or decreases the accuracy of test reading is uncertain. ⋯ At least for the tests examined, the common practice of reading diagnostic tests with clinical information seems justified. Future studies should be designed to investigate the best way of providing clinical information. These studies should also give an estimate of the accuracy of clinical information used, display ROC curves with identified data points, and include a wider range of diagnostic tests.
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Comparative Study
Racial and ethnic differences in time to acute reperfusion therapy for patients hospitalized with myocardial infarction.
Nonwhite patients experience significantly longer times to fibrinolytic therapy (door-to-drug times) and percutaneous coronary intervention (door-to-balloon times) than white patients, raising concerns of health care disparities, but the reasons for these patterns are poorly understood. ⋯ A substantial portion of the racial/ethnic disparity in time to treatment was accounted for by the specific hospital to which patients were admitted, in contrast to differential treatment by race/ethnicity inside the hospital.