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Record W2762274663 · doi:10.1177/1747016117733506

Pragmatic clinical trials and the consent process

2017· article· en· W2762274663 on OpenAlexafffundabout
Blake Murdoch, Timothy Caulfield

Bibliographic record

VenueResearch Ethics · 2017
Typearticle
Languageen
FieldMedicine
TopicEthics in Clinical Research
Canadian institutionsInstitute of Health EconomicsUniversity of Alberta
FundersAlberta Innovates - Health SolutionsUniversity of SaskatchewanUniversity of Calgary
KeywordsWaiverInformed consentLegislationContext (archaeology)Flexibility (engineering)Political sciencePsychologyPublic relationsLawBusinessEngineering ethicsMedicineAlternative medicineEconomics

Abstract

fetched live from OpenAlex

Pragmatic clinical trials (PCTs) are a relatively new methodological approach to the execution of clinical research that can increase research efficiency and provide access to unique data. Some have suggested that the costs and delays associated with obtaining informed consent could make PCTs difficult or even impossible to execute. Alternative consent models have been proposed, some of which lower standards of disclosure, delay consent, or waive it altogether. We analyze the permissibility of changes to informed consent in the context of Canadian research ethics policies, legislation, common law, professional codes of ethics, and professional standards of practice. We find that Canadian law and policy relating to informed consent clearly applies to any clinician who might be involved in a PCT. In addition, existing consent norms seem unable to accommodate alternative consent models for pragmatic research if such models would involve lowering the standard of disclosure. The strong emphasis on the primacy of individual rights that exist in law and in research ethics norms cannot easily coexist with strategies that involve either waiver of consent requirements or the provision of incomplete information about the research prior to enrolment. If Canadian policy-makers wish to create the regulatory flexibility necessary to accommodate altered consent and disclosure, it is likely this will require the alteration of existing health information legislation, national research ethics policy, and professional standards.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Direct model labels (unvalidated)

Per-model category and study-design labels from the labeling rounds. They are machine output, unvalidated, and the disagreement between models ships as data. No study design here is MEDLINE-validated yet.

Model armCategoriesStudy designConfidence
gemmaResearch integrity
Domain: not available · Genre: Empirical
About the Canadian research system: yes · About a Canadian topic: yes
Theoretical or conceptualhigh
gptMetaresearch
Domain: Methods · Genre: Commentary
About the Canadian research system: yes · About a Canadian topic: yes
Theoretical or conceptualhigh
models splitAgreement compares identical category sets and study designs across arms.

Full frame machine prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.

metaresearch head score (Codex)0.620
metaresearch head score (Gemma)0.719
Version: metacan-v3-hybrid-931329e0061cValidation status: machine_predicted_unvalidated
Candidate categoriesMetaresearch
Consensus categoriesMetaresearch
DomainCandidate signal: Methods · Consensus signal: Methods
Study designCandidate signal: Theoretical or conceptual · Consensus signal: Theoretical or conceptual
GenreCandidate signal: Methods · Consensus signal: none
Teacher disagreement score0.380
Threshold uncertainty score0.469

Distilled classifier scores by category (both heads)

CategoryCodexGemma
Metaresearch0.6200.719
Meta-epidemiology (narrow)0.0020.002
Meta-epidemiology (broad)0.0030.002
Bibliometrics0.0040.005
Science and technology studies0.0080.063
Scholarly communication0.0140.020
Open science0.0060.014
Research integrity0.0220.018
Insufficient payload (model declined to judge)0.0070.002

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.981
GPT teacher head0.848
Teacher spread0.133 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Labeled directly by 2 models reading the full record.

Research integrityMetaresearch

The models disagree on parts of this classification; every voice is preserved in the section at the end of the page.

Study designTheoretical or conceptual
DomainMethods
GenreEmpirical · Commentary

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

Quick stats

Citations8
Published2017
Admission routes3
Has abstractyes

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