Increasing Clinical Trial Participation of Black Women Diagnosed with Breast Cancer

"We Don't Get Drugs Targeted for Us:" Applying the Integrated Behavioral Model to Understand Why Black Women Chose to Participate in a Breast Cancer Clinical Trial

Guided by the integrated behavioral model, the authors interviewed 14 Black breast cancer survivors (N = 14) who had participated in a breast cancer clinical trial. This study aimed to better understand what may motivate Black women to engage in medical research and decide to participate in medical research. Findings revealed that Black women's altruistic desires to serve others and their communities are greatly influenced by the need to leave a "legacy" of better treatment for other Black women. The participants mostly learned about clinical trials through communicating with friends, family, or other breast cancer patients and survivors, rather than from their physicians. Many were influenced to participate by other Black breast cancer patients they knew, suggesting that social norms messaging may help alert other Black women about the continuing disparity in clinical trial participation. Finally, the participants in this study demonstrated high levels of involvement not only in seeking out clinical trials, but also in engaging in informed and shared decision-making with their providers about participating in the trials. The findings from this work illuminate important reasons Black women chose to participate in breast cancer clinical trials. Additionally, we offer robust and valuable theoretical and practical implications for researchers, so they can work toward successfully increasing Black women's participation in clinical trials.

Ethical data acquisition for LLMs and AI algorithms in healthcare

Artificial intelligence (AI) algorithms will become increasingly integrated into our healthcare systems in the coming decades. These algorithms require large volumes of data for development and fine-tuning. Patient data is typically acquired for AI algorithms through an opt-out system in the United States, while others support an opt-in model. We argue that ethical principles around autonomy, patient ownership of data, and privacy should be prioritized in the data acquisition paradigm.

Examining recollections of Black women with breast cancer who participated in clinical trials: A grounded practical theory study of patient-provider communication

The presence of strong barriers to research participation for Black women is indisputable. However, existing evidence supports the possibility of equal levels of participation among members of minoritized populations in past breast cancer (BC) clinical trials (CTs), demonstrating that while these participation barriers undoubtedly exist but are not insurmountable. This work aims to investigate patient-provider conversations to try to illuminate how providers can better engage Black women in communication that will positively influence their perceptions of breast cancer clinical trial participation. Fourteen women (N = 14) who self-identified as Black, Black American, or African American and who had previously or were currently involved in a BC CT participated in the grounded theory-guided study. These women were recruited through emails and social media platforms and interviewed regarding their communication with their medical providers and their pathway to CT participation. Findings revealed three primary categories: 1) participants reported the following provider types as most effective communicators: attentive, matter-of-fact, warm, or above-and beyond; 2) participants frequently received no information about CTs from their providers; and 3) cultural constructs including faith, word of mouth, and storytelling are important to the recruitment of these Black women to BC CTs. Our findings demonstrate the importance of healthcare providers adjusting their communication to meet one of the preferred provider archetypes of communication styles, understanding and incorporating cultural constructs in their communication, and providing information about BC CTs to Black women. Through improved patient-provider communication, healthcare providers may positively influence Black women's perceptions of and participation in BC CTs.

Insights into epileptogenesis from post-traumatic epilepsy

Post-traumatic epilepsy (PTE) accounts for 5% of all epilepsies. The incidence of PTE after traumatic brain injury (TBI) depends on the severity of injury, approaching one in three in groups with the most severe injuries. The repeated seizures that characterize PTE impair neurological recovery and increase the risk of poor outcomes after TBI. Given this high risk of recurrent seizures and the relatively short latency period for their development after injury, PTE serves as a model disease to understand human epileptogenesis and trial novel anti-epileptogenic therapies. Epileptogenesis is the process whereby previously normal brain tissue becomes prone to recurrent abnormal electrical activity, ultimately resulting in seizures. In this Review, we describe the clinical course of PTE and highlight promising research into epileptogenesis and treatment using animal models of PTE. Clinical, imaging, EEG and fluid biomarkers are being developed to aid the identification of patients at high risk of PTE who might benefit from anti-epileptogenic therapies. Studies in preclinical models of PTE have identified tractable pathways and novel therapeutic strategies that can potentially prevent epilepsy, which remain to be validated in humans. In addition to improving outcomes after TBI, advances in PTE research are likely to provide therapeutic insights that are relevant to all epilepsies.