Awareness Regarding Clinical Trials Among Patients with Multiple Myeloma (MM): A Systematic Study to Validate Online Platforms for Conducting Patient Surveys
Authors: Hydren Jay R. , Barnes Mason S. , Jensen Rachel M , Bojanini Leyla , Ailawadhi Dhaani , Das Saurav , Ahlstrom Jennifer M. , Ailawadhi Sikander 
Published: December 2024

Introduction: As therapeutic options for cancer increase at an unprecedented rate, understanding patient's awareness and attitudes is imperative to optimize their participation in shared decision making. Patient surveys are a powerful tool to gain insight into patient awareness but are cumbersome to administer on a large scale. With the advent of technology and virtual care, electronic surveys are being utilized more widely but their validity compared to approaching the patients in-person has not been established. We conducted a survey regarding awareness and preferences for clinical trials in-person and electronically and compared results systematically in a matched cohorts of patients with MM.
Methods: A 52-question survey (including the domains: knowledge, trust, fear, external influence and optimism) was administered in-person to cancer patients at Mayo Clinic campuses (NCT04630431), of which patients with MM were identified for this analysis. The same survey was administered to MM patients enrolled in the online portal HealthTree® Cure Hub. Observations from the in-person and online cohorts were matched and weighted based on coarsened exact matching utilizing the “MatchIt” package based on age, gender, race, ethnicity, education, and marital status. Question responses were converted to an agreeance score scaled from 1 (Strongly Disagree) to 5 (Strongly Agree). Mean and standard deviation measurements were calculated. Weighted t-tests were conducted using these numeric scores and the matched weights.
Results: Final matched cohorts included 83% (n=65) of the in-person and 69% (n=149) of the online participants. Mean age was 63.5 (± 8.5) years with 52% females for in-person vs. 65.9 (± 7.5) years and 54% females in the online participants. In-person cohort included 83% White, 14% Black and 12% Hispanic participants while online cohort had 94% White, 5% Black and 13% Hispanics/Latinos. Education level with 4-year degree or higher was reported by 66% in-person and 75% online participants. Both cohort respondents on average rated a strong likelihood of participating in a clinical trial (in-person 4.04, CI: 3.73-4.35; online 4.34, CI: 4.19-4.5). There was significant agreeance between the 2 cohorts on majority of the questionnaire domains. For basic knowledge about clinical trials, while none of the individual questions in the category were significantly different, the online group had a higher aggregate agreeance score of 3.91 vs. 3.73 for the in-person group with a significant difference of 0.18 (CI: 0.5-0.31, p=0.008). For external influence, the online group had a higher aggregate agreeance score (3.52) than the in-person group (3.15; Difference: 0.37, CI: 0.22-0.52, p&lt;0.001), with the only question-level significant difference being for the question that regulatory agencies effectively control what is being advertised by the pharmaceutical industry (4.46 ± 0.64 vs. 3.48 ± 0.76, p&lt;0.001).
Conclusions: Online surveys are an effective tool for gaining insight into patient understanding, attitudes and awareness on a variety of topics and can be conducted efficiently on a larger scale than in-person studies, which may be more time and resource intensive. Our study provides evidence of general agreeance between a matched cohort of in-person and online survey respondents, providing validity to carefully conducted, planned online survey tools. The online cohort in our study overall had better knowledge about clinical trials and a better understanding about external influences on available clinical trial result information. These results will help boost studies to collect patient-level responses such that their beliefs and awareness can be better understood and incorporated in optimizing healthcare resource utilization.