Systematic review and metasummary of attitudes toward research in emergency medical conditions


Emergency departments are challenging research settings, where truly informed consent can be difficult to obtain. A deeper understanding of emergency medical patients' opinions about research is needed. We conducted a systematic review and meta-summary of quantitative and qualitative studies on which values, attitudes, or beliefs of emergent medical research participants influence research participation. We included studies of adults that investigated opinions toward emergency medicine research participation. We excluded studies focused on the association between demographics or consent document features and participation and those focused on non-emergency research. In August 2011, we searched the following databases: MEDLINE, EMBASE, Google Scholar, Scirus, PsycINFO, AgeLine and Global Health. Titles, abstracts and then full manuscripts were independently evaluated by two reviewers. Disagreements were resolved by consensus and adjudicated by a third author. Studies were evaluated for bias using standardised scores. We report themes associated with participation or refusal. Our initial search produced over 1800 articles. A total of 44 articles were extracted for full-manuscript analysis, and 14 were retained based on our eligibility criteria. Among factors favouring participation, altruism and personal health benefit had the highest frequency. Mistrust of researchers, feeling like a 'guinea pig' and risk were leading factors favouring refusal. Many studies noted limitations of informed consent processes in emergent conditions. We conclude that highlighting the benefits to the participant and society, mitigating risk and increasing public trust may increase research participation in emergency medical research. New methods for conducting informed consent in such studies are needed.






Published Version (Please cite this version)


Publication Info

Limkakeng, Alexander T, Lucas Lentini Herling de Oliveira, Tais Moreira, Amruta Phadtare, Clarissa Garcia Rodrigues, Michael B Hocker, Ross McKinney, Corrine I Voils, et al. (2014). Systematic review and metasummary of attitudes toward research in emergency medical conditions. Journal of Medical Ethics, 40(6). pp. 401–408. 10.1136/medethics-2012-101147 Retrieved from

This is constructed from limited available data and may be imprecise. To cite this article, please review & use the official citation provided by the journal.



Ross Erwin McKinney

Professor Emeritus of Pediatrics


Dr. Ross McKinney's research is in the antiretroviral treatment of HIV infected children, and he has additionally published articles on the natural history and pathogenesis of pediatric HIV disease. Dr. McKinney chaired Pediatric AIDS Clinical Trials Group Protocol 300, a large (600 patient) study of zidovudine, didanosine, and lamivudine in HIV infected children. He recently Co-chaired PACTG 1021 (A phase I-II study of FTC, DDI, and efavirenz), and PACTG 390/PenPact 1 (an international study of treatment strategies for therapy naive children). Dr. McKinney also cochaired PACTG 247, a study of nutritional supplementation in HIV exposed and infected infants.

As of July 2007, Dr. McKinney became the director of the Trent Center for Bioethics, Humanities, and History of Medicine in the Duke University School of Medicine. His current research involves the ethics of medical research, with a particular focus on conflict of interest and on the informed consent process.

Unless otherwise indicated, scholarly articles published by Duke faculty members are made available here with a CC-BY-NC (Creative Commons Attribution Non-Commercial) license, as enabled by the Duke Open Access Policy. If you wish to use the materials in ways not already permitted under CC-BY-NC, please consult the copyright owner. Other materials are made available here through the author’s grant of a non-exclusive license to make their work openly accessible.