Ethical, Legal, and Social Issues Substudy in Relation to the GTEx Project (ELSI)

March 29, 2021 updated by: Laura Siminoff, Temple University

Ethical, Legal, and Social Issues Substudy in Relation to the Genotype-Tissue Expression Project

The Ethical, Legal and Social Issues Substudy in relation to the Genotype Tissue Expression Project (GTEx) aims to describe tissue requesters' approach to discussions about donation to GTEx and to assess the determinants of families' and patients' willingness to donate to GTEx. It also explores ethical issues such as privacy, risks, and release of incidental findings and recommend best practices for conducting authorizations and training requesters.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Completed

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Detailed Description

The Genotype Tissue Expression Project (GTEx) is a partnership between multiple NIH agencies and funded by the Common Fund. Families who agreed to donation of organs and tissues for transplantation were asked to authorize the collection of additional tissues for GTEx by participating Organ Procurement Organizations (OPO). Donated tissues are placed in a National Cancer Institute biobank, and the donor's genome and medical record information analyzed and released to researchers through NIH's database of Genotypes and Phenotypes (dbGaP). The tissues and information will be kept in the biobank indefinitely and cell lines may be developed from the donated skin and blood.

An ethical, legal and social issues (ELSI) sub-study examines the issues surrounding risks to privacy and breach of confidentiality to family decision makers (FDM) as well as FDM perspectives on the return of findings to donor families. The ELSI sub-study assessed the authorization process and make suggestions for its improvement. Semi-structured interviews were completed with families who decided to donate to GTEx as well as those who refused to donate to the project. Tissue requesters (TR) who make the GTEx approaches for participating OPOs, were also asked to complete an online survey for each approach they completed for GTEx.

The study builds on this research team's extensive work in organ and tissue donation and the work currently being conducting during the ELSI pilot of the GTEx project. Specifically, the investigators propose to examine the impact of stress and complex information on donor families' decision-making to inform the consent process; understand how variations in requesters, consent approaches, and the characteristics of family decision makers affect understanding, recall of and willingness to donate tissues for research; consider the ethical and legal issues of the request and consent process; and, test a novel intervention designed to train tissue requesters to employ effective communication techniques when making requests for tissue. The overall goal is to develop a set of recommendations that will maximize the likelihood that family decision makers (FDM) make informed donation decisions under stressful circumstances. The specific aims of the ELSI GTEx study are:

This study will build on this research team's extensive work in organ and tissue donation and the work they are currently conducting during the ELSI pilot of the GTEx project. Specifically, the investigators propose to examine the impact of stress and complex information on the decision making of donor families to inform the consent process, understand how variations in requesters, consent approaches, and the characteristics of family decision makers affect understanding and recall of and willingness to donate tissues for research, consider the ethical and legal issues of the request and consent process, and test an intervention to train tissue requesters to employ effective communication techniques when making requests for tissue. The overall goal is to develop a set of recommendations that will maximize the likelihood that family decision makers (FDM) make informed donation decisions under stressful circumstances. The specific aims of the ELSI GTEx study are:

  1. Identify elements of nonverbal and relational communication impacting FDM knowledge, recall and GTEx decision making. Using the methods and procedures of the pilot study, the investigators will conduct an observational study of the GTEx request process to understand the communication-related variables impacting FDM knowledge, recall and decision making. In addition, a subsample of audiotapes will be obtained from tissue-only donors whose consent conversations are conducted by telephone and are audiotaped. This will provide information about the important nonverbal and relational elements of communication on the outcome variables.

    H1a. Sociodemographic characteristics of FDM will impact the major outcomes of interest to this study (recall, comprehension and consent). Specifically, FDM who have more education, are white, female and younger will be more likely to donate, have better recall and knowledge.

    H1b. Relational elements of communication, such as confirmational messages (e.g., messages that expressed validation or acceptance) or persuasive tactics such as credibility, altruism, or esteem, and engaging in a lengthier conversation will be associated with a greater likelihood to donate have better recall and knowledge.

    H1c. Tissue requesters' and FDMs' comfort speaking about GTEx, the proclivity of FDMs to ask question and engage more proactively in the conversation will be associated with a greater likelihood to donate have better recall and knowledge.

  2. Conduct a study, using a quasi-experimental design, to understand the impact of the stressful environment in which the requests occur. This study will assist the ELSI team to obtain an evidence base that will allow us to disentangle the effects of stress from the complexity of the information about the purpose of the donation and guide recommendations for a final consent process.
  3. Adapt and test a communication intervention targeting tissue requesters' (TR) use of effective, ethically acceptable techniques that maximize the likelihood of consent.

H3a. Post intervention, TRs will exhibit more relational communication with FDMs during requests. H3b. Post intervention, TRs will spend more time attending to the emotional needs of FDMs.

H3c. Post intervention, TRs will spend more time discussing information identified as important to informed decision making for tissue donation.

H3d. Post intervention, there will be overall higher consent rates for donation to the research.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Interventional

Enrollment (Actual)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
512

Phase

Phase

The stage of a clinical trial studying a drug or biological product, based on definitions developed by the U.S. Food and Drug Administration (FDA). The phase is based on the study's objective, the number of participants, and other characteristics. There are five phases: Early Phase 1 (formerly listed as Phase 0), Phase 1, Phase 2, Phase 3, and Phase 4. Not Applicable is used to describe trials without FDA-defined phases, including trials of devices or behavioral interventions.
  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • United States
    • Virginia
      • Richmond, Virginia, United States, 23219
        • Virginia Commonwealth University

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

  • Child
  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

Participants must either be a:

  1. family decision maker approached to donate their loved one's tissues to the GTEx project or
  2. a staff person at an OPO that approaches family decision makers for the GTEx project.

Exclusion Criteria:

1. Persons who neither approached for GTEx or were approached are excluded from participation.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Other
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm

Participant Group / Arm

A group or subgroup of participants in a clinical trial that receives a specific intervention/treatment, or no intervention, according to the trial's protocol.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
Experimental: Intervention Group
Tissue requesters from participating OPOs are randomly assigned to complete additional informed consent training through an interactive online training website.
Other: Training Website
Additional training website can be found at gtextraing.org
Experimental: Control Group
The control group of tissue requesters receive the standard training offered by their OPO and GTEx partners.
Other: Control
Standard training given by OPOs and GTEx staff

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Number of family members who chose to donate to GTEx
Time Frame: Up to 8 months after donation request
Number of family decision makers who choose to donate to GTEx
Up to 8 months after donation request

Secondary Outcome Measures

Secondary Outcome Measures

In a clinical study's protocol, a planned outcome measure that is not as important as the primary outcome measure for evaluating the effect of an intervention but is still of interest. Most clinical studies have more than one secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
Knowledge and Comprehension of Elements of Consent
Time Frame: Up to 8 months after donation request
Knowledge and comprehension were assessed by participant answers to questionnaire.
Up to 8 months after donation request

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
Temple University

Collaborators

Collaborators

An organization other than the sponsor that provides support for a clinical study. This support may include activities related to funding, design, implementation, data analysis, or reporting.
National Cancer Institute (NCI)

Investigators

Investigators

A researcher involved in a clinical study. Related terms include site principal investigator, site sub-investigator, study chair, study director, and study principal investigator.
  • Principal Investigator: Laura Siminoff, PhD, Temple University
  • Principal Investigator: Heather Traino, PhD, Temple University

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
March 1, 2013

Primary Completion (Actual)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
August 1, 2016

Study Completion (Actual)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
December 1, 2017

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
December 17, 2015

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
August 29, 2016

First Posted (Estimate)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
September 2, 2016

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
March 30, 2021

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
March 29, 2021

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
March 1, 2021

More Information

Terms related to this study

Keywords

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • 10XS170

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

No

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

product manufactured in and exported from the U.S.

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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