e-journal
Unblinding following trial participation: Qualitative study of participants’ perspectives
The implications of offering unblinding to trial participants to treatment
arm after trial completion have been little explored.
Purpose We sought to explore trial participants’ perspectives on whether they
would like to be unblinded as to the treatment arm to which they were allocated
following involvement in a large randomised controlled trial (RCT).
Methods We conducted semi-structured interviews with 38 women who had participated
in a trial during suspected preterm labour and had received the results of a
long-term follow-up study that identified adverse outcomes for children in some of
the treatment groups. Participants were sampled purposively. Analysis was based on
the constant comparative method.
Results Most women reported that they wanted to know the treatment arm to
which they had been allocated. While the primary motive for some was curiosity,
many others wanted to know as part of an attempt to understand or explain their
child’s current health problems. These women were motivated by a search for a
coherent causal narrative, even though unblinding was unlikely to be able to meet
their aspirations. Some participants identified potential disadvantages in discovering
their treatment allocation, including feeling responsible for their child’s health
status, and some women were very clear that they did not want to know their treatment
group.
Limitations A purposive sample was used and the extent to which it represents the
views of all participants in the study is not established.
Conclusions Important challenges arise in offering to unblind trial participants,
whatever the trial results. Participants may need help and support to understand
the limitations of the knowledge they gain through being unblinded and to decide
whether they wish to know to which treatment arm they were allocated.
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