Enrollment in research under exception from informed consent: The Patients' Experiences in Emergency Research (PEER) study

Neal W. Dickert, Victoria A. Mah, Jill M. Baren, Michelle H. Biros, Prasanthi Govindarajan, Arthur Pancioli, Robert Silbergleit, David W. Wright, Rebecca D. Pentz

Research output: Contribution to journalArticlepeer-review

37 Scopus citations


Background: Resuscitation research requires an exception from informed consent (EFIC). Despite concerns that patients may find EFIC unacceptable, the views and experiences of patients enrolled in an EFIC study are largely unknown. Methods: The Patients' Experience in Emergency Research (PEER) study was nested within the Rapid Anticonvulsant Medication Prior to Arrival Trial (RAMPART) for pre-hospital treatment of status epilepticus. PEER included 61 EFIC enrollees or their surrogates from 5 sites. Interviews used a structured, interactive guide focusing on acceptance of EFIC enrollment in RAMPART and existing regulatory protections. Simple statistics were generated, and textual data were analyzed for common themes. Results: 24 enrolled patients and 37 surrogates were successfully interviewed. 49/60 (82%) were glad they or their family member were included in RAMPART; 54/57 (95%) felt research on emergency seizure treatment is important. 43/59 (73%) found their inclusion under EFIC acceptable; 10 (17%) found it unacceptable, and 6 (10%) were neutral. There were no statistically significant interactions between enrollment attitudes and demographic characteristics, though there were trends toward lower acceptance among interviewees who were non-white, less educated, or had prior research experience. The most common concerns related to lack of consent prior to RAMPART enrollment. Positive responses related to perceived medical benefits, recognition of the impracticality of consent, and wanting doctors to do what needs to be done in emergencies. Many participants had difficulty understanding the trial and EFIC. Conclusions: Most subjects had positive views of enrollment, and acceptance generally correlated with results of community consultation studies.

Original languageEnglish (US)
Pages (from-to)1416-1421
Number of pages6
Issue number10
StatePublished - Oct 2013

Bibliographical note

Funding Information:
The PEER study (1R03NS066378-01) and the RAMPART study (U01NS056975 and U01NS059041) were funded by the National Institute of Neurological Disorders and Stroke , National Institutes of Health . NINDS played no role in the design of the study, interpretation of data, or development of the manuscript.


  • Community consultation
  • Ethics
  • Research ethics
  • Research in emergency settings
  • Resuscitation research


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