{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T14:13:06Z","timestamp":1788531186346,"version":"build-2803163510"},"reference-count":23,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Internal funds from the Division of Cancer Control and Population Sciences at the National Cancer Institute"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["MDM Policy &amp; Practice"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Randomized controlled trials (RCTs) are needed to evaluate multicancer detection (MCD) tests. A novel \u201cintended-effect\u201d RCT design in which control group participants receive MCD testing but results remain undisclosed can increase statistical efficiency. Prospective participants may find this design unacceptable due to ambiguity aversion introduced by the existence of undisclosed but theoretically knowable test results. We evaluated this effect and tested if reducing ambiguity by ensuring the unknowability of test results mitigates this bias.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      US adults aged 45 to 70 y (\n                      <jats:italic toggle=\"yes\">N<\/jats:italic>\n                      = 1,576) were randomized to read about 1 of 4 RCT designs evaluating MCD testing: 1) RCT with a conventional control group (no testing), 2) RCT with a standard intended-effect control group (ie, control gets testing but not the results), 3) modified intended-effect RCT emphasizing disclosure safeguards to ensure the unknowability of control group test results to participants and researchers, and 4) modified intended-effect RCT with time-delayed testing on control group blood samples after trial completion. Outcomes were study interest (5-point scale, with higher values indicating more interest) and intention to participate (yes\/no). Analyses of variance, chi-square tests, and regression-based analyses examined the main effects and potential mediating roles of the perceived net benefit of participating in the study and trust in study researchers.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Intention to participate was similar across all conditions (range: 14%\u201321%). Study interest was higher in the conventional control (\n                      <jats:italic toggle=\"yes\">M<\/jats:italic>\n                      = 3.73) vs the 3 intended-effect designs (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.05), which did not differ (\n                      <jats:italic toggle=\"yes\">M<\/jats:italic>\n                      s = 3.36\u20133.45). The negative influence of intended-effect designs on study interest was partially mediated by perceived net benefit.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Intended-effect RCT designs lower interest in MCD trial participation, in part by reducing prospective participants\u2019 perceptions of benefiting from the trial. Strategies to reduce ambiguity do not mitigate this effect.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/23814683261477027","type":"journal-article","created":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T11:51:45Z","timestamp":1788349905000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Resistance to a Novel Clinical Trial Design for Multicancer Detection Tests: Experimental Investigation of Ambiguity Aversion"],"prefix":"10.1177","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6334-1986","authenticated-orcid":false,"given":"Jacob A.","family":"Rohde","sequence":"first","affiliation":[{"name":"Department of Allied Health Sciences, College of Agriculture, Health, and Natural Resources, University of Connecticut, Storrs, CT, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jackelyn B.","family":"Payne","sequence":"additional","affiliation":[{"name":"Cancer Prevention Fellowship Program, Division of Cancer Prevention, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard P.","family":"Moser","sequence":"additional","affiliation":[{"name":"Behavioral Research Program, Division of Cancer Prevention, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William M. P.","family":"Klein","sequence":"additional","affiliation":[{"name":"Divisions of Cancer Prevention and Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip E.","family":"Castle","sequence":"additional","affiliation":[{"name":"Behavioral Research Program, Division of Cancer Prevention, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0165-1940","authenticated-orcid":false,"given":"Paul K. J.","family":"Han","sequence":"additional","affiliation":[{"name":"Behavioral Research Program, Division of Cancer Prevention, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,9,2]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"crossref","unstructured":"Etzioni R Gulati R Weiss NS. Multicancer early detection: learning from the past to meet the future. J Natl Cancer Inst. 2022;114(3):349\u2013352. https:\/\/doi.org\/10.1093\/jnci\/djab168","DOI":"10.1093\/jnci\/djab168"},{"key":"e_1_3_2_3_2","doi-asserted-by":"crossref","unstructured":"Brito-Rocha T Constancio V Henrique R Jeronimo C. Shifting the cancer screening paradigm: the rising potential of blood-based multi-cancer early detection tests. 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