biostudies-literatureJepson MCancer Research UKMedical Research CouncilNational Institute for Health Research (NIHR)75-83https://www.ebi.ac.uk/biostudies/studies/S-EPMC6015122biostudies-literatureUnknown99<h4>Objectives</h4>To explore how the concept of randomization is described by clinicians and understood by patients in randomized controlled trials (RCTs) and how it contributes to patient understanding and recruitment.<h4>Study design and setting</h4>Qualitative analysis of 73 audio recordings of recruitment consultations from five, multicenter, UK-based RCTs with identified or anticipated recruitment difficulties.<h4>Results</h4>One in 10 appointments did not include any mention of randomization. Most included a description of the method or process of allocation. Descriptions often made reference to gambling-related metaphors or similes, or referred to allocation by a computer. Where reference was made to a computer, some patients assumed that they would receive the treatment that was "Journal of clinical epidemiologyAn observational study showed that explaining randomization using gambling-related metaphors and computer-agency descriptions impeded randomized clinical trial recruitment.PMC601512210/34/0116781NF-SI-0514-10114PB-PG-0807-1413106/303/98MR/K025643/1Falk SJGriffin SMCSAW study groupStrong SBarham PWilliams GMihaylova BStreets CBryan RChemorad study groupHayter EHalliday AVermassen FMoser JPoole CBecquemin JPGwilym SACST-2 study groupNicklin JHall PCook JCarr ADavies CStein RBartlett JRooshenas LTitcomb DThomas DHiller LHollowood ADHall ENewton MConefrey CBirtle AStallard NGough MMakris AWinterbottom AWartolowska KKrysztopik RFalzon MWilson CBeard DGray AJepson MMichaels JCao PBlazeby JMSavulescu JRees JPOUT study groupTracey IHughes-Davies LMcDonald SHiggins HKockelbergh RHulme CPinder SElliott DBelli ACrosby TRea DDonovan JLFrancis AMacpherson ILewis RWade JLewis WKeeley FDunn JKirkbank TCanney PJudge AJones ROPTIMA prelim study groupRobertson SJohnson MMcCabe CCameron DPeto REarl HBosiers MScott RRothwell PHollingworth WBrookes STMerritt NRombach IMorgan AChester JFrench APowles TLeopold PDean BMarshall AHarris CWaters RCampbell ACooper CCatto JHarmer VfalseAn observational study showed that explaining randomization using gambling-related metaphors and computer-agency descriptions impeded randomized clinical trial recruitment.<h4>Objectives</h4>To explore how the concept of randomization is described by clinicians and understood by patients in randomized controlled trials (RCTs) and how it contributes to patient understanding and recruitment.<h4>Study design and setting</h4>Qualitative analysis of 73 audio recordings of recruitment consultations from five, multicenter, UK-based RCTs with identified or anticipated recruitment difficulties.<h4>Results</h4>One in 10 appointments did not include any mention of randomization. Most included a description of the method or process of allocation. Descriptions often made reference to gambling-related metaphors or similes, or referred to allocation by a computer. Where reference was made to a computer, some patients assumed that they would receive the treatment that was "2018-01-01T00:00:00Z2018 Jul2025-04-25T19:48:34.909Z2019-03-26T23:43:47ZS-EPMC60151222950586010.1016/j.jclinepi.2018.02.018