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Opinions/Hypotheses |

The Potentially Coercive Nature of Some Clinical Research Trial Acronyms*

James P. Orlowski, MD, FCCP; James A. Christensen, AB
Author and Funding Information

*From the University Community Hospital, Tampa, FL.

Correspondence to: James P. Orlowski, MD, FCCP, Medical Director, Pediatric Intensive Care Unit, University Community Hospital, 3100 E. Fletcher Ave, Tampa, FL;



Chest. 2002;121(6):2023-2028. doi:10.1378/chest.121.6.2023
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Study objectives: To evaluate the potential coerciveness of clinical research trial (CRT) acronyms, and to make clinicians aware that some CRT acronyms may be coercive to research subjects by subliminally enticing or outwardly promising something that the CRT may not be able to deliver.

Design: Analysis of CRT acronyms for pleasantness and meaningfulness as assessed by studies in the behavioral and social psychology literature.

Results: Of 2,383 acronyms for CRTs analyzed, 155 acronyms (6.5%) were assessed as possibly, probably, or almost certainly coercive. On a Likert scale from 1 to 5 for pleasantness or meaningfulness, the acronyms identified as almost certainly coercive had a mean pleasantness score of 4.21 (range, 3.70 to 4.57), the acronyms identified as probably coercive had a mean score of 3.79 (range, 2.45 to 5.00), and the acronyms identified as possibly coercive had a mean score of 3.89 (range, 2.81 to 5.00).

Conclusions: A distraught or frightened patient with a life-threatening illness who is offered a research study with an acronym of CURE, HOPE, HELP, IMPROVED, LIFE, RESCUE, MIRACL (sic), SAVED, or ALIVE is possibly being coerced by the acronym. Institutional review boards (IRBs) and the medical research community would not tolerate a CRT entitled, “A Surefire Cure for Cancer.” They should be no more tolerant of a CRT with an acronym listed above. It is time for researchers, sponsors, and IRBs to take a more responsible approach to potentially coercive CRT acronyms and discourage or prohibit their use.


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