Multicultural Aspects Affecting Patient-Doctor Interactions and the Conduct of Clinical Research Examples Drawn from the Literature and First-Hand Knowledge

Interest in international multicenter clinical trials is increasing for a variety of reasons. Working with different cultures in clinical research creates its own unique set of problems. This paper focuses on these issues from multicenter and multicultural perspectives. The influence of culture on patient-doctor communication is considered. Expectations and the use of outcomes measurements with different cultures are also explored. Details on the issue of pain and how it is expressed and measured in different cultures is also presented. Having considered the patient-doctor dynamic, the paper concludes with an examination of the unique difficulties that international multicenter studies present. Multicultural differences manifest themselves in different forms in international clinical research. Although its impact is often ignored or minimized, this manuscript demonstrates that the impact of culture on a study's success is a very real issue. In addition to secondary sources, examples from our own clinical investigations are outlined throughout this paper. A successful model to locate researchers in previously untapped countries is also outlined. Keywords-Clinical research; multicultural; outcome measures; communication; international; patient expectations; surgeon expectations.