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	Since this article does not have an abstract, we have provided the first 143 words of the full text and any section headings.

To the Editor: Dr Kodish and colleagues¹ reported that 50% of parents of children enrolled in clinical trials of leukemia did not understand the concept of randomization, 18% did not understand they could refuse study enrollment, and 20% did not know they could withdraw their child from the trial at any time. Simes et al² and Dunn et al³ reported similar results.

Although Kodish et al provided a number of suggestions to improve understanding of randomization, they did not discuss the use of audiotapes. A recent systematic review⁴ of 8 randomized trials determined that patients with cancer found recordings of medical consultations valuable and 5 of 6 studies showed that they improved recall of the discussion. Thus, audiotapes may also be of benefit in the context of discussing informed consent.

This letter was shown to Dr Kodish, who declined to reply.—ED.

Carmen E. Guerra, MD
carmen.guerra{at}uphs.upenn.edu
Division of General Internal Medicine
University of Pennsylvania School of Medicine
Philadelphia

1. Kodish E, Eder M, Noll RB, et al. Communication of randomization in childhood leukemia trials. JAMA. 2004;291:470-475. FREE FULL TEXT 2. Simes RJ, Tattersall MH, Coates AS, et al. Randomised comparison of procedures for obtaining informed consent in clinical trials of treatment of cancer. BMJ. 1986;293:1065-1068. FREE FULL TEXT 3. Dunn SM, Butow PN, Tattersall MH, et al. General information tapes inhibit recall of the cancer consultation. J Clin Oncol. 1993;11:2279-2285. FREE FULL TEXT 4. Tatterstall MH, Butow PN. Consultation audio tapes: an underused cancer patient information aid and clinical research tool. Lancet Oncol. 2002;3:431-437. FULL TEXT | WEB OF SCIENCE | PUBMED

Letters Section Editor: Stephen J. Lurie, MD, PhD, Senior Editor.

JAMA. 2004;291:1699.

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Communication of Randomization in Childhood Leukemia Trials
Eric Kodish, Michelle Eder, Robert B. Noll, Kathleen Ruccione, Beverly Lange, Anne Angiolillo, Rebecca Pentz, Stephen Zyzanski, Laura A. Siminoff, and Dennis Drotar
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