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The Pediatric Forum
April 2005

On Misunderstanding

Arch Pediatr Adolesc Med. 2005;159(4):400-401. doi:10.1001/archpedi.159.4.400-a

We enjoyed the article by Blake et al1 “Adolescent and Young Adult Women’s Misunderstanding of the Term Pap Smear,” which appeared in the October 2004 issue of the ARCHIVES. It is always a pleasure to have clinical intuition validated by scientific fact. Indeed, the misunderstanding the authors document is so profound in our adolescent medicine practice that we developed a patient information sheet (available on request) to address the problem. We were, however, disturbed by the statement that 14- to 17-year-old patients whose parents did not accompany them to the clinic were excluded from this survey study in order to obtain institutional review board approval. Numerous publications addressing the definition of minor subjects and their right to consent to participation in low-risk survey research of this type25 suggest that in so doing the authors needlessly biased the results of their otherwise informative and clinically useful study. In the hopes of dispelling the misunderstandings implicit in this exclusion criterion and enhancing the validity of future research bearing on critically important aspects of adolescent health and behavior, we would also like to draw the attention of the readership to several publications that may be useful in addressing constraints imposed by institutional review boards.25 We find our pediatric colleagues are often unaware of these consensus statements.

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