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Inclusion criteria were: female, age 70 years and older, able to comprehend English and consent to participate, living within the greater urban area receiving home care services in their own home or in designated assisted living facilities.
Patients were eligible if they were between 18 and 75 years of age, fluent in US English, and capable of comprehending and signing an informed consent form for participation, and willing and able to participate in a 90-min focus group or cognitive interview.
However, we found that many expressions of refusal were based on misunderstandings about the research and therefore fell short of being informed and comprehended non-consent.
Sexual abuse, in which dependent, developmentally immature children are involved in sexual activities that they do not fully comprehend and to which they cannot give informed consent, has become increasingly recognized.
Truly informed consent may thus entail more than simply comprehending and memorizing information.
Exclusion criteria for patients: Under 18; likely to die within 1 week (as assessed by treating physician or senior nurse); unable to identify a primary family carer, unable to provide informed consent due to cognitive impairment or incapacity to comprehend and speak English (as assessed by treating physician, senior nurse or research assistant).
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The general eligibility criteria were, (i) English-speaking and able to comprehend informed consent, (ii) no personal history of other cancers, and (iii) at least 18 years of age.
Results of studies indicate that participants often have difficulty in comprehending lengthy consent forms, understanding confidentiality issues and recalling what they did consent for (Ormond et al. 2009; Robinson et al. 2013).
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Since I tried Ludwig back in 2017, I have been constantly using it in both editing and translation. Ever since, I suggest it to my translators at ProSciEditing.

Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com