In the television game show "Deal or No Deal," contestants are asked to make a choice between the known and the unknown. They are asked to stay with what they have or take a chance on something that might be better. When patients enter the CREST (Carotid Revascularization Endarterectomy vs. Stenting Trials) research study, they face a similar scenario. They agree to join a group of patients who will receive one of two treatments -- a known and accepted treatment (Carotid Revascularization Endarterectomy) or a known, but not commonly used treatment for their specific medical problem (stenting). The choice for patients is not which treatment to choose. Because they are randomly assigned to either group, the choice lies in whether to join the study.

"It can be a difficult choice for patients, and as a research coordinator and a patient advocate, I need to make sure that patients are properly screened, that they fit the criteria for the study, that they are properly informed and [have consented], and that they are able to make the commitment to the full duration of the study," says Cheryl Meehan, RN, BA, Clinical Research Coordinator at St. Michael's Medical Center in Newark, N.J. And when it comes to research, commitment is certainly a key factor. "In a study like the CREST trial, the actual procedure may take only an hour or so, but we are asking patients to make a four-year commitment to follow-up visits," she adds.