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What is a clinical trial

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What is a clinical trial

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  1. Whatisaclinicaltrial? Clinicaltrialsinvolveresearchconductedonhumansthatisdesignedtoevaluatetheeffectivenessofadrugortreatmentandaddtomedicalknowledge.AspertheNationalInstitutesofHealth(NIH),“Clinicaltrialsareresearchstudiesthatexplorewhetheramedicalstrategy,treatment,ordeviceissafeandeffectiveforhumans.Thesestudiesalsomayshowwhichmedicalapproachesworkbestforcertainillnessesorgroupsofpeople.” Clinical Research Training studiesarealwaysinneedofvolunteers.Withoutthesevolunteers,medicationsandtreatmentscannotbeapprovedbytheconcernedauthoritiesandthuscannotreachthepatients.Apartfromgainingaccesstoapotentialtreatmentforaparticulardisease,otherperksincludereceivingcareatthetopmostfacilities,helpingscience,andmakingapotentialimpactonallthoselivinginthatparticularcondition.Thesestudiesgenerallyoffergenerouscompensationforyourparticipation. Clinicaltrialsareusuallymedicalorclinicalstudiesinwhichhumanvolunteersparticipateincarefullyconductedinvestigationsaccordingtoapre-determinedresearchprotocol.Theclinicaltrialprogramisalongdrawnprocesstakingupto5-7yearsormoretocomplete.Aclinicaltrialisusuallyconductedasthefinalstepofanextendedresearchprocess.First,anewmedicalstrategy,drug,treatment,ordeviceisdevelopedinthelab,thenitistestedonanimals,andfinallytestedonhumanstoseehowsafeoreffectiveitis. Typesofclinicaltrials

  2. Broadlyspeaking,clinicaltrialscanbeoftwotypes: Interventional:Inthiskindoftrial,specifictreatmentsorinterventionsaregiventotheparticipantsbytheinvestigators.Theoutcomesarethencomparedtoagroupthathasbeengivenadifferenttreatmentornotreatment. Observational:Inobservationalstudies,theinvestigatorsortheresearchersobservethetreatmentsormanagementtechniquesthataregiventoagroupofpatientsandnotetheoutcomes.However,theresearchersdonotgivetheinterventions. Basedonthepurposeofthestudy,theNIHhasclassifiedclinicaltrialsintothefollowingtypes: Treatmenttrials:Thesearedesignedtotestnewtreatments,newcombinationsofdrugs,newsurgicalapproaches,orradiationtherapy. Preventiontrials:Theobjectiveofthesetrialsistofindwaystopreventadiseasefromoccurringorrelapsing.Theseoftenincludemedicines,vaccination,orlifestylechanges. Screeningtrials:Thistypeofstudyteststhebestwaytodetectspecificdiseasesorhealthconditions. Diagnostictrials:Thesestudiesaimtocomeupwithbettertestsorproceduresfordiagnosingadiseaseorhealthcondition.

  3. Qualityoflifetrials:Alsoknownassupportivecaretrials,thesestudiesexplorewaystoimprovethecomfortandqualityoflifeofpeoplewithachronicillness.Qualityoflifetrials:Alsoknownassupportivecaretrials,thesestudiesexplorewaystoimprovethecomfortandqualityoflifeofpeoplewithachronicillness. Registrationofclinicaltrials TheDeclarationofHelsinkistatesthat"Everyclinicaltrialmustberegisteredinapubliclyaccessibledatabasebeforerecruitmentofthefirstsubject.” OrganizationslikeWorldHealthOrganization(WHO)andtheInternationalCommitteeofMedicalJournalEditors(ICMJE)arestrongadvocatesofclinicaltrialregistration.AlljournalslistedontheICMJEwebsiterequireregistrationofclinicaltrialsinapublictrialsregistrybeforethefirstpatientisenrolledasaconditionofconsiderationforpublication.ClinicalTrials.govrunbytheUnitedStatesNationalLibraryofMedicine(NLM)istheworld’slargestandmostwidelyusedclinicaltrialsregistry.TheWHOmaintainsaclinicaltrialsregistrynetwork.TheICMJEacceptsregistrationinClinicalTrials.govorinanyprimaryregistryoftheWHOInternationalClinicalTrialsRegistryPlatform(ICTRP).Oncetheclinicaltrialisover,theresultsdatashouldbesubmittedtotheregistry.WhiletheICMJEencouragessubmissionofresultsasagoodpractice,thisisnotmandatory. Casereportformforclinicaltrials Acasereportform(CRF)isapaperorelectronicquestionnaireusedinclinicaltrialresearchtorecordallprotocol-requiredinformationoneachsubject/participatingpatientinthestudy.Casereportformscontaindataobtainedduringthepatient'sparticipationintheclinicaltrial.AccordingtotheInternationalConferenceonHarmonizationGuidelinesforGoodClinicalPractice,aCRFis“Aprinted,opticalorelectronicarchive

  4. intendedtorecordthegreaterpartoftheprotocol– expecteddatatopresenttothesponsoroneverytrialsubject.” Itencompassestheentiremedicalhistoryincludingadverseeventsfromthepatientandiscollectedoveraperiodofweeksormonths. TheCRFshouldaccuratelyrepresenttheprotocoloftheclinicaltrial,aswellasmanagingitsproduction,monitoringthedatacollectionandauditingthecontentofthefilled-inCRFs.TheCRFassistsinobtainingthecomplete,comprehensiveandstandardizeddatacollectionthatpromotesefficientprocessing,analysis,andreportingofinformation,aswellastheexchangeofdataacrosssites.ThedatafromtheCRFisfurtherusedbyclinicalresearchcoordinators,biostatisticians,investigators,datamanagersoraprogrammer. ThemainpurposeofaCRFistogathercompleteandaccuratedatainaclinicaltrialandtosmoothlytranscribethedatafromthesourcedocumenttoaretrievableform.Inotherwords,aCRFpreservesandmaintainsthequalityandintegrityofdatafromaclinicaltrial.ThestructuringoftheCRFshouldenabledatacollectionofthehighestquality.Thesponsor/pharmacompanyusuallydesignsaCRF.ThesponsorshouldensurethattheCRFrepresentsthetrialprotocol;additionally,thesponsorisalsoresponsibleformanagementoftheproduction,monitoringofthedatacollectionandtheauditingthecontentoftheCRFs.However,thepatient’snameandmedicalrecordnumberareusuallyde-identifiedbeforesendingthedetailstothesponsoringagency.

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