Author: Institute of Medicine Publisher: National Academies Press ISBN: 0309316324 Category : Medical Languages : en Pages : 236
Book Description
Data sharing can accelerate new discoveries by avoiding duplicative trials, stimulating new ideas for research, and enabling the maximal scientific knowledge and benefits to be gained from the efforts of clinical trial participants and investigators. At the same time, sharing clinical trial data presents risks, burdens, and challenges. These include the need to protect the privacy and honor the consent of clinical trial participants; safeguard the legitimate economic interests of sponsors; and guard against invalid secondary analyses, which could undermine trust in clinical trials or otherwise harm public health. Sharing Clinical Trial Data presents activities and strategies for the responsible sharing of clinical trial data. With the goal of increasing scientific knowledge to lead to better therapies for patients, this book identifies guiding principles and makes recommendations to maximize the benefits and minimize risks. This report offers guidance on the types of clinical trial data available at different points in the process, the points in the process at which each type of data should be shared, methods for sharing data, what groups should have access to data, and future knowledge and infrastructure needs. Responsible sharing of clinical trial data will allow other investigators to replicate published findings and carry out additional analyses, strengthen the evidence base for regulatory and clinical decisions, and increase the scientific knowledge gained from investments by the funders of clinical trials. The recommendations of Sharing Clinical Trial Data will be useful both now and well into the future as improved sharing of data leads to a stronger evidence base for treatment. This book will be of interest to stakeholders across the spectrum of research-from funders, to researchers, to journals, to physicians, and ultimately, to patients.
Author: Institute of Medicine Publisher: National Academies Press ISBN: 0309171148 Category : Medical Languages : en Pages : 221
Book Description
Clinical trials are used to elucidate the most appropriate preventive, diagnostic, or treatment options for individuals with a given medical condition. Perhaps the most essential feature of a clinical trial is that it aims to use results based on a limited sample of research participants to see if the intervention is safe and effective or if it is comparable to a comparison treatment. Sample size is a crucial component of any clinical trial. A trial with a small number of research participants is more prone to variability and carries a considerable risk of failing to demonstrate the effectiveness of a given intervention when one really is present. This may occur in phase I (safety and pharmacologic profiles), II (pilot efficacy evaluation), and III (extensive assessment of safety and efficacy) trials. Although phase I and II studies may have smaller sample sizes, they usually have adequate statistical power, which is the committee's definition of a "large" trial. Sometimes a trial with eight participants may have adequate statistical power, statistical power being the probability of rejecting the null hypothesis when the hypothesis is false. Small Clinical Trials assesses the current methodologies and the appropriate situations for the conduct of clinical trials with small sample sizes. This report assesses the published literature on various strategies such as (1) meta-analysis to combine disparate information from several studies including Bayesian techniques as in the confidence profile method and (2) other alternatives such as assessing therapeutic results in a single treated population (e.g., astronauts) by sequentially measuring whether the intervention is falling above or below a preestablished probability outcome range and meeting predesigned specifications as opposed to incremental improvement.
Author: Lawrence M. Friedman Publisher: Springer Science & Business Media ISBN: 9780387985862 Category : Clinical trials Languages : en Pages : 384
Book Description
This classic reference, now updated with the newest applications and results, addresses the fundamentals of such trials based on sound scientific methodology, statistical principles, and years of accumulated experience by the three authors.
Author: Henry A. Glick Publisher: OUP Oxford ISBN: 0191508055 Category : Medical Languages : en Pages : 265
Book Description
It is becoming increasingly important to examine the relationship between the outcomes of a clinical trial and the costs of the medical therapy under study. The results of such analysis can affect reimbursement decisions for new medical technologies, drugs, devices or diagnostics. It can aid companies seeking to make claims about the cost-effectiveness of their product, as well as allowing early consideration of the economic value of therapies which may be important to improving initial adoption decisions. It is also vital for addressing the requirements of regulatory bodies. Economic Evaluation in Clinical Trials provides practical advice on how to conduct cost-effectiveness analyses in controlled trials of medical therapies. This new edition has been extensively rewritten and revised; topics discussed range from design issues such as the types of services that should be measured and price weights, to assessment of quality-adjusted life years. Illustrative materials, case histories and worked examples are included to encourage the reader to apply the methods discussed. These exercises are supported with datasets, programmes and solutions made available online.
Author: Institute of Medicine Publisher: National Academies Press ISBN: 030921646X Category : Medical Languages : en Pages : 217
Book Description
Advances in medical, biomedical and health services research have reduced the level of uncertainty in clinical practice. Clinical practice guidelines (CPGs) complement this progress by establishing standards of care backed by strong scientific evidence. CPGs are statements that include recommendations intended to optimize patient care. These statements are informed by a systematic review of evidence and an assessment of the benefits and costs of alternative care options. Clinical Practice Guidelines We Can Trust examines the current state of clinical practice guidelines and how they can be improved to enhance healthcare quality and patient outcomes. Clinical practice guidelines now are ubiquitous in our healthcare system. The Guidelines International Network (GIN) database currently lists more than 3,700 guidelines from 39 countries. Developing guidelines presents a number of challenges including lack of transparent methodological practices, difficulty reconciling conflicting guidelines, and conflicts of interest. Clinical Practice Guidelines We Can Trust explores questions surrounding the quality of CPG development processes and the establishment of standards. It proposes eight standards for developing trustworthy clinical practice guidelines emphasizing transparency; management of conflict of interest ; systematic review-guideline development intersection; establishing evidence foundations for and rating strength of guideline recommendations; articulation of recommendations; external review; and updating. Clinical Practice Guidelines We Can Trust shows how clinical practice guidelines can enhance clinician and patient decision-making by translating complex scientific research findings into recommendations for clinical practice that are relevant to the individual patient encounter, instead of implementing a one size fits all approach to patient care. This book contains information directly related to the work of the Agency for Healthcare Research and Quality (AHRQ), as well as various Congressional staff and policymakers. It is a vital resource for medical specialty societies, disease advocacy groups, health professionals, private and international organizations that develop or use clinical practice guidelines, consumers, clinicians, and payers.
Author: Ton J. Cleophas Publisher: Springer Science & Business Media ISBN: 9401595089 Category : Medical Languages : en Pages : 105
Book Description
In 1948 the first randomized controlled trial was published by the English Medical Research Council in the British Medical Journal. Until then, observations had been uncontrolled. Initially, trials frequently did not confirm the hypotheses to be tested. This phenomenon was attributed to low sensitivity due to small samples, as well as inappropriate hypotheses based on biased prior trials. Additional flaws were recognized and, subsequently, were better accounted for: carryover effects due to insufficient washout from previous treatments, time effects due to external factors and the natural history of the condition under study, bias due to asymmetry between treatment groups, lack of sensitivity due to a negative correlation between treatment responses, and so on. Such flaws, mainly of a technical nature, have been largely corrected and led to trials after 1970 being of significantly higher quality. The past decade has focused, in addition to technical aspects, on the need for circumspection in the planning and conducting of clinical trials. As a consequence, prior to approval, clinical trial protocols are now routinely scrutinized by different circumstantial organs, including ethics committees, institutional and federal review boards, national and international scientific organizations, and monitoring committees charged with conducting interim analyses. This book not only explains classical statistical analyses of clinical trials, but also addresses relatively novel issues, including equivalence testing, interim analyses, sequential analyses, and meta-analyses, and provides a framework of the best statistical methods currently available for such purposes. This book is not only useful for investigators involved in the field of clinical trials, but also for all physicians who wish to better understand the data of trials as currently published.
Author: David Bowers Publisher: John Wiley & Sons ISBN: 0470091312 Category : Medical Languages : en Pages : 247
Book Description
Now in its Second Edition, this book helps to unravel the processof evidence-based practice, which requires clinicians to evaluateand collate information from the journals they read.Understanding Clinical Papers, SecondEdition uses actual papers to illustrate how tounderstand and evaluate published research, but goes beyond this toprovide an explanation of a range of important research-relatedtopics. Understanding Clinical Papers, Second Edition: Covers everything necessary to understand a clinical researchpaper Examples are illustrated and based uniquely on tables,abstracts and exerts from published clinical research papers Amazingly clear, lively, accessible style The new edition has been markedly improved and extended,containing, for example, new material on measurement scales,systematic reviews, writing a paper, statistics software andcritical appraisal “What strikes the reader... straight away isclarity… promises to become a recommended text forundergraduate and postgraduate courses." JOURNAL OF TROPICALPEDIATRICS “The writing style is amazingly clear and does notrequire formal course work in biostatistics orepidemiology…We strongly recommend it for beginners and foreasy entry into a complex domain and to experts who we think willenjoy it and who will find it useful as they teach, advise and helpothers.” QUALITY IN HEALTH CARE “What makes this book unique is that each pointpresented is illustrated with excerpts from actual papers, oftenthree or four per chapter... this is a very effective teachingdevice." JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION “This book should be an essential addition to thepersonal libraries of all health care workers who need to usearticles in journals. In these days of evidence-based medicine,this should apply to all physicians, nurses and other healthprofessionals.” ONCOLOGY Understanding Clinical Papers, Second Edition isan invaluable resource for everyone involved directly or indirectlyin health care – an ultimate guide for those who readclinical literature.
Author: Peter G. Smith Publisher: ISBN: 0198732864 Category : Health & Fitness Languages : en Pages : 479
Book Description
This is an open access title available under the terms of a CC BY-NC 4.0 International licence. It is free to read at Oxford Scholarship Online and offered as a free PDF download from OUP and selected open access locations. Before new interventions are released into disease control programmes, it is essential that they are carefully evaluated in field trials'. These may be complex and expensive undertakings, requiring the follow-up of hundreds, or thousands, of individuals, often for long periods. Descriptions of the detailed procedures and methods used in the trials that have been conducted have rarely been published. A consequence of this, individuals planning such trials have few guidelines available and little access to knowledge accumulated previously, other than their own. In this manual, practical issues in trial design and conduct are discussed fully and in sufficient detail, that Field Trials of Health Interventions may be used as a toolbox' by field investigators. It has been compiled by an international group of over 30 authors with direct experience in the design, conduct, and analysis of field trials in low and middle income countries and is based on their accumulated knowledge and experience. Available as an open access book via Oxford Medicine Online, this new edition is a comprehensive revision, incorporating the new developments that have taken place in recent years with respect to trials, including seven new chapters on subjects ranging from trial governance, and preliminary studies to pilot testing.
Author: Institute of Medicine Publisher: National Academies Press ISBN: 0309124999 Category : Computers Languages : en Pages : 334
Book Description
In the realm of health care, privacy protections are needed to preserve patients' dignity and prevent possible harms. Ten years ago, to address these concerns as well as set guidelines for ethical health research, Congress called for a set of federal standards now known as the HIPAA Privacy Rule. In its 2009 report, Beyond the HIPAA Privacy Rule: Enhancing Privacy, Improving Health Through Research, the Institute of Medicine's Committee on Health Research and the Privacy of Health Information concludes that the HIPAA Privacy Rule does not protect privacy as well as it should, and that it impedes important health research.
Author: David Bowers Publisher: John Wiley & Sons ISBN: 1119573165 Category : Medical Languages : en Pages : 304
Book Description
For two decades, Understanding Clinical Papers has been helping students and professionals understand the research that supports evidence-based practice. Now in its fourth edition, this popular introductory textbook covers every major aspect of reading and evaluating clinical research literature, from identifying the aims and objectives of a paper to analysing the data with different multivariable methods. Numerous excerpts from actual clinical research papers make learning real and immediate, supported by a unique visual approach that reinforces key points and connects examples with the chapter material. The fourth edition includes extensively revised content throughout, including four brand-new chapters covering qualitative studies, Poisson regression, studies of complex interventions, and research using previously collected data. New and updated material discusses the difference between clinical and statistical significance, the consequences of multiple testing and methods of correction, how topic guides are used to explore and explain participants' experiences, standardised guidelines for writing trials and reviews, and much more. Offering clear explanations of important research-related topics, this reader-friendly resource: Offers a clear, concise, and accessible approach to learning how to read and analyse clinical research literature Features new coverage of qualitative research, including descriptive studies, sampling and populations, and identifying, summarising, and measuring qualitative characteristics Provides new material on missing data, sub-group analysis, feasibility and pilot studies, cluster randomised trials, and adaptive trial designs Includes new tables, abstracts, and excerpts from recent clinical research literature Understanding Clinical Papers is essential reading for all healthcare professionals and students, particularly those involved in clinical work and medical research, as well as general readers wanting to improve their understanding of research literature.
Author: Institute of Medicine
Author: Institute of Medicine
Author: Lawrence M. Friedman
Author: Henry A. Glick
Author: Institute of Medicine
Author: Ton J. Cleophas
Author: David Bowers
Author: Peter G. Smith
Author: Institute of Medicine
Author: David Bowers