What is a clinical trial?
A clinical trial is a research study in which volunteers receive investigational treatments under the supervision of a doctor and other research professionals. These treatments are developed by pharmaceutical and biotechnology companies who select qualified doctors, also known as investigators, to conduct clinical trials to determine the benefits of investigational drugs.
Who can participate in a clinical trial?
All clinical trials have guidelines about who can participate. Before joining a clinical trial, a volunteer must qualify for the study. The factors that allow volunteers to participate in a clinical trial are called “inclusion criteria” and the factors that disallow volunteers from participating are called “exclusion criteria.” These criteria can include age, gender, the type and stage of a disease, previous treatment history, and other medical conditions.
It is important to note that inclusion and exclusion criteria are used to identify appropriate participants, promote participants’ safety, and ensure that researchers learn the information they need.
How does a clinical trial work?
In a clinical trial, a volunteer is usually assigned a specific study group. Volunteers in one study group may receive an investigational treatment or study drug while other volunteers may receive a placebo or a treatment already available.
A placebo is an inactive product used to assess the experimental treatment’s effectiveness. The participant, doctor, and research staff may not know which volunteer receives a placebo and which receives the active treatment. Not knowing which participants are receiving the active treatment allows the doctor and research staff to objectively observe the volunteers during the study. Regardless of which treatment volunteers receive, however, the level of medical attention and care that each receives is the same.
What questions should be asked before choosing to participate?
Patients considering participating in a clinical trial should talk about it with their doctors and medical caregivers. Potential volunteers should also understand the credentials and experience of the staff and the facility involved in conducting the study.
Questions to ask a doctor or medical caregiver:
- How long will the trial last?
- Where is the trial being conducted?
- What treatments will be used and how?
- What is the main purpose of the trial?
- How will patient safety be monitored?
- Are there any risks involved?
- What are the possible benefits?
- What are the alternative treatments besides the one being tested in the trial?
- Who is sponsoring the trial?
- Do I have to pay for any part of the trial?
- What happens if I am harmed by the trial?
- Can I opt to remain on this treatment, even after termination of the trial?
What can volunteers expect if they choose to participate?
In some studies, participants receive a physical examination and their medical histories are reviewed by either the study doctor or a research staff member once they are enrolled in the study. The volunteers’ health will continue to be monitored during and after the trial. A detailed description of what’s expected of volunteers will be outlined in consent forms along with specific clinical trial information.
What is informed consent?
Prior to agreeing to participate, every volunteer has the right to know and understand what will happen during a clinical trial. This is called informed consent and it is a process that can help you decide whether or not participating in a trial is right for you.
When you give written consent to participate in a clinical trial, you are acknowledging that you understand and accept all aspects of the research study—including any risks or benefits involved. However, informed consent is not strictly about signing a document. It is a process that involves ongoing conversations between the research staff and you before, and even after, you decide to become a study volunteer.
To begin, the research staff is obligated to discuss all the pertinent information about the trial – its purpose, the procedures involved, the potential risks and benefits with you. It is your responsibility to ask questions if there is something you do not understand.
If you do not understand any part of the process, ask the researcher to repeat the information or to explain it in another way, using everyday words. If English is not your first language, inform the researcher that you are not comfortable speaking about a clinical trial in English. Upon request, research centres can and should produce documents that explain every aspect of the study and study personnel should be able to explain the information to you in your preferred language. If this is not possible, you should not participate in the study.
It is the responsibility of the research staff to help you understand the information they provide you and to give you enough time to ask any additional questions you may have. In some instances, this may not be possible to accomplish in a single visit, therefore it is essential to take the time you need to make an informed decision. You may discover important concerns that you did not think about during the first visit.
What are the benefits and risks of joining a trial?
Volunteers in a clinical trial participate in the development of medical therapies that may offer better treatments and even cures for life-threatening and chronic diseases. However, there are risks involved.
Possible benefits for volunteers:
Play an active role in their health care.
- Gain access to research treatments before they are widely available.
- Obtain medical care at health care facilities during the trial.
- Help others by contributing to medical research.
Possible risks for volunteers:
- There may be unpleasant, serious, or even life-threatening side effects to experimental treatment.
- The experimental treatment may not be effective.
- The protocol may require more time and attention than a non-protocol treatment, including trips to the study site, more treatments, hospital stays, or complex dosage requirements.
Please note: volunteers may withdraw from a study at any time for any reason.
Does information remain confidential and private?
Access to personal information is usually available to the investigator and research team conducting the clinical trial. The IRB overseeing the research and the sponsor or contract research organisation coordinating the trial will also have access to personal information. This is explained more specifically in the consent form that participating volunteers are asked to sign. As a clinical trial progresses, researchers report the results of the trial at scientific meetings, to medical journals, and to various government agencies.
What happens after the trial?
After a study phase is complete, the data is collected to determine the drug’s effectiveness, if it is safe and if there are any side effects. Depending on the results, researchers then determine whether to stop testing or move to the next phase of study.
After phase III of a study is complete, researchers decide if the results are medically important and may submit them to journals for peer-review. Data then may be submitted to the Food and Drug Administration (FDA) for approval.
If a drug is approved, pharmaceutical companies may continue to conduct studies that compare the new drug—in terms of its safety, effectiveness, and cost—to other drugs already on the market or assess a drug’s long-term effectiveness and its impact on the quality of a person’s life.