CMB2000/L05 Clinical Trials I Flashcards

1
Q

Define a clinical trial.

A

A research study in which one or more human subjects are prospectively assigned to one or more interventions to evaluate the effects of those interventions on health-related biomedical or behavioural outcomes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the difference between clinical studies and trials?

A

Studies use human participants which can be interventional and observational
Trials involve investigational medicinal products

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What was the world’s first clinical trial in 562 BCE?

A

Comparison of 2 dietary regimes over 10 days
Meat & wine vs legumes & water
Vegetable eaters more nourished at end of experiment and continued diet

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Describe the first trial of 2 medical treatments in 1537.

A

Cauterization of wounds with boiling oil
New oil used on wounds giving reduced inflammation and swelling

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Describe one of the earliest controlled clinical trials in 1747.

A

Treatment of scurvy on HMS Salisbury
12 patients allocated either quart of cider, 25 drops of H2SO4, nutmeg, seawater or citrus fruits
Lemon/lime juice now compulsory in British navy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Describe the first UK double blind clinical trial.

A

1944
MRC large scale trial comparing Patulin with in inert control solution (citrate buffer)
Patulin caused toxic effects (mycotoxin produced by Penecillin)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What was the first ‘true’ randomised control trial?

A

1948
MRC streptomycin trial for pulmonary tuberculosis
Usual care + streptomycin and usual care
Random allocation (stratified by sex)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Give 2 kinds of experimental studies.

A

Randomised control trials (RCTs)
Non-randomised control trials (nRCTs)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Give 3 kinds of observational studies.

A

Cohort studies
Case-control studies
Cross-sectional studies
Ecological studies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the key idea of randomised control trials?

A

Test effectiveness of new treatment while eliminating as many biases as possible

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Define a cohort study.

A

An observational study in which the defined group of people (cohort with similar characteristics) is followed over time

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How is a case-control study carried out?

A

Comparing a group who have a disease or condition with controls who are otherwise as similar as possible

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the goal of case-control studies?

A

To find out possible causes of a disease/condition

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is a cross-sectional study?

A

A snapshot observation of a set of people at 1 time

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Why are cross-sectional studies used?

A

To assess exposure (cause) and a disease (effect)
To compare the rates of diseases and symptoms of an exposed group with an unexposed group

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Why are ecological studies used?

A

To understand relationships between outcome and exposure at a population level
Population - group with shared characteristic

17
Q

Give the 5 phases of a clinical trial.

A

Laboratory studies
Phases I-IV

18
Q

Describe the role of laboratory studies. (4)

A

Basic & preclinical research
Drug discovery
In vitro and in vivo testing
Model desired effect and predict adverse effects

19
Q

Describe phase I of clinical trials. (3)

A

Testing in small group (20-80 people)
Learn about safety and side effects
Several months
52% success

20
Q

Describe phase II of a clinical trial. (3)

A

Testing in larger group (100-300)
Emphasis of effectiveness in people with disease/condition
1-4 years
30% success

21
Q

Describe phase III of a clinical trial. (3)

A

Large groups of people (1000-3000)
Safety, effectiveness and dosages
Polypharmacy
58% success

22
Q

When is an NDA (New Drug Application) submitted?

A

After phase III of a clinical trial
Submitted to e.g., FDA

23
Q

Describe phase IV of a clinical trial. (2)

A

Drug available to public and monitored in large, diverse populations
More side effects or treatment benefits become apparent

24
Q

How was the COVID-19 vaccine manufactured so quickly?

A

AdVac viral vector (version of adenovirus 26) used in Ebola vaccine used to deliver virus