Introduction to Clinical Trials Flashcards

1
Q

What is the definition of a ‘fair test’?

A

A fair test is the controlled investigation carried out to answer a scientific question.

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2
Q

What is a clinical trial?

A

Clinical Trial is any research study which prospectively assigns human participants or groups of humans to one or more health - related interventions to evaluate the effects on health outcomes.
*HEALTH RELATED INTERVENTIONS = Drugs, Cells, Surgical procedures and Radiological procedures.

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3
Q

How many phases are there in clinical trials?

A

Phase 0 / Phase 1 / Phase 2 / Phase 3 / Phase 4

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4
Q

Explain phase 1 of the clinical trials.

A

Often has about 50 - 200 healthy volunteers.
Main questions needed to be answered are:
- Is the IMP safe in humans?
- Pharmacokinetics
- Pharmacodynamics

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5
Q

Explain phase 2 of the clinical trials.

A

Often has about 100 - 400 patients with the targeted disease.
Main questions needed to be answered are:
same as phase 1
Would it work on patients?

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6
Q

Explain phase 3 of the clinical trials.

A

Often has 100 - 5000 patients : (depending on how common the disease is).
Main questions needed to be answered are:
- As mentioned in Phases 1 & 2 : but has less pharmacokinetics and pharmacodynamics.
- Would it work? (efficacy)

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7
Q

Explain phase 4 of the clinical trials.

A
Often 1000 to 1 million patients. 
Main questions needed to be answered are:
-  Safety in clinical practice.
- Efficacy in clinical practice.
- Comparison to existing treatment.
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8
Q

Explain phase 0 of the clinical trials.

A

Often for cancer medicine. Known as ‘Microdose’ study.
Main questions needed to be answered are:
- Does the drug bind the target protein?
- Pharmacokinetics.

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9
Q

List the 3 clinical trial regulations.

A

Under PURPOSE:

  • Protect the clinical trail participants. (Rights / Safety / Welfare.)
  • Quality of assurance of data.
  • Harmonise + Simplify administrative procedures.
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10
Q

Who decide whether a clinical trial should be conducted at a national scale?

A

There are 2 main organisations : MHRA and HRA.
MRHA is the Medicine and Healthcare products Regulatory Agency.
HRA is the Health research authorities. They are known as being part of the ethics committee.

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11
Q

What is a sponsor in drug trials and why are they important?

A

A sponsor is an individual / company / institution / organisation / group of organisations which takes responsibility for initiation // management // financing of the research.
It’s a legal requirement for any clinical trial to be an investigational medicinal product.

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12
Q

Who is a chief investigator in the clinical trials?

A

An individual who has overall responsibility for the conduct of the whole project in the UK.

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13
Q

Who is a principal investigator?

A

An individual who is responsible for the conduct of the research at a research site.
There should be one PI for each research site.

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14
Q

What are the characteristics of a successful clinical trial?

A

1) Address simple and relevant clinical questions.
2) Results would be useful for everyday clinical practice.
3) Clearly defined endpoint and statistical input and analysis.
4) Robust binding (if appropriate).

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15
Q

How do we eliminate bias from clinical trials?

A
  • Randomised
  • Double blinded
  • Controlled (placebo // active // historical control)
  • Pre-specify data analysis. (avoiding multiplicity and post - hoc analysis)
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16
Q

What is the basic design of clinical trials?

A

Parallel Group = Independent groups receiving different treatment.
Crossover Group = Participants receive the same treatments in different order or sequence. May involve a washout period in between.

17
Q

What are the sources of bias in clinical trials?

A
  • Selection Bias
  • Performance Bias
  • Detection Bias
  • Attrition Bias
  • Observer Bias
18
Q

What is the CONSORT statement?

A

An evidence - based, minimum set of recommendations for reporting randomised trials.
Promotes transparent reporting of trials.

19
Q

What is selection bias?

A

The systemic differences between baseline characteristics of the groups that are compared.
NOT EASY TO CONTROL

20
Q

What is performance bias?

A

Systematic differences between the care that is provided // in exposure to factors other than interventions of interest.
BIAS TOWARDS NEW TREATMENT // PLACEBO

21
Q

What is detection bias?

A

Systematic differences between groups in how outcomes are determined.

22
Q

What is attrition bias?

A

Systematic differences between groups in withdrawal from a study.

23
Q

What is observer bias?

A

Failure to measure // classify the exposure or outcomes appropriately.