U.12 EXPERIMENTING WITH HUMANS: CLINICAL TRIALS Flashcards
What is the common problem of the experimentation with humasn?
Tension between therapeutic experiments and clinical experiments
The objective of clinical trials is to…
detect differences between compared drug/therapeutic strategies and eliminate non-real differences.
To acomplish the objetive of clinical trials you have to control:
- Sample size
- Sample selection
- Masking
The variables involve in clinical trials can be…
quantitative or qualitative
The variability of the main variable is a…
larger sample, greater variability.
In the sample selection all patients should be…
equally likely to belong to one group or an other.
Types of sample selection:
- Simple
- By blocks
- Stratified (by categories)
Masking is ….
concealing the treatment to avoid influence its evaluation.
A placebo is….
a product with no therapeutic effect yo compare it with another therapeutically active product.
The placebo effect is the …
improvement, of a patient symtons that has been taking the placebo.
Types of masking?
- Open (unmasked)
- Single blind (patient)
- Double blind (patient+researcher)
- Triple blind (patient+researcher+analyst)
- Blind for thrid parties (analyst)
Types of clinical trials according to its design?
- Not controlled
- Controlled
A not controlled clinical trial is the one with…
no comparison or historical comparison.
A controlled clinical trial is the one with…
comparison between groups
Types of controlled clinical trials?
- Parallel design
- Crossed design
- Factorial design
Tyoes of clinical trials depending on the phase of the study?
- Phase I
- Phase II
- Phase III
- Phase IV
The phase I is the study on…
humans
The objective of the phase I is to prove the…
safety and tolerability
In the phase I the doses are…
very low and the increase
The phase I is done in….
healthy volunteers
What is the size of the sample of the phase I?
Small
The phase II is the study on…
efficacy, dose, form of treatment, risks….
What is the size of the sample of the phase II?
Sample of 100 to 400, vert homogeneous
The phase III investigate the….
active principle for the specific disease.
The phase III is very…
rigorous
What is the size of the sample of the phase III?
Large
The phase IV is done after…
commercialisation
The objective of the phase IV is to see…
new indicators, effectiveness, efficancy….
What is the size of the sample of the phase IV?
Large
What are the 2 types of studies base on ots objective?
- Explanatory studies
- Pragmatic studies
What is the goal of explanatory studies?
Knowledge concerning a treatment
What is the goal of pragmatic studies?
Decide on clinical use
What are the phases use on explanatory studies?
Phase I, II and early III
What are the phases use on pragmatic studies?
Phase late III, IV
What is the inclusion criteria for explanatory studies?
Restrictive
What is the inclusion criteria for pragmatic studies?
Less restrictive
What is the patients type on explanatory studies?
Homogeneus sample
What is the patients type on pragmatic studies?
Heterogenous sample
What is the sample size of the explanatory estudies?
Small
What is the sample size of the pragmatic estudies?
large
Objetive of the explanatory studies?
Pharmacokinetics, pharmacodynamics, dose-response, efficancy
Objetive of the pragmatic studies?
Effectivity, tolerability, safety, efficancy
What is the main variable of a explanatory study?
Biological relevance
What is the main variable of a pragmatic study?
Clinical relevance
What is the statistical analysis of a explanatory study?
Protocol
What is the statistical analysis of a pragmatic study?
Treatment intention
What is the ethical evaluation of a clinical trial?
Principle of non-maleficient, principle of justice and principle of autonomy
CLINICAL TRIALS
1. Number of patients
2. Duration
3. Type of patients
4. Indications
5. Associated pathologies
6. Interactions
7. Dose
8. Therapeutic compliance
- Small
- Short
- Adults
- Restricted
- No
- Limited
- Standarised
- Controlled
CLINICAL PRACTICE
1. Number of patients
2. Duration
3. Type of patients
4. Indications
5. Associated pathologies
6. Interactions
7. Dose
8. Therapeutic compliance
- Large
- Long
- Aults, children, elderly pregnant (all)
- Less restricted
- Yes
- Broad
- Variable
- Non-controlled
Clinical trials should be carried out under conditions of…
respects and fundamental rights
No clinical trial may be initiated until sufficient scientific, pharmacological and toxicological data on…
animals are available
To avoid obsolete or repetitive research, clinical trials may only be initiated to demonstrate ….
the efficancy and safety of the proposed therapeutic modifications.
The subject of the trial shall give his…
written consent
No clinical trial may be conducted without a favorable prior….
report from an Ethical Commitee for clinical research