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Li Y, Tian Y, Pei S, Xie B, Xu X, Wang B. Worldwide Trends in Registering Real-World Studies at ClinicalTrials.gov: A Cross-Sectional Analysis. Int J Gen Med 2023; 16:1123-1136. [PMID: 37007912 PMCID: PMC10065426 DOI: 10.2147/ijgm.s402478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 03/22/2023] [Indexed: 03/29/2023] Open
Abstract
Objective The purpose of this study was to characterize real-world studies (RWSs) registered at ClinicalTrials.gov to help investigators better conduct relevant research in clinical practice. Methods A retrospective analysis of 944 studies was performed on February 28, 2023. Results A total of 944 studies were included. The included studies involved a total of 48 countries. China was the leading country in terms of the total number of registered studies (37.9%, 358), followed by the United States (19.7%, 186). Regarding intervention type, 42.4% (400) of the studies involved drugs, and only 9.1% (86) of the studies involved devices. Only 8.5% (80) of the studies mentioned both the detailed study design type and data source in the "Brief Summary". A total of 49.4% (466) of studies had a sample size of 500 participants and above. Overall, 63% (595) of the studies were single-center studies. A total of 213 conditions were covered in the included studies. One-third of the studies (32.7%, 309) involved neoplasms (or tumors). China and the United States were very different regarding the study of different conditions. Conclusion Although the pandemic has provided new opportunities for RWSs, the rigor of scientific research still needs to be emphasized. Special attention needs to be given to the correct and comprehensive description of the study design in the Brief Summary of registered studies, thereby promoting communication and understanding. In addition, deficiencies in ClinicalTrials.gov registration data remain prominent.
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Affiliation(s)
- Yuanxiao Li
- Department of Pediatric Gastroenterology, Lanzhou University Second Hospital, Lanzhou, People’s Republic of China
| | - Ying Tian
- Department of Clinical Medicine, Lanzhou University Second Hospital, Lanzhou, People’s Republic of China
| | - Shufen Pei
- Department of Clinical Medicine, North Sichuan Medical College, Nanchong, People’s Republic of China
| | - Baoyuan Xie
- Department of Clinical Medicine, Lanzhou University Second Hospital, Lanzhou, People’s Republic of China
| | - Xiaonan Xu
- Department of Pediatric Gastroenterology, Lanzhou University Second Hospital, Lanzhou, People’s Republic of China
| | - Bin Wang
- Department of Infectious Diseases, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, People’s Republic of China
- Correspondence: Bin Wang, 88 Jie Fang Lu, Shangcheng District, Hangzhou, Zhejiang, 310009, People’s Republic of China, Email
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Lysaght T, Schaefer GO, Voo TC, Wee HL, Joseph R. Professional Oversight of Emergency-Use Interventions and Monitoring Systems: Ethical Guidance From the Singapore Experience of COVID-19. JOURNAL OF BIOETHICAL INQUIRY 2022; 19:327-339. [PMID: 35420376 PMCID: PMC9008394 DOI: 10.1007/s11673-022-10171-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 01/10/2022] [Indexed: 06/14/2023]
Abstract
High degrees of uncertainty and a lack of effective therapeutic treatments have characterized the COVID-19 pandemic and the provision of drug products outside research settings has been controversial. International guidelines for providing patients with experimental interventions to treat infectious diseases outside of clinical trials exist but it is unclear if or how they should apply in settings where clinical trials and research are strongly regulated. We propose the Professional Oversight of Emergency-Use Interventions and Monitoring System (POEIMS) as an alternative pathway based on guidance developed for the ethical provision of experimental interventions to treat COVID-19 in Singapore. We support our proposal with justifications that establish moral duties for physicians to record outcomes data and for institutions to establish monitoring systems for reporting information on safety and effectiveness to the relevant authorities. Institutions also have a duty to support generation of evidence for what constitutes good clinical practice and so should ensure the unproven intervention is made the subject of research studies that can contribute to generalizable knowledge as soon as practical and that physicians remain committed to supporting learning health systems. We outline key differences between POEIMS and other pathways for the provision of experimental interventions in public health emergencies.
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Affiliation(s)
- Tamra Lysaght
- Centre for Biomedical Ethics, Yong Yoo Lin School of Medicine, Clinical Research Centre MD 11 #02-03, National University of Singapore, 10 Medical Drive, Singapore, Singapore
| | - Gerald Owen Schaefer
- Centre for Biomedical Ethics, Yong Yoo Lin School of Medicine, Clinical Research Centre MD 11 #02-03, National University of Singapore, 10 Medical Drive, Singapore, Singapore
| | - Teck Chuan Voo
- Centre for Biomedical Ethics, Yong Yoo Lin School of Medicine, Clinical Research Centre MD 11 #02-03, National University of Singapore, 10 Medical Drive, Singapore, Singapore
| | - Hwee Lin Wee
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
- Department of Pharmacy, Faculty of Science, National University of Singapore, Singapore, Singapore
| | - Roy Joseph
- Centre for Biomedical Ethics, Yong Yoo Lin School of Medicine, Clinical Research Centre MD 11 #02-03, National University of Singapore, 10 Medical Drive, Singapore, Singapore
- Department of Paediatrics, National University Hospital, Singapore, Singapore
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Obermeier PE, Heim A, Biere B, Hage E, Alchikh M, Conrad T, Schweiger B, Rath BA. Linking digital surveillance and in-depth virology to study clinical patterns of viral respiratory infections in vulnerable patient populations. iScience 2022; 25:104276. [PMID: 35573195 PMCID: PMC9092969 DOI: 10.1016/j.isci.2022.104276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 03/09/2022] [Accepted: 04/17/2022] [Indexed: 11/29/2022] Open
Abstract
To improve the identification and management of viral respiratory infections, we established a clinical and virologic surveillance program for pediatric patients fulfilling pre-defined case criteria of influenza-like illness and viral respiratory infections. The program resulted in a cohort comprising 6,073 patients (56% male, median age 1.6 years, range 0–18.8 years), where every patient was assessed with a validated disease severity score at the point-of-care using the ViVI ScoreApp. We used machine learning and agnostic feature selection to identify characteristic clinical patterns. We tested all patients for human adenoviruses, 571 (9%) were positive. Adenovirus infections were particularly common and mild in children ≥1 month of age but rare and potentially severe in neonates: with lower airway involvement, disseminated disease, and a 50% mortality rate (n = 2/4). In one fatal case, we discovered a novel virus: HAdV-80. Standardized surveillance leveraging digital technology helps to identify characteristic clinical patterns, risk factors, and emerging pathogens. We used mobile health technology to enable clinical pattern recognition The ViVI ScoreApp provided precision data for cross-cohort meta-analysis Neonates with adenovirus infection are at risk of severe or fatal disease outcomes In one neonate with disseminated disease, we found a new adenovirus: HAdV-D80
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Affiliation(s)
- Patrick E. Obermeier
- Vienna Vaccine Safety Initiative, Pediatric Infectious Diseases, Berlin, Germany
- Charité University Medical Center, Department of Pediatrics, Berlin, Germany
- UMR Chrono-environnement, Université Bourgogne Franche-Comté, Besançon, France
| | - Albert Heim
- National Reference Laboratory for Adenoviruses, Hannover Medical School, Hannover, Germany
| | - Barbara Biere
- National Reference Centre for Influenza, Robert Koch-Institute, Berlin, Germany
| | - Elias Hage
- National Reference Laboratory for Adenoviruses, Hannover Medical School, Hannover, Germany
| | - Maren Alchikh
- Vienna Vaccine Safety Initiative, Pediatric Infectious Diseases, Berlin, Germany
- Charité University Medical Center, Department of Pediatrics, Berlin, Germany
- UMR Chrono-environnement, Université Bourgogne Franche-Comté, Besançon, France
| | - Tim Conrad
- Department of Mathematics and Computer Science, Freie Universität Berlin, Berlin, Germany
| | - Brunhilde Schweiger
- National Reference Centre for Influenza, Robert Koch-Institute, Berlin, Germany
| | - Barbara A. Rath
- Vienna Vaccine Safety Initiative, Pediatric Infectious Diseases, Berlin, Germany
- Charité University Medical Center, Department of Pediatrics, Berlin, Germany
- UMR Chrono-environnement, Université Bourgogne Franche-Comté, Besançon, France
- Corresponding author
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