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Meskell P, Biesty LM, Dowling M, Roche K, Meehan E, Glenton C, Devane D, Shepperd S, Booth A, Cox R, Chan XHS, Houghton C. Factors that impact on recruitment to vaccine trials in the context of a pandemic or epidemic: a qualitative evidence synthesis. Cochrane Database Syst Rev 2023; 9:MR000065. [PMID: 37655964 PMCID: PMC10472890 DOI: 10.1002/14651858.mr000065.pub2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
Abstract
BACKGROUND The World Health Organization declared the COVID-19 pandemic on 11 March 2020. Vaccine development and deployment were swiftly prioritised as a method to manage and control disease spread. The development of an effective vaccine relies on people's participation in randomised trials. Recruitment to vaccine trials is particularly challenging as it involves healthy volunteers who may have concerns around the potential risks and benefits associated with rapidly developed vaccines. OBJECTIVES To explore the factors that influence a person's decision to participate in a vaccine trial in the context of a pandemic or epidemic. SEARCH METHODS We used standard, extensive Cochrane search methods. The latest search date was June 2021. SELECTION CRITERIA We included qualitative studies and mixed-methods studies with an identifiable qualitative component. We included studies that explored the perspectives of adults aged 18 years or older who were invited to take part in vaccine trials in the context of a pandemic or epidemic. DATA COLLECTION AND ANALYSIS We assessed the title, abstracts and full texts identified by the search. We used a sampling frame to identify data-rich studies that represented a range of diseases and geographical spread. We used QSR NVivo to manage extracted data. We assessed methodological limitations using an adapted version of the Critical Skills Appraisal Programme (CASP) tool for qualitative studies. We used the 'best-fit framework approach' to analyse and synthesise the evidence from our included studies. We then used the Confidence in the Evidence from Reviews of Qualitative research (GRADE-CERQual) assessment to assess our confidence in each finding and develop implications for practice. MAIN RESULTS We included 34 studies in our review. Most studies related to HIV vaccine trials. The other studies related to Ebola virus, tuberculosis, Zika virus and COVID-19. We developed 20 key findings, under three broad themes (with seven subthemes), that described the factors that people consider when deciding whether to take part in a vaccine trial for a pandemic or epidemic disease. Our GRADE-CERQual confidence was high in nine of the key findings, moderate in 10 key findings and low in one key finding. The main reason for downgrading review findings were concerns regarding the relevance and adequacy of the underlying data. As a result of the over-representation of HIV studies, our GRADE-CERQual assessment of some findings was downgraded in terms of relevance because the views described may not reflect those of people regarding vaccine trials for other pandemic or epidemic diseases. Adequacy relates to the degree of richness and quantity of data supporting a review finding. Moderate concerns about adequacy resulted in a downgrading of some review findings. Some factors were considered to be under the control of the trial team. These included how trial information was communicated and the inclusion of people in the community to help with trial information dissemination. Aspects of trial design were also considered under control of the trial team and included convenience of participation, provision of financial incentives and access to additional support services for those taking part in the trial. Other factors influencing people's decision to take part could be personal, from family, friends or wider society. From a personal perceptive, people had concerns about vaccine side effects, vaccine efficacy and possible impact on their daily lives (carer responsibilities, work, etc.). People were also influenced by their families, and the impact participation may have on relationships. The fear of stigma from society influenced the decision to take part. Also, from a societal perspective, the level of trust in governments' involvement in research and trial may influence a person's decision. Finally, the perceived rewards, both personal and societal, were influencing factors on the decision to participate. Personal rewards included access to a vaccine, improved health and improved disease knowledge, and a return to normality in the context of a pandemic or epidemic. Potential societal rewards included helping the community and contributing to science, often motivated by the memories of family and friends who had died from the disease. AUTHORS' CONCLUSIONS This review identifies many of the factors that influence a person's decision to take part in a vaccine trial, and these reflect findings from reviews that examine trials more broadly. However, we also recognise some factors that become more important in connection with a vaccine trial in the context of a pandemic or epidemic. These factors include the potential stigma of taking part, the possible adverse effects of a vaccine, the added motivation for helping society, the role of community leaders in trial dissemination, and the level of trust placed in governments and companies developing vaccines. These specific influences need to be considered by trial teams when designing, and communicating about, vaccine trials in the context of a pandemic or epidemic.
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Affiliation(s)
- Pauline Meskell
- Department of Nursing and Midwifery, University of Limerick, Limerick, Ireland
| | - Linda M Biesty
- School of Nursing and Midwifery, National University of Ireland, Galway, Galway, Ireland
| | - Maura Dowling
- School of Nursing and Midwifery, National University of Ireland, Galway, Galway, Ireland
| | | | - Elaine Meehan
- Ageing Research Centre, School of Allied Health, University of Limerick, Limerick, Ireland
| | | | - Declan Devane
- School of Nursing and Midwifery, National University of Ireland, Galway, Galway, Ireland
| | - Sasha Shepperd
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Andrew Booth
- School of Health and Related Research, University of Sheffield, ScHARR, Sheffield, UK
| | - Rebecca Cox
- Department of Clinical Sciences, University of Bergen, Bergen, Norway
| | - Xin Hui S Chan
- Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK
| | - Catherine Houghton
- School of Nursing and Midwifery, National University of Ireland, Galway, Galway, Ireland
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Davies A, Ormel I, Bernier A, Harriss E, Mumba N, Gobat N, Schwartz L, Cheah PY. A rapid review of community engagement and informed consent processes for adaptive platform trials and alternative design trials for public health emergencies. Wellcome Open Res 2023; 8:194. [PMID: 37654739 PMCID: PMC10465998 DOI: 10.12688/wellcomeopenres.19318.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/19/2023] [Indexed: 09/02/2023] Open
Abstract
Background : Public Health Emergencies (PHE) demand expeditious research responses to evaluate new or repurposed therapies and prevention strategies. Alternative Design Trials (ADTs) and Adaptive Platform Trials (APTs) have enabled efficient large-scale testing of biomedical interventions during recent PHEs. Design features of these trials may have implications for engagement and/or informed consent processes. We aimed to rapidly review evidence on engagement and informed consent for ADTs and APTs during PHE to consider what (if any) recommendations can inform practice. Method : In 2022, we searched 8 prominent databases for relevant peer reviewed publications and guidelines for ADTs/APTs in PHE contexts. Articles were selected based on pre-identified inclusion and exclusion criteria. We reviewed protocols and informed consent documents for a sample of large platform trials and consulted with key informants from ADTs/APT trial teams. Data were extracted and summarised using narrative synthesis. Results : Of the 49 articles included, 10 were guidance documents, 14 discussed engagement, 10 discussed informed consent, and 15 discussed both. Included articles addressed ADTs delivered during the West African Ebola epidemic and APTs delivered during COVID-19. PHE clinical research guidance documents highlight the value of ADTs/APTs and the importance of community engagement, but do not provide practice-specific guidance for engagement or informed consent. Engagement and consent practice for ADTs conducted during the West African Ebola epidemic have been well-documented. For COVID-19, engagement and consent practice was described for APTs primarily delivered in high income countries with well-developed health service structures. A key consideration is strong communication of the complexity of trial design in clear, accessible ways. Conclusion: We highlight key considerations for best practice in community engagement and informed consent relevant to ADTs and APTs for PHEs which may helpfully be included in future guidance. Protocol: The review protocol is published online at Prospero on 15/06/2022: registration number CRD42022334170.
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Affiliation(s)
- Alun Davies
- Health Systems Collaborative, Nuffield Department of Medicine, University of Oxford, Oxford, England, UK
| | - Ilja Ormel
- Faculty of Health Sciences, Department of Health Research Methods, Evidence & Impact, McMaster University, Hamilton, Ontario, Canada
| | - Alexe Bernier
- Faculty of Social Sciences, School of Social Work, McMaster University, Hamilton, Ontario, Canada
| | - Eli Harriss
- Bodleian Health Care Libraries, University of Oxford, Oxford, England, UK
| | - Noni Mumba
- The KEMRI-Wellcome Trust Research Programme, Kilifi, 80108, Kenya
| | - Nina Gobat
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, England, UK
| | - Lisa Schwartz
- Faculty of Health Sciences, Department of Health Research Methods, Evidence & Impact, McMaster University, Hamilton, Ontario, Canada
| | - Phaik Yeong Cheah
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Salaya, Nakhon Pathom, Thailand
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, England, UK
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Tosoni S, Voruganti I, Lajkosz K, Mustafa S, Phillips A, Kim SJ, Wong RKS, Willison D, Virtanen C, Heesters A, Liu FF. Patient consent preferences on sharing personal health information during the COVID-19 pandemic: "the more informed we are, the more likely we are to help". BMC Med Ethics 2022; 23:53. [PMID: 35596210 PMCID: PMC9122733 DOI: 10.1186/s12910-022-00790-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 04/27/2022] [Indexed: 11/10/2022] Open
Abstract
Background Rapid ethical access to personal health information (PHI) to support research is extremely important during pandemics, yet little is known regarding patient preferences for consent during such crises. This follow-up study sought to ascertain whether there were differences in consent preferences between pre-pandemic times compared to during Wave 1 of the COVID-19 global pandemic, and to better understand the reasons behind these preferences.
Methods A total of 183 patients in the pandemic cohort completed the survey via email, and responses were compared to the distinct pre-pandemic cohort (n = 222); all were patients of a large Canadian cancer center. The survey covered (a) broad versus study-specific consent; (b) opt-in versus opt-out contact approach; (c) levels of comfort sharing with different recipients; (d) perceptions of commercialization; and (e) options to track use of information and be notified of results. Four focus groups (n = 12) were subsequently conducted to elucidate reasons motivating dominant preferences. Results Patients in the pandemic cohort were significantly more comfortable with sharing all information and biological samples (90% vs. 79%, p = 0.009), sharing information with the health care institution (97% vs. 83%, p < 0.001), sharing information with researchers at other hospitals (85% vs. 70%, p < 0.001), sharing PHI provincially (69% vs. 53%, p < 0.002), nationally (65% vs. 53%, p = 0.022) and internationally (48% vs. 39%, p = 0.024) compared to the pre-pandemic cohort. Discomfort with sharing information with commercial companies remained unchanged between the two cohorts (50% vs. 51% uncomfortable, p = 0.58). Significantly more pandemic cohort patients expressed a wish to track use of PHI (75% vs. 61%, p = 0.007), and to be notified of results (83% vs. 70%, p = 0.012). Thematic analysis uncovered that transparency was strongly desired on outside PHI use, particularly when commercialization was involved. Conclusions In pandemic times, patients were more comfortable sharing information with all parties, except with commercial entities, where levels of discomfort (~ 50%) remained unchanged. Focus groups identified that the ability to track and receive results of studies using one’s PHI is an important way to reduce discomfort and increase trust. These findings meaningfully inform wider discussions on the use of personal health information for research during global crises. Supplementary Information The online version contains supplementary material available at 10.1186/s12910-022-00790-z.
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Affiliation(s)
- Sarah Tosoni
- Radiation Medicine Program, Princess Margaret Cancer Centre, 700 University Avenue, Toronto, ON, M5G 2M9, Canada
| | - Indu Voruganti
- Radiation Medicine Program, Princess Margaret Cancer Centre, 700 University Avenue, Toronto, ON, M5G 2M9, Canada.,Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada
| | - Katherine Lajkosz
- Department of Biostatistics, Princess Margaret Cancer Centre, Toronto, ON, Canada
| | - Shahbano Mustafa
- Radiation Medicine Program, Princess Margaret Cancer Centre, 700 University Avenue, Toronto, ON, M5G 2M9, Canada
| | | | - S Joseph Kim
- Department of Medicine, University Health Network, Toronto, ON, Canada
| | - Rebecca K S Wong
- Radiation Medicine Program, Princess Margaret Cancer Centre, 700 University Avenue, Toronto, ON, M5G 2M9, Canada.,Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada.,Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Donald Willison
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Carl Virtanen
- University Health Network Digital, Toronto, ON, Canada
| | - Ann Heesters
- Department of Bioethics, University Health Network, Toronto, ON, Canada.,Joint Centre for Bioethics, University of Toronto, Toronto, ON, Canada
| | - Fei-Fei Liu
- Radiation Medicine Program, Princess Margaret Cancer Centre, 700 University Avenue, Toronto, ON, M5G 2M9, Canada. .,Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada.
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Cochrane Methodology Review Group, Cochrane Effective Practice and Organisation of Care Group, Pauline Meskell, Linda M Biesty, Maura Dowling, Elaine Meehan, Claire Glenton, Declan Devane, Sasha Shepperd, Andrew Booth, Rebecca Cox, Xin Hui S Chan, Catherine Houghton. Factors that impact on recruitment to vaccine trials during a pandemic or epidemic: a qualitative evidence synthesis. Cochrane Database Syst Rev 2022; 2022:MR000065. [ DOI: 10.1002/14651858.MR000065] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
Abstract
This is a protocol for a Cochrane Review (qualitative). The objectives are as follows: This is a protocol for a Cochrane Review (qualitative). The review aims to explore the factors associated with a person’s decision to take part in a pandemic or epidemic vaccine trial.
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Deane CS, Gates A, Traviss-Turner GD, Wilkinson DJ, Smith K, Atherton PJ, Phillips BE. Exploring the impact of COVID-19 on the willingness of older adults to participate in physiology research: views from past and potential volunteers. Appl Physiol Nutr Metab 2021; 46:1147-1151. [PMID: 34181868 DOI: 10.1139/apnm-2021-0204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
We explored the views of older (≥65 years) past and potential volunteers in regard to participating in physiology research during the COVID-19 pandemic. Using an online questionnaire and focus groups, we found that past volunteers (n = 55) were more likely to take part in both acute (p < 0.05) and chronic (p < 0.05) physiology studies, compared with potential future volunteers (n = 57). Both cohorts demonstrated a positive attitude towards volunteering during the COVID-19 pandemic, although concern was evident. Novelty: Volunteers demonstrated a positive attitude and also concern towards participating in physiology research during COVID-19.
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Affiliation(s)
- Colleen S Deane
- Department of Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, Exeter, EX1 2LU, UK
- Living Systems Institute, University of Exeter, Exeter, EX4 4QD, UK
| | - Amanda Gates
- MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research & NIHR Nottingham Biomedical Research Centre, University of Nottingham, Royal Derby Hospital Centre, Derby, DE22 3DT, UK
| | | | - Daniel J Wilkinson
- MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research & NIHR Nottingham Biomedical Research Centre, University of Nottingham, Royal Derby Hospital Centre, Derby, DE22 3DT, UK
| | - Kenneth Smith
- MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research & NIHR Nottingham Biomedical Research Centre, University of Nottingham, Royal Derby Hospital Centre, Derby, DE22 3DT, UK
| | - Philip J Atherton
- MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research & NIHR Nottingham Biomedical Research Centre, University of Nottingham, Royal Derby Hospital Centre, Derby, DE22 3DT, UK
| | - Bethan E Phillips
- MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research & NIHR Nottingham Biomedical Research Centre, University of Nottingham, Royal Derby Hospital Centre, Derby, DE22 3DT, UK
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Bedson J, Skrip LA, Pedi D, Abramowitz S, Carter S, Jalloh MF, Funk S, Gobat N, Giles-Vernick T, Chowell G, de Almeida JR, Elessawi R, Scarpino SV, Hammond RA, Briand S, Epstein JM, Hébert-Dufresne L, Althouse BM. A review and agenda for integrated disease models including social and behavioural factors. Nat Hum Behav 2021; 5:834-46. [PMID: 34183799 DOI: 10.1038/s41562-021-01136-2] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 05/14/2021] [Indexed: 02/05/2023]
Abstract
Social and behavioural factors are critical to the emergence, spread and containment of human disease, and are key determinants of the course, duration and outcomes of disease outbreaks. Recent epidemics of Ebola in West Africa and coronavirus disease 2019 (COVID-19) globally have reinforced the importance of developing infectious disease models that better integrate social and behavioural dynamics and theories. Meanwhile, the growth in capacity, coordination and prioritization of social science research and of risk communication and community engagement (RCCE) practice within the current pandemic response provides an opportunity for collaboration among epidemiological modellers, social scientists and RCCE practitioners towards a mutually beneficial research and practice agenda. Here, we provide a review of the current modelling methodologies and describe the challenges and opportunities for integrating them with social science research and RCCE practice. Finally, we set out an agenda for advancing transdisciplinary collaboration for integrated disease modelling and for more robust policy and practice for reducing disease transmission.
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7
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Chiam AL, Cheng NWI, Larson H. Community engagement for outbreak preparedness and response in high-income settings: A systematic review. Glob Public Health 2021; 17:1113-1135. [PMID: 33938368 DOI: 10.1080/17441692.2021.1919734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND This review aims to (i) identify and critique existing methods of community engagement for outbreak preparedness and response in high-income settings, and (ii) understand community members' experiences of community engagement, and their views and concerns towards pandemic planning/response. METHODS Following the PRISMA guidelines, a systematic review was conducted by searching Medline, Embase, PubMed, Global Health, CINAHL Plus and Scopus for publications from 2004 to June 2019. Potential literature was screened using explicit inclusion and exclusion criteria. Included studies were appraised using the Critical Appraisal Skills Programme Qualitative Research checklist. Those using deliberative approaches were appraised using additional criteria for judging deliberation quality. Thematic synthesis was then conducted. RESULTS Primary studies employed participatory research approaches, deliberative forums, interviews/focus groups to engage community members on pandemic planning/response with varying degrees of involvement and methodological rigour. This review indicates such endeavours must take into account instrumental and relational considerations: socioeconomic pressures; agency and capacity; diversity and divergent views; educate, communicate and engage; trust and transparency. CONCLUSION Community engagement for pandemic planning/response requires clear methods, processes and who 'community' constitutes. Instrumental and relational considerations must be addressed concurrently in pandemic planning/response to enhance preparedness for public health emergencies.
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Affiliation(s)
| | | | - Heidi Larson
- London School of Hygiene & Tropical Medicine, London, UK
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8
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Lapid MI, Meagher KM, Giunta HC, Clarke BL, Ouellette Y, Armbrust TL, Sharp RR, Wright RS. Ethical Challenges in COVID-19 Biospecimen Research: Perspectives From Institutional Review Board Members and Bioethicists. Mayo Clin Proc 2021; 96:165-173. [PMID: 33413815 PMCID: PMC7584427 DOI: 10.1016/j.mayocp.2020.10.021] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 09/28/2020] [Accepted: 10/20/2020] [Indexed: 02/06/2023]
Abstract
Biospecimen research is a prominent investigative strategy that aims to provide novel insights into coronavirus disease 2019 (COVID-19), inform clinical trials, and develop effective, life-saving treatments. However, COVID-19 biospecimen research raises accompanying ethical concerns and practical challenges for investigators and participants. In this special article, we discuss the ethical issues that are associated with autonomy, beneficence, and justice in COVID-19 biospecimen research and describe strategies to manage the practical challenges, with an emphasis on protecting the rights and welfare of human research participants during a pandemic response. Appropriate institutional review board oversight and bioethics guidance for COVID-19 biospecimen research must maintain their focus on protecting the rights and welfare of research participants, despite the urgent need for more knowledge about the virus and the threat it poses to communities and nations.
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Affiliation(s)
- Maria I Lapid
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN.
| | - Karen M Meagher
- Division of Health Care Policy and Research, Mayo Clinic, Rochester, MN; Biomedical Ethics Research Program, Mayo Clinic, Rochester, MN
| | - Hannah C Giunta
- Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN
| | - Bart L Clarke
- Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic, Rochester, MN
| | - Yves Ouellette
- Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN
| | - Tamyra L Armbrust
- Office for Human Research Protection and Institutional Review Board, Mayo Clinic, Rochester, MN
| | - Richard R Sharp
- Division of Health Care Policy and Research, Mayo Clinic, Rochester, MN; Biomedical Ethics Research Program, Mayo Clinic, Rochester, MN; Center for Individualized Medicine, Mayo Clinic, Rochester, MN
| | - R Scott Wright
- Office for Human Research Protection and Institutional Review Board, Mayo Clinic, Rochester, MN; Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN
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Lum HD, Padala KP, Dean KT, Padala PR. Psychogeriatric research during COVID-19 pandemic: qualitative analysis of participant views. Int Psychogeriatr 2020; 32:1357-1360. [PMID: 32522305 PMCID: PMC7338433 DOI: 10.1017/s1041610220001179] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Revised: 05/23/2020] [Accepted: 06/05/2020] [Indexed: 11/15/2022]
Affiliation(s)
- Hillary D. Lum
- Geriatrics Research Education and Clinical Center, VA Eastern Colorado Healthcare System, Aurora, CO, USA
- Division of Geriatric Medicine, University of Colorado School of Medicine, Aurora, CO, USA
| | - Kalpana P. Padala
- Geriatric Research Education, and Clinical Center (GRECC), Central Arkansas Veterans Healthcare System (CAVHS), Little Rock, AR, USA
- Department of Geriatrics, University of Arkansas for Medical Sciences (UAMS), Little Rock, AR, USA
| | - Kim T. Dean
- Geriatric Research Education, and Clinical Center (GRECC), Central Arkansas Veterans Healthcare System (CAVHS), Little Rock, AR, USA
| | - Prasad R. Padala
- Geriatric Research Education, and Clinical Center (GRECC), Central Arkansas Veterans Healthcare System (CAVHS), Little Rock, AR, USA
- Department of Geriatrics, University of Arkansas for Medical Sciences (UAMS), Little Rock, AR, USA
- Department of Psychiatry, University of Arkansas for Medical Sciences (UAMS), Little Rock, AR, USA
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Cheng MP, Lee TC, Tan DHS, Murthy S. Générer des données d’essais randomisés pour optimiser le traitement à l’ère de la pandémie de COVID-19. CMAJ 2020; 192:E1296-E1298. [PMID: 33077531 PMCID: PMC7588204 DOI: 10.1503/cmaj.200438-f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Affiliation(s)
- Matthew P Cheng
- Division d'infectiologie (Cheng, Lee), Département de médecine et Division de microbiologie médicale (Cheng), Département de médecine de laboratoire, Centre universitaire de santé McGill; Plateforme des essais cliniques (Cheng, Lee), Initiative interdisciplinaire en infection et immunité McGill, Montréal, Qué.; Division d'infectiologie (Tan) MAP Centre for Urban Health Solutions (Tan), Hôpital St. Michael; Département de médecine (Tan), Université de Toronto, Toronto, Ont.; Département de pédiatrie (Murthy), Université de la Colombie-Britannique, Vancouver, C.-B
| | - Todd C Lee
- Division d'infectiologie (Cheng, Lee), Département de médecine et Division de microbiologie médicale (Cheng), Département de médecine de laboratoire, Centre universitaire de santé McGill; Plateforme des essais cliniques (Cheng, Lee), Initiative interdisciplinaire en infection et immunité McGill, Montréal, Qué.; Division d'infectiologie (Tan) MAP Centre for Urban Health Solutions (Tan), Hôpital St. Michael; Département de médecine (Tan), Université de Toronto, Toronto, Ont.; Département de pédiatrie (Murthy), Université de la Colombie-Britannique, Vancouver, C.-B
| | - Darrell H S Tan
- Division d'infectiologie (Cheng, Lee), Département de médecine et Division de microbiologie médicale (Cheng), Département de médecine de laboratoire, Centre universitaire de santé McGill; Plateforme des essais cliniques (Cheng, Lee), Initiative interdisciplinaire en infection et immunité McGill, Montréal, Qué.; Division d'infectiologie (Tan) MAP Centre for Urban Health Solutions (Tan), Hôpital St. Michael; Département de médecine (Tan), Université de Toronto, Toronto, Ont.; Département de pédiatrie (Murthy), Université de la Colombie-Britannique, Vancouver, C.-B
| | - Srinivas Murthy
- Division d'infectiologie (Cheng, Lee), Département de médecine et Division de microbiologie médicale (Cheng), Département de médecine de laboratoire, Centre universitaire de santé McGill; Plateforme des essais cliniques (Cheng, Lee), Initiative interdisciplinaire en infection et immunité McGill, Montréal, Qué.; Division d'infectiologie (Tan) MAP Centre for Urban Health Solutions (Tan), Hôpital St. Michael; Département de médecine (Tan), Université de Toronto, Toronto, Ont.; Département de pédiatrie (Murthy), Université de la Colombie-Britannique, Vancouver, C.-B.
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Sigfrid L, Maskell K, Bannister PG, Ismail SA, Collinson S, Regmi S, Blackmore C, Harriss E, Longuere KS, Gobat N, Horby P, Clarke M, Carson G. Addressing challenges for clinical research responses to emerging epidemics and pandemics: a scoping review. BMC Med 2020; 18:190. [PMID: 32586391 PMCID: PMC7315698 DOI: 10.1186/s12916-020-01624-8] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Accepted: 05/07/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Major infectious disease outbreaks are a constant threat to human health. Clinical research responses to outbreaks generate evidence to improve outcomes and outbreak control. Experiences from previous epidemics have identified multiple challenges to undertaking timely clinical research responses. This scoping review is a systematic appraisal of political, economic, administrative, regulatory, logistical, ethical and social (PEARLES) challenges to clinical research responses to emergency epidemics and solutions identified to address these. METHODS A scoping review. We searched six databases (MEDLINE, Embase, Global Health, PsycINFO, Scopus and Epistemonikos) for articles published from 2008 to July 2018. We included publications reporting PEARLES challenges to clinical research responses to emerging epidemics and pandemics and solutions identified to address these. Two reviewers screened articles for inclusion, extracted and analysed the data. RESULTS Of 2678 articles screened, 76 were included. Most presented data relating to the 2014-2016 Ebola virus outbreak or the H1N1 outbreak in 2009. The articles related to clinical research responses in Africa (n = 37), Europe (n = 8), North America (n = 5), Latin America and the Caribbean (n = 3) and Asia (n = 1) and/or globally (n = 22). A wide range of solutions to PEARLES challenges was presented, including a need to strengthen global collaborations and coordination at all levels and develop pre-approved protocols and equitable frameworks, protocols and standards for emergencies. Clinical trial networks and expedited funding and approvals were some solutions implemented. National ownership and community engagement from the outset were a key enabler for delivery. Despite the wide range of recommended solutions, none had been formally evaluated. CONCLUSIONS To strengthen global preparedness and response to the COVID-19 pandemic and future epidemics, identified solutions for rapid clinical research deployment, delivery, and dissemination must be implemented. Improvements are urgently needed to strengthen collaborations, funding mechanisms, global and national research capacity and capability, targeting regions vulnerable to epidemics and pandemics. Solutions need to be flexible to allow timely adaptations to context, and research led by governments of affected regions. Research communities globally need to evaluate their activities and incorporate lessons learnt to refine and rehearse collaborative outbreak response plans in between epidemics.
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Affiliation(s)
- Louise Sigfrid
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, New Richards Building, Old Road Campus, Oxford, OX3 7LG, UK.
| | - Katherine Maskell
- Deparment for Primary Care and Public Health, Brighton and Sussex Medical School, Brighton, UK
| | - Peter G Bannister
- Deparment for Primary Care and Public Health, Brighton and Sussex Medical School, Brighton, UK
| | - Sharif A Ismail
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK
| | - Shelui Collinson
- School of Population Health and Environmental Sciences, King's College London, London, UK
| | - Sadie Regmi
- Department of Primary Care and Public Health, Imperial College London, London, UK
| | - Claire Blackmore
- University Hospitals of Derby and Burton NHS Foundation Trust, Derby, UK
| | - Eli Harriss
- Bodleian Health Care Libraries, University of Oxford, Oxford, UK
| | - Kajsa-Stina Longuere
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, New Richards Building, Old Road Campus, Oxford, OX3 7LG, UK
| | - Nina Gobat
- Nuffield Dep of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Peter Horby
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, New Richards Building, Old Road Campus, Oxford, OX3 7LG, UK
| | - Mike Clarke
- Evidence Aid, Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - Gail Carson
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, New Richards Building, Old Road Campus, Oxford, OX3 7LG, UK
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12
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Patel SS, Webster RK, Greenberg N, Weston D, Brooks SK. Research fatigue in COVID-19 pandemic and post-disaster research: Causes, consequences and recommendations. Disaster Prev Manag 2020; 29:445-455. [PMID: 33679011 PMCID: PMC7932124 DOI: 10.1108/dpm-05-2020-0164] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
PURPOSE Research fatigue occurs when an individual or population of interest tires of engaging with research, consequently avoiding further participation. This paper considers research fatigue in the context of the current COVID-19 pandemic, to identify contributory factors and possible solutions for future post-disaster research. METHODOLOGY We draw on examples from the literature and our own observations from the recruitment and data collection phases of qualitative and quantitative studies, to provide an overview of possible research fatigue in the current COVID-19 pandemic, with implications for future post-disaster research. FINDINGS People affected by disasters sometimes receive multiple requests for study participation by separate teams who may not necessarily be coordinating their work. Not keeping participants informed of the research process or outcomes can lead to disillusionment. Being overburdened with too many research requests and failing to see any subsequent changes following participation may cause individuals to experience research fatigue. ORIGINALITY Guidelines for researchers wishing to reduce the occurrence of research fatigue include ensuring greater transparency within research; sharing of results; and using oversight or gatekeeper bodies to aid coordination. Failure to restrict the number of times that people are asked to participate in studies risks poor participation rates. This can subsequently affect the quality of information with which to inform policy-makers and protect the health of the public during the COVID-19 pandemic or other public health disasters/emergencies.
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Affiliation(s)
- Sonny S Patel
- Fellow, NIH Global Health Scholar, Department of Global Health and Population, Harvard Humanitarian Initiative, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Rebecca K Webster
- Department of Psychology, University of Sheffield, Sheffield, S1 2LT, UK
| | - Neil Greenberg
- Department of Psychological Medicine, King's College London, Weston Education Centre and NIHR Health Protection Research Unit in Emergency Preparedness and Response at King's College London, London SE5 9RJ, UK
| | - Dale Weston
- Behavioural Science Team, Emergency Response Department Science & Technology, Public Health England, Porton Down, Salisbury, SP4 0JG, UK
| | - Samantha K Brooks
- Department of Psychological Medicine, King's College London, Weston Education Centre and NIHR Health Protection Research Unit in Emergency Preparedness and Response at King's College London, London SE5 9RJ, UK
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13
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Padala PR, Jendro AM, Gauss CH, Orr LC, Dean KT, Wilson KB, Parkes CM, Padala KP. Participant and Caregiver Perspectives on Clinical Research During Covid-19 Pandemic. J Am Geriatr Soc 2020; 68:E14-E18. [PMID: 32315076 PMCID: PMC7264630 DOI: 10.1111/jgs.16500] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 04/11/2020] [Accepted: 04/14/2020] [Indexed: 01/09/2023]
Abstract
BACKGROUND/OBJECTIVES The COVID‐19 pandemic has massively disrupted essential clinical research. Many regulatory organizations have rightfully advocated to temporarily halt enrollment and curtail all face‐to‐face interactions. Views and opinions of patients and their caregivers are seldom considered while making such decisions. The objective was to study older participantsʼ and their caregiversʼ perspectives to participate in ongoing clinical research during the COVID‐19 pandemic. DESIGN Cross‐sectional. SETTING VISN‐16/Geriatric Research, Education and Clinical Center (GRECC), Department of Veterans Affairs. PARTICIPANTS Older participants and their caregivers (N = 51) enrolled in ongoing clinical research studies. MEASUREMENTS Questions about perceptions of safety to attend research visit, the level of panic among the general public, and medical centerʼs preparedness in handling the pandemic. Other questions identified the source of pandemic information and the preference of a phone or in‐person visit. RESULTS Mean age was 69.3 (±9.4) years, 53% were male, 39% were caregivers, and 65% were Caucasian. Majority (78%) of the participants felt safe/very safe attending the scheduled research appointment; 63% felt that the extra screening made them feel safe/very safe; 82% felt that the medical center was prepared/very prepared for the pandemic. Participants split evenly on their preference for phone versus in‐person visits. Family members and television news media were the commonly used sources of pandemic information irrespective of their education. Perceptions were influenced by gender and source of information, not by age or education. Females perceived higher level of panic compared to males (P = .02). Those relying on news media felt safer compared to those that relied on family members (P = .008). CONCLUSION Even though informants felt that the medical center was prepared to handle the pandemic, only half the participants preferred the in‐person visit. Pandemic information was obtained from family members or the television news media. Knowing patientsʼ perspectives may help researchers be better prepared for future pandemics. J Am Geriatr Soc 68:E14–E18, 2020.
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Affiliation(s)
- Prasad R Padala
- Geriatric Research Education, and Clinical Center (GRECC), Central Arkansas Veterans Healthcare System (CAVHS), Little Rock, Arkansas, USA.,Department of Psychiatry, University of Arkansas for Medical Sciences (UAMS), Little Rock, Arkansas, USA.,Department of Geriatrics, UAMS, Little Rock, Arkansas, USA
| | - Ashlyn M Jendro
- Geriatric Research Education, and Clinical Center (GRECC), Central Arkansas Veterans Healthcare System (CAVHS), Little Rock, Arkansas, USA
| | - C Heath Gauss
- Geriatric Research Education, and Clinical Center (GRECC), Central Arkansas Veterans Healthcare System (CAVHS), Little Rock, Arkansas, USA.,Department of Biostatistics, UAMS, Little Rock, Arkansas, USA
| | - L Casey Orr
- Geriatric Research Education, and Clinical Center (GRECC), Central Arkansas Veterans Healthcare System (CAVHS), Little Rock, Arkansas, USA.,Department of Psychiatry, University of Arkansas for Medical Sciences (UAMS), Little Rock, Arkansas, USA.,Department of Geriatrics, UAMS, Little Rock, Arkansas, USA
| | - Kim T Dean
- Geriatric Research Education, and Clinical Center (GRECC), Central Arkansas Veterans Healthcare System (CAVHS), Little Rock, Arkansas, USA
| | - Kerrie B Wilson
- Geriatric Research Education, and Clinical Center (GRECC), Central Arkansas Veterans Healthcare System (CAVHS), Little Rock, Arkansas, USA
| | - Christopher M Parkes
- Geriatric Research Education, and Clinical Center (GRECC), Central Arkansas Veterans Healthcare System (CAVHS), Little Rock, Arkansas, USA
| | - Kalpana P Padala
- Geriatric Research Education, and Clinical Center (GRECC), Central Arkansas Veterans Healthcare System (CAVHS), Little Rock, Arkansas, USA.,Department of Geriatrics, UAMS, Little Rock, Arkansas, USA
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14
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Cheng MP, Lee TC, Tan DHS, Murthy S. Generating randomized trial evidence to optimize treatment in the COVID-19 pandemic. CMAJ 2020; 192:E405-E407. [PMID: 32336678 DOI: 10.1503/cmaj.200438] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Affiliation(s)
- Matthew P Cheng
- Division of Infectious Diseases (Cheng, Lee), Department of Medicine, and Division of Medical Microbiology (Cheng), Department of Laboratory Medicine, McGill University Health Centre; Clinical Trials Platform (Cheng, Lee), McGill Interdisciplinary Initiative in Infection and Immunity, Montréal, Que.; Division of Infectious Diseases (Tan) and MAP Centre for Urban Health Solutions (Tan), St. Michael's Hospital; Department of Medicine (Tan), University of Toronto, Toronto, Ont.; Department of Pediatrics (Murthy), University of British Columbia, Vancouver, BC
| | - Todd C Lee
- Division of Infectious Diseases (Cheng, Lee), Department of Medicine, and Division of Medical Microbiology (Cheng), Department of Laboratory Medicine, McGill University Health Centre; Clinical Trials Platform (Cheng, Lee), McGill Interdisciplinary Initiative in Infection and Immunity, Montréal, Que.; Division of Infectious Diseases (Tan) and MAP Centre for Urban Health Solutions (Tan), St. Michael's Hospital; Department of Medicine (Tan), University of Toronto, Toronto, Ont.; Department of Pediatrics (Murthy), University of British Columbia, Vancouver, BC
| | - Darrell H S Tan
- Division of Infectious Diseases (Cheng, Lee), Department of Medicine, and Division of Medical Microbiology (Cheng), Department of Laboratory Medicine, McGill University Health Centre; Clinical Trials Platform (Cheng, Lee), McGill Interdisciplinary Initiative in Infection and Immunity, Montréal, Que.; Division of Infectious Diseases (Tan) and MAP Centre for Urban Health Solutions (Tan), St. Michael's Hospital; Department of Medicine (Tan), University of Toronto, Toronto, Ont.; Department of Pediatrics (Murthy), University of British Columbia, Vancouver, BC
| | - Srinivas Murthy
- Division of Infectious Diseases (Cheng, Lee), Department of Medicine, and Division of Medical Microbiology (Cheng), Department of Laboratory Medicine, McGill University Health Centre; Clinical Trials Platform (Cheng, Lee), McGill Interdisciplinary Initiative in Infection and Immunity, Montréal, Que.; Division of Infectious Diseases (Tan) and MAP Centre for Urban Health Solutions (Tan), St. Michael's Hospital; Department of Medicine (Tan), University of Toronto, Toronto, Ont.; Department of Pediatrics (Murthy), University of British Columbia, Vancouver, BC
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15
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Gobat N, Butler CC, Mollison J, Francis NA, Gal M, Harris V, Webb SAR, Byrne JP, Watkins A, Sukumar P, Hood K, Nichol A. What the public think about participation in medical research during an influenza pandemic: an international cross-sectional survey. Public Health 2019; 177:80-94. [PMID: 31557667 DOI: 10.1016/j.puhe.2019.07.005] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Revised: 06/03/2019] [Accepted: 07/02/2019] [Indexed: 10/25/2022]
Abstract
OBJECTIVES The public and patients are primary contributors and beneficiaries of pandemic-relevant clinical research. However, their views on research participation during a pandemic have not been systematically studied. We aimed to understand public views regarding participation in clinical research during a hypothetical influenza pandemic. STUDY DESIGN This is an international cross-sectional survey. METHODS We surveyed the views of nationally representative samples of people in Belgium, Poland, Spain, Ireland, the United Kingdom, Canada, Australia and New Zealand, using a scenario-based instrument during the 2017 regional influenza season. Descriptive and regression analyses were conducted. RESULTS Of the 6804 respondents, 5572 (81.8%) thought pandemic-relevant research was important, and 5089 (74.8%) thought 'special rules' should be applied to make this research feasible. The respondents indicated willingness to take part in lower risk (4715, 69.3%) and higher risk (3585, 52.7%) primary care and lower risk (4780, 70.3%) and higher risk (4113, 60.4%) intensive care unit (ICU) study scenarios. For primary care studies, most (3972, 58.4%) participants preferred standard enrolment procedures such as prospective written informed consent, but 2327 (34.2%) thought simplified procedures would be acceptable. For ICU studies, 2800 (41.2%) preferred deferred consent, and 2623 (38.6%) preferred prospective third-party consent. Greater knowledge about pandemics, trust in a health professional, trust in the government, therapeutic misconception and having had ICU experience as a patient or carer predicted increased willingness to participate in pandemic-relevant research. CONCLUSIONS Our study indicates current public support for pandemic-relevant clinical research. Tailored information and initiatives to advance research literacy and maintain trust are required to support pandemic-relevant research participation and engagement.
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Affiliation(s)
- N Gobat
- Nuffield Department of Primary Care Health Sciences, University of Oxford, United Kingdom.
| | - C C Butler
- Nuffield Department of Primary Care Health Sciences, University of Oxford, United Kingdom
| | - J Mollison
- Clinical Trials Unit, Nuffield Department of Primary Care Health Sciences, University of Oxford, United Kingdom
| | - N A Francis
- Division of Population Medicine, School of Medicine, Cardiff University, Wales, United Kingdom
| | - M Gal
- Division of Population Medicine, School of Medicine, Cardiff University, Wales, United Kingdom
| | - V Harris
- Clinical Trials Unit, Nuffield Department of Primary Care Health Sciences, University of Oxford, United Kingdom
| | - S A R Webb
- University of Western Australia, Perth, Australia
| | | | - A Watkins
- Division of Population Medicine, School of Medicine, Cardiff University, Wales, United Kingdom
| | | | - K Hood
- Centre for Trials Research, Cardiff University, Wales, United Kingdom
| | - A Nichol
- HRB Funded Irish Critical Care-Clinical Trials Network, St Vincent's University Hospital-Clinical Research Centre, University College Dublin, Ireland and the Alfred Hospital and Australian and New Zealand Intensive Care- Research Centre, Monash University, Melbourne, Australia
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16
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Gobat N, Amuasi J, Yazdanpanah Y, Sigfid L, Davies H, Byrne JP, Carson G, Butler C, Nichol A, Goossens H. Advancing preparedness for clinical research during infectious disease epidemics. ERJ Open Res 2019. [PMID: 31123684 DOI: 10.1183/2312054.00227-2018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Clinical research is vital for an effective response to infectious disease epidemics. To be viable, preparations must be made in anticipation of infectious disease epidemics and must address barriers to rapid deployment and implementation. bit.ly/2IzUlyv.
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Affiliation(s)
- Nina Gobat
- Nuffield Dept of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - John Amuasi
- Dept of Global Health, Kumasi Collaborative Center for Research in Tropical Medicine, Kumasi, Ghana
| | - Yazdan Yazdanpanah
- Dept Infectious Diseases, Hopital Bichat - Claude-Bernard, Paris, France
| | - Louise Sigfid
- Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK
| | - Hugh Davies
- Oxford Research Ethics Committee, Oxford, UK
| | - John-Paul Byrne
- Clinical Research Center, University College Dublin, Dublin, UK
| | - Gail Carson
- Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK
| | - Christopher Butler
- Nuffield Dept of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Alistair Nichol
- Clinical Research Center, University College Dublin, Dublin, UK
| | - Herman Goossens
- Dept of Microbiology, University of Antwerp, Antwerp, Belgium
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17
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Gobat N, Amuasi J, Yazdanpanah Y, Sigfid L, Davies H, Byrne JP, Carson G, Butler C, Nichol A, Goossens H. Advancing preparedness for clinical research during infectious disease epidemics. ERJ Open Res 2019; 5:00227-2018. [PMID: 31123684 PMCID: PMC6526201 DOI: 10.1183/23120541.00227-2018] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Accepted: 03/25/2019] [Indexed: 11/23/2022] Open
Abstract
The Spanish Flu of 1918 reached every continent, infected one-third of the world's population and claimed over 50 million lives [1]. The centenary of this event presented a stark reminder of the threat of infectious disease epidemics to global health and security. These threats persist, fuelled in part by features of modern-day living such as climate change, globalisation, deforestation and population growth [2]. While progress has been made for managing infectious disease epidemics, critical gaps in leadership, governance, coordination and finance remain [3]. Clinical research is vital for an effective response to infectious disease epidemics. To be viable, preparations must be made in anticipation of infectious disease epidemics and must address barriers to rapid deployment and implementation.bit.ly/2IzUlyv
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Affiliation(s)
- Nina Gobat
- Nuffield Dept of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - John Amuasi
- Dept of Global Health, Kumasi Collaborative Center for Research in Tropical Medicine, Kumasi, Ghana
| | - Yazdan Yazdanpanah
- Dept Infectious Diseases, Hopital Bichat - Claude-Bernard, Paris, France
| | - Louise Sigfid
- Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK
| | - Hugh Davies
- Oxford Research Ethics Committee, Oxford, UK
| | - John-Paul Byrne
- Clinical Research Center, University College Dublin, Dublin, UK
| | - Gail Carson
- Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK
| | - Christopher Butler
- Nuffield Dept of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Alistair Nichol
- Clinical Research Center, University College Dublin, Dublin, UK
| | - Herman Goossens
- Dept of Microbiology, University of Antwerp, Antwerp, Belgium
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18
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Adeoti AO, Marbus S. The European Respiratory Society course on acute respiratory pandemics: how to plan for and manage them. ERJ Open Res 2018; 4:00156-2017. [PMID: 29450202 PMCID: PMC5809820 DOI: 10.1183/23120541.00156-2017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Accepted: 12/30/2017] [Indexed: 11/17/2022] Open
Abstract
Learn about the @ERStalk course on acute respiratory pandemics http://ow.ly/XGe430i7743.
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Affiliation(s)
- Adekunle Olatayo Adeoti
- Respiratory Unit, Dept of Medicine, Ekiti State University Teaching Hospital, Ado-Ekiti, Nigeria
- Both authors contributed equally
| | - Sierk Marbus
- Centre for Epidemiology and Surveillance of Infectious disease, Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
- Both authors contributed equally
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19
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Gobat NH, Gal M, Butler CC, Webb SAR, Francis NA, Stanton H, Anthierens S, Bastiaens H, Godycki-Ćwirko M, Kowalczyk A, Pons-Vigués M, Pujol-Ribera E, Berenguera A, Watkins A, Sukumar P, Moore RG, Hood K, Nichol A. Talking to the people that really matter about their participation in pandemic clinical research: A qualitative study in four European countries. Health Expect 2017; 21:387-395. [PMID: 28960624 PMCID: PMC5750735 DOI: 10.1111/hex.12634] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/11/2017] [Indexed: 11/27/2022] Open
Abstract
Background Pandemics of new and emerging infectious diseases are unpredictable, recurrent events that rapidly threaten global health and security. We aimed to identify public views regarding provision of information and consent to participate in primary and critical care clinical research during a future influenza‐like illness pandemic. Methods Descriptive‐interpretive qualitative study, using focus groups (n = 10) and semi‐structured interviews (n = 16), with 80 members of the public (>18 years) in Belgium, Spain, Poland and the UK. Local qualitative researchers followed a scenario‐based topic guide to collect data. Data were transcribed verbatim, translated into English and subject to framework analysis. Results Public understandings of pandemics were shaped by personal factors (illness during the previous H1N1 pandemic, experience of life‐threatening illness) and social factors (historical references, media, public health information). Informants appreciated safeguards provided by ethically robust research procedures, but current enrolment procedures were seen as a barrier. They proposed simplified enrolment processes for higher risk research and consent waiver for certain types of low‐risk research. Decision making about research participation was influenced by contextual, research and personal factors. Informants generally either carefully weighed up various approaches to research participation or responded instinctively. They supported the principle of using routinely collected, anonymized clinical biological samples for research without explicit consent, but regarded this as less acceptable if researchers were motivated primarily by commercial gain. Conclusions This bottom‐up approach to ascertaining public views on pandemic clinical research has identified support for more proportionate research protection procedures for publically funded, low‐risk studies.
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Affiliation(s)
- Nina H Gobat
- Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, UK
| | - Micaela Gal
- Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, UK
| | - Christopher C Butler
- Nuffield department of Primary Care Health Sciences, Medical School Division, Oxford University, Cardiff, UK
| | | | - Nicholas A Francis
- Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, UK
| | - Helen Stanton
- Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, UK
| | - Sibyl Anthierens
- Department of Primary and Interdisciplinary care, Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijik, Belgium
| | - Hilde Bastiaens
- Department of Primary and Interdisciplinary care, Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijik, Belgium
| | - Maciek Godycki-Ćwirko
- Centre for Family and Community Medicine, Faculty of Medical Sciences, Medical University of Lodz, Lodz, Poland
| | - Anna Kowalczyk
- Centre for Family and Community Medicine, Faculty of Medical Sciences, Medical University of Lodz, Lodz, Poland
| | - Mariona Pons-Vigués
- Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Barcelona, Spain
| | - Enriqueta Pujol-Ribera
- Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Barcelona, Spain
| | - Anna Berenguera
- Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Barcelona, Spain
| | - Angela Watkins
- Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, UK
| | | | - Ronald G Moore
- University College Dublin School of Medicine, Dublin, Ireland
| | - Kerenza Hood
- Centre for Trials Research, Cardiff University, Cardiff, UK
| | - Alistair Nichol
- HRB funded Irish Critical Care-Clinical Research Core, University College Dublin School of Medicine, Dublin, Ireland
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