Blake Kathryn, Holbrook Janet T, Antal Holly, Shade David, Bunnell H Timothy, McCahan Suzanne M, Wise Robert A, Pennington Chris, Garfinkel Paul, Wysocki Tim
Center for Pharmacogenomics and Translational Research, Nemours Children's Specialty Care, 807 Children's Way, Jacksonville, FL 32207, USA.
Center for Clinical Trials and Evidence Synthesis, Johns Hopkins University, 415 N Washington Street, Baltimore, MD 21205, USA.
Contemp Clin Trials. 2015 May;42:105-18. doi: 10.1016/j.cct.2015.03.012. Epub 2015 Apr 3.
Phase III/IV clinical trials are expensive and time consuming and often suffer from poor enrollment and retention rates. Pediatric trials are particularly difficult because scheduling around the parent, participant and potentially other sibling schedules can be burdensome. We are evaluating using the internet and mobile devices to conduct the consent process and study visits in a streamlined pediatric asthma trial. Our hypothesis is that these study processes will be non-inferior and will be less expensive compared to a traditional pediatric asthma trial.
MATERIALS/METHODS: Parents and participants, aged 12 through 17 years, complete the informed consent process by viewing a multi-media website containing a consent video and study material in the streamlined trial. Participants are provided an iPad with WiFi and EasyOne spirometer for use during FaceTime visits and online twice daily symptom reporting during an 8-week run-in followed by a 12-week study period. Outcomes are compared with participants completing a similarly designed traditional trial comparing the same treatments within the same pediatric health-system. After 8 weeks of open-label Advair 250/50 twice daily, participants in both trial types are randomized to Advair 250/50, Flovent 250, or Advair 100/50 given 1 inhalation twice daily. Study staff track time spent to determine study costs.
Participants have been enrolled in the streamlined and traditional trials and recruitment is ongoing.
This project will provide important information on both clinical and economic outcomes for a novel method of conducting clinical trials. The results will be broadly applicable to trials of other diseases.
III/IV期临床试验成本高昂且耗时,往往存在入组率和保留率低的问题。儿科试验尤其困难,因为要围绕家长、参与者以及可能还有其他兄弟姐妹的日程安排,这可能会很麻烦。我们正在评估在一项简化的儿科哮喘试验中使用互联网和移动设备来进行知情同意过程和研究访视。我们的假设是,与传统的儿科哮喘试验相比,这些研究过程将不会逊色且成本更低。
材料/方法:年龄在12至17岁的家长和参与者,在简化试验中通过查看一个包含知情同意视频和研究材料的多媒体网站来完成知情同意过程。为参与者提供一台带WiFi的iPad和EasyOne肺活量计,以便在FaceTime访视期间使用,并在为期8周的导入期以及随后12周的研究期内每天在线报告两次症状。将结果与在同一儿科医疗系统内完成一项比较相同治疗方法的类似设计传统试验的参与者进行比较。在每天两次开放标签使用250/50剂量的信必可都保8周后,两种试验类型的参与者被随机分配接受每天两次吸入250/50剂量的信必可都保、250剂量的辅舒酮或100/50剂量的信必可都保。研究人员记录所花费的时间以确定研究成本。
参与者已被纳入简化试验和传统试验,招募工作正在进行中。
该项目将为一种开展临床试验的新方法提供有关临床和经济结果的重要信息。这些结果将广泛适用于其他疾病的试验。