Mutebi Miriam, Scroggins Dicey, Simmons Virgil, Oti Naomi Ohene, Hammad Nazik
Aga Khan University, Nairobi, Kenya.
Pinkie Hugs Foundation, Washington, DC.
JCO Glob Oncol. 2020 Jun;6:942-947. doi: 10.1200/JGO.19.00190.
Clinical trials in oncology are an emergent field in sub-Saharan Africa. There is a long history of clinical trials in high-income countries (HICs), with increasing attempts to develop patient-centric approaches and to evaluate patient-centered outcomes. The challenge remains as to how these trends could be adopted in low-resource settings and adapted to best fit the different health ecosystems that coexist on the African continent. Models that evaluate patient-related outcomes and measures and that are used in HICs must be modified, adopted, and adapted to suit the diverse populations and the low-resource settings in most of the continent. Patient engagement in clinical trials in Africa must be well nuanced, and it demands innovation and application of models that consider established but tailored notions/principles of patient and community engagement and the unique sociocultural aspects of different populations. It also must be linked to strategies that aim to improve patient education, health literacy, and access to services and to encourage and protect patient autonomy.
肿瘤学临床试验在撒哈拉以南非洲是一个新兴领域。高收入国家(HICs)有着悠久的临床试验历史,并且越来越多地尝试开发以患者为中心的方法并评估以患者为中心的结果。挑战仍然在于如何在资源匮乏的环境中采用这些趋势,并使其适应非洲大陆共存的不同健康生态系统。在高收入国家使用的评估患者相关结果和措施的模型必须进行修改、采用和调整,以适应非洲大陆大部分地区的多样化人群和资源匮乏的环境。非洲患者参与临床试验必须有细致入微的考量,这需要创新并应用一些模型,这些模型要考虑到既定但经过调整的患者及社区参与的理念/原则以及不同人群独特的社会文化方面。它还必须与旨在改善患者教育、健康素养、服务可及性以及鼓励和保护患者自主性的策略相联系。