Department of Medicine, Division of Medical Oncology, The Ottawa Hospital, University of Ottawa, Ottawa, ON K1H 8L6, Canada.
Cancer Therapeutics Program, Ottawa Hospital Research Institute, Ottawa, ON K1H 8L6, Canada.
Curr Oncol. 2024 Mar 6;31(3):1376-1388. doi: 10.3390/curroncol31030104.
Patients, families, healthcare providers and funders face multiple comparable treatment options without knowing which provides the best quality of care. As a step towards improving this, the REthinking Clinical Trials (REaCT) pragmatic trials program started in 2014 to break down many of the traditional barriers to performing clinical trials. However, until other innovative methodologies become widely used, the impact of this program will remain limited. These innovations include the incorporation of near equivalence analyses and the incorporation of artificial intelligence (AI) into clinical trial design. Near equivalence analyses allow for the comparison of different treatments (drug and non-drug) using quality of life, toxicity, cost-effectiveness, and pharmacokinetic/pharmacodynamic data. AI offers unique opportunities to maximize the information gleaned from clinical trials, reduces sample size estimates, and can potentially "rescue" poorly accruing trials. On 2 May 2023, the first REaCT international symposium took place to connect clinicians and scientists, set goals and identify future avenues for investigator-led clinical trials. Here, we summarize the topics presented at this meeting to promote sharing and support other similarly motivated groups to learn and share their experiences.
患者、家属、医疗保健提供者和资助者面临着多种可比较的治疗选择，但却不知道哪种选择能提供最佳的护理质量。为了改善这一状况，REthinking Clinical Trials（REaCT）实用临床试验计划于 2014 年启动，旨在打破进行临床试验的许多传统障碍。然而，在其他创新方法得到广泛应用之前，该计划的影响仍将有限。这些创新包括将近似等效分析和人工智能（AI）纳入临床试验设计。近似等效分析允许使用生活质量、毒性、成本效益和药代动力学/药效学数据来比较不同的治疗方法（药物和非药物）。人工智能提供了从临床试验中获取最大信息、减少样本量估计的独特机会，并且可以潜在地“挽救”效果不佳的试验。2023 年 5 月 2 日，举行了第一次 REaCT 国际研讨会，旨在将临床医生和科学家联系起来，设定目标，并确定未来由研究人员主导的临床试验的途径。在这里，我们总结了本次会议上提出的主题，以促进分享并支持其他具有类似动机的团体学习和分享他们的经验。
