Clinical trials: myth and reality
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It’s Science Week in Australia. Sometimes we hold science on a pedestal, as something for the intellectuals to pursue. But some science actually needs community involvement to move forward. Clinical trials are one such example.
Eighty-two percent of Australians say they are familiar with the term “clinical trial”1, and more than 60% show a willingness to take part on clinical trials. And yet, some 80% of clinical trials still struggle to find people as quickly as planned. This gap between awareness and willingness to take part, and actually taking part is what slows how quickly new treatments become available.
There are lots of misunderstandings about clinical trials, which possibly contribute to this gap. Let’s take a look at some of these.
1: Clinical trials are for people that very sick, with no other options available
While it is true that some clinical trials are a last resort, more often than not, they are about doing something different or additional to the current standard of care treatment. They could be preventative activities, or designed to diagnose or cure, improve quality of life, or even extend it.
2: Clinical trials test new drugs
This too is true, but again is not the whole story. Drug trials actually account for only about half of the clinical trials being conducted in Australia2, and not all those drug trials are for new drugs. Sometimes they are just if drugs already available can be used in a different way, for eg., a different dose or for a different health issue.
In the other half of trials, new diet or exercise regimes, psychological or behavioural interventions, mobile apps and other medical technologies, or even new diagnostics might be getting tested.
3: My doctor will tell me if there is a clinical trial I should consider
While we would all hope this is true, it is just not feasible for any doctor to be across the 1000+ trials that start in Australia every year. Equally, short appointment times mean doctors don’t really have time to add clinical trials into the discussion. The fact is, you will need to go looking yourself if you want to take part in clinical trials. Once you’ve found something, you can then always contact the study team, or your own doctor for advice.
4: I might get the placebo and miss out on any treatment
Placebo’s are occasionally used, but that doesn’t mean you are necessarily missing out on care. With few exceptions, placebo are used in combination with the best care option – it would be unethical not to. Human research ethics committees will always weigh up the benefits vs risks for individuals involved (including those on the placebo arm), before agreeing that a trial can begin. Make sure this approval is in place for your doctor and the trial, before you start.
It is also worth remembering that clinical trials are only ethical to run if there is a real uncertainty about what the best treatment is. Just because something is new, it doesn’t mean it will be the best treatment. In 50% of cases the placebo arm may turn out to be the best treatment arm.
5: I will be treated like a guinea pig in a clinical trial
Clinical trialists are not mad scientists looking for opportunities to poke, prod and make your life difficult. They actually do what they do to help improve lives. They value your contributions, and with few exceptions, will ask you to consent to the research before starting. Researchers work in a very regulated environment, with ethical oversight from independent committees, to make sure that they keep the welfare, safety and respect of participants top of mind. The value of taking part in a clinical trial, and in some cases needing to put up with extra tests and visits, is that you have a team of people (some that you see, and some that you will never meet) with a vested interest in keeping you safe. Can you say the same when you take a medicine prescribed by your GP?
The next time you are diagnosed with a health issue, or being prescribed a treatment by your doctor, you might like to consider if there is something new around the corner. Consider taking that step from supporting the idea of clinical trials, to action and get involved. You’ll not only help science move faster to find better treatments, you might help yourself along the way.
If you want to learn more about clinical trials, visit www.AustralianClinicalTrials.gov.au, and connect with the Research4Me community if you have any questions or experiences to share - https://www.facebook.com/Res4Me/
1 Dept Industry, Innovation and Science 2012 National Survey on Attitudes Towards Clinical Trials Last accessed 9Aug17: https://industry.gov.au/industry/IndustrySectors/PharmaceuticalsandHealthTechnologies/National-Survey-and-Literature-Review/Pages/NationalSurveyonAttitudesTowardsClinicalTrials.aspx
2 Report, Jun17: ‘Clinical Trials in Australia: the economic profile and competitive position of the sector' Last accessed 9Aug17 via: https://www.mtpconnect.org.au/clinicaltrials