Choosing to participate in a clinical trial is a deeply personal decision, and it’s important to gather as much information as possible to make it an informed decision. The following frequently asked questions provide information that you may find helpful as you consider participation.
Where do the ideas for trials come from?
Ideas for clinical trials usually come from researchers. Researchers first test new therapies or procedures in the laboratory and in animal studies. The potential treatments with the most promising laboratory results are moved into clinical trials. During a trial, more and more information is gained about a new possible treatment, its risks and how well it may work.
Who sponsors clinical trials?
Clinical trials are sponsored (i.e. funded) by organizations or individuals: physicians, medical institutions, foundations, voluntary groups, and pharmaceutical companies, as well as federal agencies such as the National Institutes of Health (NIH), the Department of Defense (DOD), and the Department of Veteran's Affairs (VA). Trials can take place in a variety of locations, including hospitals, universities, doctors' offices or community clinics.
What is a protocol?
A protocol is a study plan on which all clinical trials are based. The plan is carefully designed to safeguard the health of the participants as well as answer specific research questions. A protocol describes what types of people may participate in the trial; the schedule of tests, procedures, medications, and dosages; and the length of the study. While in a clinical trial, participants following a protocol are seen regularly by the research staff to monitor their health and to determine the safety and effectiveness of their treatment.
What is a placebo?
A placebo is an inactive pill, liquid, or powder that has no treatment value. In clinical trials, experimental treatments are often compared with placebos to assess the treatment's effectiveness. In some studies, the participants in the control group will receive a placebo instead of an active drug or treatment.
What is a control or control group?
A control is the standard by which experimental observations are evaluated. In many clinical trials, one group of patients will be given an experimental drug or investigational treatment, while the control group is given either a standard treatment for the illness or a placebo.
What are the different types of clinical trials?
- Treatment trials test new possible treatments, new combinations of drugs, or new approaches to surgery or radiation therapy.
- Prevention trials look for better ways to prevent disease in people who have never had the disease or to prevent a disease from returning. These approaches may include medicines, vitamins, vaccines, minerals, or lifestyle changes.
- Diagnostic trials are conducted to find better tests or procedures for diagnosing a particular disease or condition.
- Screening trials test the best way to detect certain diseases or health conditions.
- Quality of Life trials (or Supportive Care trials) explore ways to improve comfort and the quality of life for individuals with a chronic illness.
What are side effects and adverse reactions?
Side effects are any undesired actions or effects of drug or treatment. Negative or adverse effects may include headache, nausea, hair loss, skin irritation, or other physical problems. Experimental treatments must be evaluated for both immediate and long-term side effects.
As a clinical trial participant, how is your safety protected?
The ethical and legal codes that govern medical practice also apply to clinical trials. In addition, most clinical research is federally regulated with built-in safeguards to protect you.
Each trial follows a carefully controlled protocol – a study plan which details what researchers will do in the study. As a clinical trial progresses, researchers report the results of the trial at scientific meetings, to medical journals, and to various government agencies. Individual participants' names will remain secret and will not be mentioned in these reports.
Every clinical study in the U.S. must be approved and monitored by an Institutional Review Board (IRB) to make sure the risks are as low as possible and are worth any potential benefits. An IRB is a committee of physicians, statisticians, community advocates, and others that helps ensure that a clinical study is conducted in an ethical manner and the rights of study participants are protected. All institutions that conduct or support biomedical research involving people must, by federal regulation, have an IRB that initially approves and periodically reviews the research.
What is informed consent ?
Informed consent is the process in which researchers communicate with potential and enrolled participants about a clinical study. It provides the potential benefits as well as the risks to the patient. It informs the patients that participation in the trial is voluntary, and they may discontinue participation at any time.
The goal of the informed consent process is to protect participants. It begins when a potential participant first asks for information about a study and continues until the study ends.
How should you prepare for the meeting with the research coordinator or doctor?
- Plan ahead and write down possible questions to ask.
- Ask a friend or relative to come along for support and to hear the responses to the questions.
- Bring a tape recorder to record the discussion to replay later.
Will you continue to work with your primary healthcare provider while in a trial?
Yes. Most clinical trials provide short-term treatments related to a designated illness or condition but do not provide extended or complete primary healthcare. In addition, by having the healthcare provider work with the research team, you can ensure that other medications or treatments will not conflict with the protocol.
Can you leave a clinical trial after it has begun?
Yes. You can leave a clinical trial at any time. When withdrawing from the trial, you should let the research team know about it, and the reasons for leaving the study.
What is an "expanded access" protocol?
Most human use of investigational new drugs takes place in controlled clinical trials conducted to assess safety and efficacy of new drugs. Data from the trials can serve as the basis for the drug marketing application. Sometimes, patients do not qualify for these carefully controlled trials because of other health problems, age, or other factors. For patients who may benefit from the drug use but don't qualify for the trials, FDA regulations enable manufacturers of investigational new drugs to provide for "expanded access" use of the drug. For example, a treatment IND (Investigational New Drug application) or treatment protocol is a relatively unrestricted study. The primary intent of a treatment IND/protocol is to provide for access to the new drug for people with a life-threatening or serious disease for which there is no good alternative treatment. A secondary purpose for a treatment IND/protocol is to generate additional information about the drug, especially its safety. Expanded access protocols can be undertaken only if clinical investigators are actively studying the new treatment in well-controlled studies, or all studies have been completed. There must be evidence that the drug may be an effective treatment in patients like those to be treated under the protocol. The drug cannot expose patients to unreasonable risks given the severity of the disease to be treated.
Some investigational drugs are available from pharmaceutical manufacturers through expanded access programs listed in ClinicalTrials.gov. Expanded access protocols are generally managed by the manufacturer, with the investigational treatment administered by researchers or doctors in office-based practice.