Principles and Practice of Clinical Research

Principles and Practice of Clinical Research

3rd Edition - May 31, 2012

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  • Editors: John Gallin, Frederick Ognibene
  • eBook ISBN: 9780123821683
  • Hardcover ISBN: 9780123821676

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Description

The third edition of this innovative work again provides a unique perspective on the clinical discovery process by providing input from experts within the NIH on the principles and practice of clinical research. Molecular medicine, genomics, and proteomics have opened vast opportunities for translation of basic science observations to the bedside through clinical research. As an introductory reference it gives clinical investigators in all fields an awareness of the tools required to ensure research protocols are well designed and comply with the rigorous regulatory requirements necessary to maximize the safety of research subjects. Complete with sections on the history of clinical research and ethics, copious figures and charts, and sample documents it serves as an excellent companion text for any course on clinical research and as a must-have reference for seasoned researchers.

Key Features

  • Incorporates new chapters on Managing Conflicts of Interest in Human Subjects Research, Clinical Research from the Patient's Perspective, The Clinical Researcher and the Media, Data Management in Clinical Research, Evaluation of a Protocol Budget, Clinical Research from the Industry Perspective, and Genetics in Clinical Research
  • Addresses the vast opportunities for translation of basic science observations to the bedside through clinical research
  • Delves into data management and addresses how to collect data and use it for discovery
  • Contains valuable, up-to-date information on how to obtain funding from the federal government

Readership

All individuals engaged in clinical research both student and researcher as well as physicians, dental investigators, PhD basic scientists, and members of allied health professions

Table of Contents

  • Contributors

    Preface

    Acknowledgments

    Chapter 1. A Historical Perspective on Clinical Research

    The Earliest Clinical Research

    Greek and Roman Influence

    Middle Ages and Renaissance

    Seventeenth Century

    Eighteenth Century

    Nineteenth Century

    Twentieth Century and Beyond

    Acknowledgment

    Summary Questions

    REFERENCES

    Part I Ethical, Regulatory and Legal Issues

    Chapter 2. Ethical Principles in Clinical Research

    Distinguishing Clinical Research from Clinical Practice

    What does Ethics have to do with Clinical Research?

    History of Ethical Attention to Clinical Research

    Codes of Research Ethics and Regulations

    Ethical Framework for Clinical Research

    Ethical Considerations in Randomized Clinical Trials

    Conclusion

    Summary Questions

    REFERENCES

    Chapter 3. Researching a Bioethical Question

    Types of Bioethical Issues

    Types of Bioethical Research Methodologies

    Examples of Important Bioethical Research

    Special Considerations in Bioethical Research

    REFERENCES AND NOTES

    Chapter 4. Integrity in Research

    Guidelines for the Conduct of Research

    Scientific Integrity and Misconduct

    Mentor–Trainee Relationships

    Data Acquisition, Management, Sharing, and Ownership

    Research Involving Human and Animal Subjects

    Collaborative Science

    Conflict of Interest and Commitment

    Peer Review

    Publication Practices and Responsible Authorship

    Acknowledgment

    Summary Questions

    REFERENCES

    Chapter 5. Institutional Review Boards

    Historical, Ethical, and Regulatory Foundations of Current Requirements for Research Involving Human Subjects

    Institutional Review Boards

    Clinical Researchers and IRBS

    The Current IRB System Under Evaluation

    Conclusion

    Summary Questions

    REFERENCES AND NOTES

    Chapter 6. The Role of Independent Institutional Review Boards

    History

    Reasons to use an Independent IRB

    Limitations of Independent IRBs

    Selecting an Independent IRB

    Working with an Independent IRB

    Future Directions

    Author’s Note

    Resources

    Summary Questions

    REFERENCES

    Chapter 7. The Regulation of Drugs and Biological Products by the Food and Drug Administration

    Introduction

    Background

    Mission, Organization, and Terminology

    Drug and Biologic Life Cycle

    Summary Questions

    Chapter 8. Data Management in Clinical Trials

    The Research Team

    Data Management Considerations during Protocol Design and Development

    Data Collection

    Auditing

    Adverse Event Monitoring and Reporting

    Legal And Regulatory Issues Related to Data Reporting

    Follow-Up and Analysis

    Record Retention

    Conclusion

    Summary Questions

    REFERENCES

    Chapter 9. Data and Safety Monitoring

    Introduction

    Description of the Data and Safety Monitoring Board

    Data and Safety Monitoring Board Functions

    Data and Safety Monitoring Board Decision Making

    Examples

    Conclusions

    Summary Questions

    REFERENCES

    Chapter 10. Unanticipated Risk in Clinical Research

    The Reasons

    The Drug

    The Target

    The Trials

    Cassandra Revealed

    Extended Studies

    Fiau Toxicity

    Reassessing the Preclinical Studies

    Research Oversight

    The Investigations Begin

    Scientific Misconduct

    The FDA

    The National Institutes of Health

    The Institute of Medicine

    The Media

    The Congress

    The Law

    Epilogue

    Acknowledgments

    REFERENCES

    Chapter 11. Legal Issues

    Legal Issues Related to Informed Consent for Clinical and Research Care

    Advance Directives/Substitute Consent

    Children in Research

    Medical/Research Records

    Confidentiality

    Legal Liability

    Conflict of Interest

    Authorship/Rights in Data

    Summary Questions

    Appendix

    Instructions

    Medical Record

    NOTES AND REFERENCES

    Further Reading

    Chapter 12. Rules to Prevent Conflict of Interest for Clinical Investigators Conducting Human Subjects Research

    Preventing Conflict of Interest in Clinical Research in the NIH Intramural Research Program

    Preventing Conflict of Interest by Members of Institutional Review Boards

    Appendix

    Appendix 1

    Summary Questions

    REFERENCES

    Chapter 13. National Institutes of Health Policy on the Inclusion of Women and Minorities as Subjects in Clinical Research

    NIH Policy

    Scientific Considerations and Implementation

    Role of Peer Review

    Role of the Institutional Review Board

    Role of Volunteers and their Communities

    Demographic Data on Subject Enrollment

    Women of Childbearing Potential, Pregnant Women, and Children

    What have We Learned

    Conclusion

    Summary Questions

    REFERENCES AND NOTES

    Chapter 14. Accreditation of Human Research Protection Programs

    Brief History

    Principles of Accreditation

    What AAHRPP Expects from Organizations

    What Organizations can Expect from AAHRPP

    The Concept of a Human Research Protection Program

    The Accreditation Standards

    Summary Questions

    REFERENCES

    Chapter 15. The Role and Importance of Clinical Trial Registries and Results Databases

    Introduction

    Background

    Current Policies

    Registering Clinical Trials at ClinicalTrials.gov

    Reporting Results to ClinicalTrials.gov

    Using ClinicalTrials.gov Data

    Conclusion

    Summary/Discussion Questions

    REFERENCES

    Chapter 16. The Clinical Researcher and the Media

    What Makes News In Science and Medicine?

    Published Science—the Media’s Bread and Butter

    Novelty

    The Unexpected

    Celebrity

    Tragedy and Controversy

    Impact

    Why Talk to Reporters?

    Why Reporters Want to Talk to You

    Why you Should Talk to Reporters

    Engaging the Media—The Process

    A Word About E-Mail, the Internet, and New Media

    If you Get a Call…

    The Interview

    What if you are Misquoted?

    What the Public Does not Know About Science

    Unexpected Questions

    When the News is not Good

    A Word About Investigative Reporters

    The Freedom of Information Act (FOIA)

    Embargoes

    The Inglefinger Rule

    Clinical Alerts

    When to Contact your Institute’s/Center’s Communications Office

    Conclusion

    Summary Questions

    Chapter 17. Clinical Research

    The Patient–Scientist Partnership

    Walking Away: Why Patients Refuse to Participate in Clinical Trials

    The Trial Begins: Understanding the Patient Experience

    Understanding the Caregiver

    The Role of Palliative Care

    Managing Difficult News

    Effective Patient Communications: Recommendations and Considerations

    The Assertive Patient: Ally in Scientific Research

    Conclusion

    FURTHER READING

    Part II Biostatistics and Epidemiology

    Chapter 18. Design of Observational Studies

    Introduction

    Ecological (Correlational) Studies

    Case Reports and Case Series

    Single Time Point Studies: Cross-Sectional Studies, Prevalence Surveys, and Incidence Studies

    Case–Control Studies

    Cohort Studies: Retrospective, Prospective, and Studies Nested Within a Cohort

    Odds Ratios, Risk Ratios, Relative Risks, and Attributable Risk

    Mistakes, Misconceptions, and Misinterpretations

    Conclusions

    Acknowledgments

    Summary Questions

    REFERENCES

    Chapter 19. Design of Clinical Studies and Trials

    The Purpose of Clinical Trials and Studies

    Understanding the Spectrum of the Research Continuum

    Clinical Trial Designs

    Critical Issues in Clinical Study Design

    Control Groups

    Placebo Responses

    Mistakes and Misconceptions

    Conclusions

    Acknowledgments

    Summary Questions

    REFERENCES

    Chapter 20. Issues in Randomization

    Introduction

    History of the Randomized Trial

    Randomization Methods

    Issues in Implementation

    Special Considerations

    Conclusion

    Acknowledgment

    Summary Questions

    REFERENCES

    Chapter 21. Hypothesis Testing

    Introduction

    The Formulation of Statistical Hypotheses in the Motivating Examples

    One-Sample Hypothesis Tests With Applications to Clinical Research

    Two-Sample Hypothesis Tests With Applications to Clinical Research

    Hypothesis Tests for the Motivating Examples

    Common Mistakes in Hypothesis Testing

    Misstatements and Misconceptions

    Special Considerations

    Conclusion

    Acknowledgments

    Summary Questions

    REFERENCES

    Chapter 22. Power and Sample Size Calculations

    Introduction

    Sample Size Calculations for Precision in Confidence Interval Construction

    Sample Size Calculations for Hypothesis Tests: One Sample of Data

    Sample Size Calculations for Hypothesis Tests: Paired Data

    Sample Size Calculations for Hypothesis Tests: Two Independent Samples

    Advanced Methods and Other Topics

    Conclusion

    Exercises

    Acknowledgments

    REFERENCES

    Chapter 23. An Introduction to Survival Analysis

    Introduction

    Features of Survival Data

    Survival Function

    Common Mistakes

    Conclusion

    Summary Questions

    REFERENCES

    Chapter 24. Intermediate Topics in Biostatistics

    1 Special Topics in Trial Design

    2 Special Considerations in Data Analysis

    3 Regression to the Mean

    4 Diagnostic Testing

    5 Special Considerations in Survival Analysis

    6 Missing Data

    7 Causal Inference in Observational Studies

    8 Concluding Remarks

    Summary Questions

    Acknowledgement

    REFERENCES

    Chapter 25. Measures of Function and Health-related Quality of Life

    Introduction to Function and Health-Related Quality of Life (HRQL) Measures

    How are Function, QOL, and HRQL Measures Used?

    Examples of Functional Measures and Health-Related Quality of Life Measures

    Other Instruments to Consider

    Importance of Quality of Life Measures for Health Care

    Summary Questions

    REFERENCES

    Chapter 26. Large Clinical Trials and Registries—Clinical Research Institutes

    Introduction

    History

    Phases of Evaluation of Therapies

    Critical General Concepts

    Expressing Clinical Trial Results

    Concepts Underlying Trial Design

    General Design Considerations

    Legal and Ethical Issues

    Hypothesis Formulation

    Publication Bias

    Statistical Considerations

    Meta-Analysis and Systematic Overviews

    Understanding Covariates and Subgroups

    Therapeutic Truisms

    Study Organization

    Integration Into Practice

    Controversies and Personal Perspective

    The Future

    Summary Questions

    REFERENCES

    Chapter 27. Meta-analysis of Clinical Trials

    Techniques of Meta-Analysis

    Meta-Analysis of Clinical Trials of Anti-Inflammatory Agents in Sepsis

    Conclusions

    Summary Questions

    REFERENCES

    Chapter 28. Using Large Datasets for Population-based Health Research

    Introduction

    Where Does the Data Come from?

    Uses of Secondary Data in Health Research

    Strengths

    Limitations (and Solutions)

    Surveys

    Linking Data Sets

    Ethical Considerations

    Future Directions and Conclusions

    Summary Questions

    REFERENCES

    Chapter 29. Development and Conduct of Studies

    How to Choose a Study Design

    Development and Importance of a Study Protocol

    Equipoise

    Manual of Operating Procedures

    Reporting the Results

    Conclusions

    Acknowledgments

    Summary Questions

    REFERENCES

    Part III Technology Transfer, Protocol Development, and Funding

    Chapter 30. Overview of Technology Development

    Introduction

    Scenario: Disasters Waiting to Happen

    The First and Biggest Mistake: Signing the Agreements

    Agreements Not to Disclose: Trade Secrets and the Confidential Disclosure Agreement

    Agreements to Transfer Materials

    Collaboration and Inventions: The Cooperative Research and Development Agreement

    Proprietary Materials: The Materials CRADA

    Conclusion

    Summary Questions

    REFERENCES AND NOTES

    Chapter 31. Patents and Patent Licenses

    Introduction

    Part One: Patents Generally

    Core Concepts of us Patent Law

    Basic Elements of the Patent Application Process

    Part Two: Patents And Technology Transfer

    Patenting and Licensing by Federal Agencies

    Conclusion

    Brief Glossary of Critical Terms in Patenting

    Summary Questions

    REFERENCES AND NOTES

    Chapter 32. Writing a Protocol

    Types of Protocols

    Writing a Protocol

    What Happens to your Protocol?

    Essential Elements to Include in the Protocol

    Summary

    Summary Questions

    REFERENCES

    Chapter 33. Evaluating a Protocol Budget

    Introduction

    Requirements

    Establishing a Protocol Budget

    Summary

    Chapter 34. Clinical Research Data

    Introduction

    Data as Surrogates

    Types of Data

    Data Standards

    Data Capture, Storage, and Retrieval

    Responsible Stewardship of Data

    Cooperative Sharing Efforts

    Summary

    Summary Questions

    REFERENCES

    Chapter 35. Management of Patient Samples and Specimens

    Successful Research Rests On A Foundation of Careful Planning

    The Role of Pre-Analytic Variables in Research Using Patient Specimens

    The Importance of Good Record Keeping

    Specimen Tracking

    Specimen Collection

    Specimen Handling

    Specimen Transit

    Specimen Storage

    Access To Patient Samples

    Specimen Culling, Transfer of Collections, and Repository Closings

    Summary Questions

    REFERENCES

    Chapter 36. Getting the Funding You Need to Support Your Research

    Overview of NIH

    The NIH Peer Review Process for Grants

    Hints for Preparing Better Grant Applications

    NIH Grant Programs for Clinical Researchers at Various Stages in their Careers

    How to Stay Informed about NIH Peer Review

    Chapter 37. Clinical Research from the Industry Perspective

    History of the Pharmaceutical Industry

    Components of the Pharmaceutical Industry

    Issues Impacting Industry Clinical Research

    Industry Outlook

    Public–Private Opportunities

    Summary Questions

    REFERENCES

    Chapter 38. Philanthropic Sector Support for Medical Research and Training

    Introduction

    Prior to 1950

    1950 to Present

    Alliances of Funders and Other Resources

    Future Directions

    Summary Questions

    REFERENCES

    Part IV Clinical Research Infrastructure

    Chapter 39. Managing Clinical Risk and Measuring Participants’ Perceptions of the Clinical Research Process

    Identifying and Managing Clinical Risk in the Clinical Research Environment

    Assessing Clinical Research Participants’ Perceptions of the Clinical Research Experience

    Conclusion

    REFERENCES

    Chapter 40. Integration of Specialized Research Services into Clinical Laboratory Operations

    Introduction

    Specialized Laboratory Services Developed for Clinical Research

    Testing Approaches Used in Support of Clinical Research

    Test Reporting

    Examples of Specialized Laboratory Services Developed for Clinical Research

    Summary

    REFERENCES

    Chapter 41. Imaging in Clinical Trials

    Introduction: The Use of Imaging in Clinical Trials

    Imaging Modalities

    Imaging Interpretation

    Imaging Core Laboratories

    Incidental Imaging Findings

    Risk Considerations From Imaging

    Issues Regarding Sample Size

    Picture Archiving and Communication System (PACS)

    Role of the Imaging Specialist On the Clinical Trial Team

    Summary

    Summary Questions

    REFERENCES

    Chapter 42. Role of Blood Bank and Transfusion Medicine in Clinical Research

    Introduction

    Structure of the “Blood Bank”

    The NIH Clinical Center’s Department of Transfusion Medicine

    Summary Questions

    REFERENCES

    Chapter 43. Clinical Pharmacology and its Role in Pharmaceutical Development

    Clinical Pharmacology as a Translational Discipline—Definition and Scope

    Overview of Drug Development

    Current State of Affairs in Drug Development

    Contribution of Clinical Pharmacology

    The Role of the Food and Drug Administration

    Summary Questions

    REFERENCES

    Chapter 44. Career Paths in Clinical Research

    Background

    Student and Resident Training in Clinical Research

    Clinical Research Curriculum

    NIH Clinical Center Core Curriculum

    Additional Educational Approaches and Support for Training

    Conclusions

    REFERENCES

    Chapter 45. Clinical Research Nursing

    Introduction

    Clinical Research Nursing: A New Practice Specialty

    Defining and Documenting the Specialty of Clinical Research Nursing

    Legal Scope of Practice Issues

    Tools to Assist a Principal Investigator in Staffing a Study

    Future Considerations

    Summary/Discussion Questions

    REFERENCES

    Chapter 46. Clinical Research Applications of Health Disparities Science in Community Settings

    Background

    Clinical Research Studies that can be Conducted in Community Settings

    Health Services Research

    Patient-Oriented Research

    Steps to Consider When Conducting Clinical Research in Community Settings

    Community Engagement, Collaboration, and Participatory Research

    Future Directions

    Summary Questions

    REFERENCES AND NOTES

    Chapter 47. Issues and Challenges for Clinical Research in International Settings

    Introduction

    Historical Perspectives

    Challenges

    Proffered Solutions

    Conclusion

    Summary Questions

    REFERENCES

    Chapter 48. The Power of an Undiagnosed Diseases Program in a Clinical Research Enterprise

    Introduction

    Mechanics

    Cases

    Genetics

    Publicity

    Future

    Insights

    Acknowledgments

    Summary Questions

    REFERENCES

    Chapter 49. Human Genome Project, Genomics, and Clinical Research

    Overview

    Genetic Models

    Complex Trait Dissection

    Sample Collection and Informed Consent

    Approach to Genotyping

    Linkage Analysis

    Association and Linkage Disequilibrium

    Gene Identification

    Integration of Genetics into Medical Practice

    Summary

    Acknowledgments

    Summary Questions

    REFERENCES

    Chapter 50. Harnessing Information Using Genomic Platforms

    Introduction

    SNP Arrays

    Whole Exome Sequencing

    Methylation

    Summary/Discussion Questions

    REFERENCES

    APPENDIX 1. Answer Key to Summary Questions

    Chapter 1

    Chapter 2

    Chapter 4

    Chapter 5

    Chapter 6

    Chapter 7

    Chapter 8

    Chapter 9

    Chapter 11

    Chapter 12

    Chapter 13

    Chapter 14

    Chapter 15

    Chapter 16

    Chapter 18

    Chapter 19

    Chapter 20

    Chapter 21

    Chapter 23

    Chapter 24

    Chapter 25

    Chapter 26

    Chapter 27

    Chapter 28

    Chapter 29

    Chapter 30

    Chapter 31

    Chapter 32

    Chapter 34

    Chapter 35

    Chapter 37

    Chapter 38

    Chapter 41

    Chapter 42

    Chapter 43

    Chapter 44

    Chapter 45

    Chapter 46

    Chapter 47

    Chapter 48

    Chapter 49

    Chapter 50

    APPENDIX 2. Principles and Practice of Clinical Research, 3rd Edition Acronyms by Chapter

    Chapter 1 (Dr. J.I. Gallin)

    Chapter 2 (Dr. Grady)

    Chapter 3 (Dr. Emanuel)

    Chapter 4 (Dr. Colbert)

    Chapter 5 (Dr. Wichman)

    Chapter 6 (Dr. Rosenfeld)

    Chapter 7 (Dr. Zoon)

    Chapter 8 (Ms. St. Germain)

    Chapter 9 (Dr. Friedman)

    Chapter 10 (Dr. Straus)

    Chapter 11 (Patricia Kvochak, Esq.)

    Chapter 12 (Dr. Nussenblatt)

    Chapter 13 (Dr. Kelty)

    Chapter 14 (Dr. Speers)

    Chapter 15 (Dr. Zarin)

    Chapter 16 (Mr. Burklow)

    Chapter 17 (Ms. Butler)

    Chapter 18 (Dr. Johnson)

    Chapter 19 (Dr. Stoney)

    Chapter 20 (Dr. Shaw)

    Chapter 21 (Dr. Johnson)

    Chapter 22 (Dr. Borkowf)

    Chapter 23 (Dr. Johnson)

    Chapter 24 (Dr. Johnson)

    Chapter 25 (Dr. Gerber)

    Chapter 26 (Dr. Califf)

    Chapter 27 (Dr. Sun)

    Chapter 28 (Dr. Chan)

    Chapter 29 (Dr. Stoney)

    Chapter 30 (Mr. Goldstein)

    Chapter 31 (Mr. Goldstein)

    Chapter 32 (Dr. Nussenblatt)

    Chapter 33 (Ms. Matula)

    Chapter 34 (Dr. Cimino)

    Chapter 35 (Dr. Pitt)

    Chapter 36 (Dr. Bartlett)

    Chapter 37 (Ms. Resnik)

    Chapter 38 (Dr. E.K. Gallin)

    Chapter 39 (Ms. Lee)

    Chapter 40 (Dr. Remaley)

    Chapter 41 (Dr. Bluemke)

    Chapter 42 (Dr. Klein)

    Chapter 43 (Dr. Lertora)

    Chapter 44 (Dr. Ognibene)

    Chapter 45 (Dr. Hastings)

    Chapter 46 (Dr. Dankwa-Mullan)

    Chapter 47 (Dr. Olopade)

    Chapter 48 (Dr. Gahl)

    Chapter 49 (Dr. Korf)

    Chapter 50 (Dr. Hart)

    Index

Product details

  • No. of pages: 796
  • Language: English
  • Copyright: © Academic Press 2012
  • Published: May 31, 2012
  • Imprint: Academic Press
  • eBook ISBN: 9780123821683
  • Hardcover ISBN: 9780123821676

About the Editors

John Gallin

Affiliations and Expertise

Chief Scientific Officer, Clinical Center, Associate Director for Clinical Research, National Institutes of Health, Bethesda, MD

Frederick Ognibene

Affiliations and Expertise

MD, MCCM, FACP, Deputy Director, Educational Affairs and Strategic Partnerships, NIH Clinical Center and Director, Office of Clinical Research Training and Medical Education, NIH Clinical Center, National Institutes of Health, Bethesda, MD, USA

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