1. Framework of the strengths and challenges of clinically integrated trials: An expert panel report.
- Author
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Peters AE, Jones WS, Anderson B, Bramante CT, Broedl U, Hornik CP, Kehoe L, Knowlton KU, Krofah E, Landray M, Locke T, Patel MR, Psotka M, Rockhold FW, Roessig L, Rothman RL, Schofield L, Stockbridge N, Trontell A, Curtis LH, Tenaerts P, and Hernandez AF
- Subjects
- Humans, Research Design, Clinical Trials as Topic
- Abstract
The limitations of the explanatory clinical trial framework include the high expense of implementing explanatory trials, restrictive entry criteria for participants, and redundant logistical processes. These limitations can result in slow evidence generation that is not responsive to population health needs, yielding evidence that is not generalizable. Clinically integrated trials, which integrate clinical research into routine care, represent a potential solution to this challenge and an opportunity to support learning health systems. The operational and design features of clinically integrated trials include a focused scope, simplicity in design and requirements, the leveraging of existing data structures, and patient participation in the entire trial process. These features are designed to minimize barriers to participation and trial execution and reduce additional research burdens for participants and clinicians alike. Broad adoption and scalability of clinically integrated trials are dependent, in part, on continuing regulatory, healthcare system, and payer support. This analysis presents a framework of the strengths and challenges of clinically integrated trials and is based on a multidisciplinary expert "Think Tank" panel discussion that included representatives from patient populations, academia, non-profit funding agencies, the U.S. Food and Drug Administration, and industry., Competing Interests: Disclosures Dr. Peters is supported by the National Heart Lung and Blood Institute (T32HL069749) and has received honoraria from Cytokinetics. Dr. Jones has received grants from Bayer, Boehringer Ingelheim, and Merck. Dr. Broedl is an employee of Boehringer Ingelheim. Dr. Hornik received a research grant from Before Brands and consulting fees from SC Pharma. Dr. Knowlton received a salary from Intermountain Health Care. Dr. Krofah had leadership roles in Protas, the Reagan Udall Foundation, Clinical Trials Transformation Initiative (CTTI), Duke Margolis Center for Health Policy, Alliance for a Stronger FDA, Patient Focused Medicines Development (PFMD), and Medical Device Innovation Consortium (MDIC). Dr. Landray received grants from Janssen, FluLab, Schmidt Futures, Google Ventures, the National Institute for Health Research, UK Research & Innovation, Wellcome, and the Bill & Melinda Gates Foundation, as well as study drugs from Regeneron, Roche, AbbVie, and GSK. Dr. Rockhold received grants from the NIH, PCORI, BMS, AstraZeneca, American Regent, the Gates Foundation, and Eidos and consulting fees from Janssen, Clover, Doctor Evidence, and Intercept. He also participated on Data Safety Monitoring Boards for Lilly, AstraZeneca, Merck, Gilead, Novartis, Icosavax, Sanofi, UCB, Amgen, Biogen, BMS, Pulmocide, Alkermes, and Diurnal. He had an unpaid leadership role for the Frontier Science Foundation. He has stock or stock options for GSK, Clover, Athira, Doctor Evidence, DataVant, Spencer Health Solutions, and Adaptic Health. Dr. Roessig is a full-time employee of Bayer AG. Dr. Rothman has received grants from PCORI, the CDC, NIH, and AHRQ. Lesley Schofield is an employee of Novartis and has stock or stock options from Novartis. Dr. Tenaerts is an employee of Medable, Inc., and has a stock option grant with Medable, Inc. Dr. Tenaerts also received an honorarium for participation on a data monitoring committee., (Copyright © 2024. Published by Elsevier Inc.)
- Published
- 2024
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