This blog is a collaborative effort between the Foundation for Student Science and Technology (formerly the Canadian Young Scientist Journal) and Science.gc.ca. Our aim is to offer an interactive platform where Canadian students can talk about their passions, challenges and ideas on how to further pursue scientific interests and education. We welcome new contributors -- if you are interested please contact us at information@science.gc.ca.

Thursday, February 27, 2014

Bridging the Gap

Originally Published: February 27, 2014
By: Alicia Liang

Two years ago, our neighbor was diagnosed with stage IV prostate cancer. Within a year, he had exhausted all known treatment options, none of which provided even minor relief. Last January, he was told that he had less than three months to live.

After consulting with numerous physicians, one specialist finally informed him of a new drug for prostate cancer that was in the clinical trial stage. Since his quality of life was already extremely low, he eagerly volunteered as a trial test subject.

Soon after being put on the treatment, his symptoms lessened dramatically. He was no longer bedridden, and as the months passed, he regained enough strength to go on short walks around our cul-de-sac with his walker!

Today, all 8 of the original volunteer test subjects are still alive, despite doctors’ predictions that they would die within a few months. Meanwhile, clinical trials struggle to find enough participants.

“About 85 percent of people with cancer were either unaware or unsure that participation in clinical trials was an option, though about 75 percent of these people said they would have been willing to enroll had they known it was possible.” – Frank, Genevieve. "Current Challenges in Clinical Trial Patient Recruitment and Enrollment." SoCRA Source (2004): 36.
Clinical trials are vital to us all. Failed recruitment efforts are costly and delay invaluable medications and therapies from reaching the market. Studies based on too small of a sample size fail to expose benefits and side-effects for certain patient groups. Moreover, there are areas that could use more clinical research, but are systematically ignored because recruitment of enough test subjects is nearly impossible using current methods, something that I personally experienced in my independent research at UBC.
Thus, in order to create a fundamentally more innovative and effective model of health care for the benefit of all, the following questions are a good place to start:
How do most people find out about clinical trials?

Are patients aware of major clinical trial websites? Are they centralized and user-friendly?
What is the most effective means for clinical trials to reach out to different demographic groups?

How often do physicians refer their patients for a clinical trial? What are their reasons for not doing so (e.g. lack of easy, up-to-date and comprehensive information, legal implications)? Would a system of incentivized referrals help?

Which clinical trial recruiting websites are the most successful, and what can be learned from them?

How can competition between different trials in a region for a specific patient group be minimized?

Should a patient recruitment plan be a mandatory part of clinical trial proposals?
Ultimately, the difficulties associated with recruiting patients for clinical trials highlight a broader problem in our healthcare system: a lack of collaboration between patients, governments, organizations, physicians, and researchers. From health policy and health literacy to urban planning, my passion lies in bridging this gap between the laboratory and our contemporary society’s most pressing health and healthcare challenges.

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