Abstract
Clinical trials are a key component in the practice of evidence-based medicine. Much thought should be put into the design of a trial and only then should a protocol be developed to ensure that the targeted outcome is successfully achieved. The first duty when considering the methodology to be used in a clinical trial is to ensure the safety of the participants (patients and healthy volunteers). Ethical principles and practices should guide the physicians running the trial, which should be designed and conducted in such a way that the reliability of the data is of the highest possible standard. An experienced statistician should be consulted before the trial commences. Suitable endpoints, methods of comparison, and statistical analyses must be carefully selected to achieve the intended goals of the research. Although running a well-designed clinical trial may appear a relatively straightforward task, the underlying protocols can be flawed unless founded on meticulous methodology. The purpose of this chapter is to provide a brief guide to some factors that need to be considered when designing a clinical trial, with particular emphasis on dermatology.
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References
Berndt E, Cockburn I. Price indexes for clinical trial research: a feasibility study. 2012. p. 1–27. PriceIndexesForClinicalTrialResearch: preview.pdf.
Umscheid C, Margolis DJ, Craig E, Grossman CE. Key concepts of clinical trials: a narrative review. Postgrad Med. 2011;123(5):194–204.
Williams HC, Dellavalle RP. The growth of clinical trials and systematic reviews in informing dermatological patient care. J Invest Dermatol. 2012;132:1008–17.
Gonzalez U, Pinart M, Rengifo-Pardo M, Macaya A, Alvar J, et al. Interventions for American cutaneous and mucocutaneous leishmaniasis. Cochrane Database Syst Rev 2009;(2):CD004834.
Gonzalez U, Pinart M, Reveiz L, Alvar J. Interventions for Old World cutaneous leishmaniasis. Cochrane Database Syst Rev 2008;(4):CD005067.
Gonzalez U, Pinart M, Reveiz L, Rengifo-Pardo M, Tweed J, et al. Designing and reporting clinical trials on treatments for cutaneous leishmaniasis. Clin Infect Dis. 2010;51:409–19.
Risk of bias. http://handbook.cochrane.org/chapter_8/table_8_4_a_a_common_classification_scheme_for_bias.htm
Harbour R, Miller J. A new system for grading recommendations in evidence based guidelines. Br Med J. 2001;323:334–6.
Stewart-Brown S, Anthony R, Wilson L, et al. Should randomised controlled trials be the “gold standard” for research on preventive interventions for children? J Child Serv. 2011;6(4):228–35.
Nankervis H, Maplethorpe A, Williams HC. Mapping randomized controlled trials of treatments for eczema—the GREAT database (the Global Resource of EczemA Trials: a collection of key data on randomized controlled trials of treatments for eczema from 2000 to 2010). BMC Dermatol. 2011;11:10.
Hoch HE, Busse KL, Dellavalle RP. The growth of clinical trials and systematic reviews in informing dermatological patient care. J Invest Dermatol. 2012;132:1008–17.
BLISTER Study/The Bullous Pemphigoid Steroids and Tetracyclines Study 2013. http://public.ukcrn.org.uk/search/StudyDetail.aspx?StudyID=4611
Craig FF, Thomas KS, Mitchell EJ, et al. UK Dermatology Clinical Trials Network’s STOP GAP trial (a multicentre trial of prednisolone versus ciclosporin for pyoderma gangrenosum): protocol for a randomised controlled trial. Trials. 2012;13:51.
Nuremberg Code. Trials of war criminals before the Nuremberg Military Tribunals under Control Council Law No. 10. Vol. 2. Washington, DC: US Government Printing Office; 1949. p. 181–2.
World Medical Organization Declaration of Helsinki. Br Med J. 1996;313(7070):1448–9.
Freedman B. Equipoise and the ethics of clinical research. N Engl J Med. 1987;317(3):141–5.
Services DoHaH, editor. Code of Federal Regulations—The Common Rule: Protection of Human Subjects. Vol. 45. 2009.
Bagatin E, Miot HA. How to design and write a clinical research protocol in cosmetic dermatology. An Bras Dermatol. 2013;88(1):69–75.
Bhardwaj SS, Camacho F, Derrow A, Fleischer Jr AB, Feldman SR. Statistical significance and clinical relevance: the importance of power in clinical trials in dermatology. Arch Dermatol. 2004;140(12):1520–3.
Sheps S. Sample size and power. J Invest Surg. 1993;6:469–75.
Lachin JM. Introduction to sample size determination and power analysis for clinical trials. Control Clin Trials. 1981;2(2):93–113.
Phillips WC, Scott JA, Blasczcynski G. The significance of “no significance”: what a negative statistical test really means. Am J Roentgenol. 1983;141(1):203–6.
Kraemer HC. Sample size: when is enough enough? Am J Med Sci. 1988;296:360–3.
Javitt JC. When does the failure to find a difference mean that there is none? Arch Ophthalmol. 1989;107:1034–40.
Tetzlaff JM, Marie J, Moher J, Chan A. Developing a guideline for clinical trial protocol content: Delphi consensus survey. Trials. 2012;13:176.
FDA Clinical Trials Guidance Documents. http://www.fda.gov/regulatoryinformation/guidances/ucm122046.htm
Sampogna F, Spagnoli A, Di Pietro C, Pagliarello C, Paradisi A, Tabolli S, Abeni D. Field performance of the Skindex-17 quality of life questionnaire: a comparison with the Skindex-29 in a large sample of dermatological outpatients. J Invest Dermatol. 2013;133:104–9.
Corey G, Wilcox M, Talbot G, Friedland H, Baculik T, Witherell G, Critchley I, Das A, Thye D. Integrated analysis of CANVAS 1 and 2: phase 3, multicenter, randomized, double-blind studies to evaluate the safety and efficacy of ceftaroline versus vancomycin plus aztreonam in complicated skin and skin-structure infection. Clin Infect Dis. 2010;51(6):641–50.
Patient involvement in clinical trials. The active involvement of patients and patient organisations in (the) clinical trial (development process). http://www.patientpartner-europe.eu/en/resources/active-involvement-in-the-process
U.K Dermatology Clinical Trials Network’s PATCH Trial Team. Prophylactic antibiotics for the prevention of cellulitis (erysipelas) of the leg: results of the U.K. Dermatology Clinical Trials Network’s PATCH II trial. Br J Dermatol. 2012;166(1):169–78.
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Emanuele, E. (2015). Statistics. In: Nasir, A. (eds) Clinical Dermatology Trials 101. Springer, Cham. https://doi.org/10.1007/978-3-319-09027-6_10
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