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Abernethy NF, McCloskey K, Trahey M, Rinn L, Broder GB, Andrasik M, Laborde R, McGhan D, Spendolini S, Marimuthu S, Kanzmeier A, Hanes J, Kublin J. Rapid Development of a Registry to Accelerate COVID-19 Vaccine Clinical Trials. RESEARCH SQUARE 2024:rs.3.rs-4397271. [PMID: 38947011 PMCID: PMC11213164 DOI: 10.21203/rs.3.rs-4397271/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/02/2024]
Abstract
Background The unprecedented scientific response to the SARS-Cov-2 pandemic in 2020 required the rapid development and activation of extensive clinical trial networks to study vaccines and therapeutics. The COVID-19 Prevention Network (CoVPN) coordinated hundreds of sites conducting phase 2 and 3 clinical trials of vaccines and antibody therapeutics. To facilitate these clinical trials, the CoVPN Volunteer Screening Registry (VSR) was created to collect volunteer information at scale, identify volunteers at risk of COVID-19 who met enrollment criteria, distribute candidates across clinical trial sites, and enable monitoring of volunteering and enrollment progress. Methods We developed a secure database to support three primary web-based interfaces: a national volunteer questionnaire intake form, a clinical trial site portal, and an Administrative Portal. The Site Portal supported filters based on volunteer attributes, visual analytics, enrollment status tracking, geographic search, and clinical risk prediction. The Administrative Portal supported oversight and development with pre-specified reports aggregated by geography, trial, and trial site; charts of volunteer rates over time; volunteer risk score calculation; and dynamic, user-defined reports. Findings Over 650,000 volunteers joined the VSR, and 1094 users were trained to utilize the system. The VSR played a key role in recruitment for the Moderna, Oxford-AstraZeneca, Janssen, and Novavax vaccine clinical trials, provided support to the Pfizer and Sanofi vaccine and prophylactic antibody clinical trials, and enhanced the diversity of trial participants. Clinical trial sites selected 166,729 volunteer records for follow-up screening, and of these 47·7% represented groups prioritized for increased enrollment. Despite the unprecedented urgency of its development, the system maintained 99·99% uptime. Interpretation The success of the VSR demonstrates that information tools can be rapidly yet safely developed through a public-private partnership and integrated into a distributed and accelerated clinical trial setting. We further summarize the requirements, design, and development of the system, and discuss lessons learned for future pandemic preparedness.
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Affiliation(s)
- Neil F. Abernethy
- Biomedical Informatics and Medical Education, University of Washington, 850 Republican St., Seattle, WA 98109
| | - Kylie McCloskey
- HIV Vaccine Trials Network (HVTN), COVID-19 Prevention Network (CoVPN), Fred Hutchinson Cancer Center, 1100 Fairview Ave. N., Mail Stop M2-B500, Seattle, WA 98109
| | - Meg Trahey
- HIV Vaccine Trials Network (HVTN), COVID-19 Prevention Network (CoVPN), Fred Hutchinson Cancer Center, 1100 Fairview Ave. N., Mail Stop M2-B500, Seattle, WA 98109
| | - Laurie Rinn
- HIV Vaccine Trials Network (HVTN), COVID-19 Prevention Network (CoVPN), Fred Hutchinson Cancer Center, Fred Hutch Cancer Center, 1100 Fairview Ave. N., Mail Stop M2-B500, Seattle, WA 98109
| | - Gail B. Broder
- HIV Vaccine Trials Network (HVTN), COVID-19 Prevention Network (CoVPN), Fred Hutchinson Cancer Center, 1100 Fairview Ave. N., Mail Stop M2-B500, Seattle, WA 98109
| | - Michele Andrasik
- HIV Vaccine Trials Network (HVTN), COVID-19 Prevention Network (CoVPN), Fred Hutchinson Cancer Center, 1100 Fairview Ave. N., Mail Stop M2-B500, Seattle, WA 98109
| | | | - Daniel McGhan
- Oracle Corporation, 2300 Oracle Way, Austin, TX 78741
| | | | | | | | - Jayson Hanes
- Oracle Corporation, 2300 Oracle Way, Austin, TX 78741
| | - James Kublin
- HIV Vaccine Trials Network (HVTN), COVID-19 Prevention Network (CoVPN), Fred Hutchinson Cancer Center, 1100 Fairview Ave. N., Mail Stop M2-B500, Seattle, WA 98109
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Goin-Kochel RP, Lozano I, Duhon G, Marzano G, Daniels A, Law JK, Diehl K, Green Snyder L, Feliciano P, Chung WK. Evidence-based recruitment strategies for clinical research: Study personnel's and research participants' perceptions about successful methods of outreach for a U.S. Autism-Research Cohort. J Clin Transl Sci 2024; 8:e65. [PMID: 38690223 PMCID: PMC11058577 DOI: 10.1017/cts.2024.512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Revised: 02/15/2024] [Accepted: 03/25/2024] [Indexed: 05/02/2024] Open
Abstract
Introduction Under enrollment of participants in clinical research is costly and delays study completion to impact public health. Given that research personnel make decisions about which strategies to pursue and participants are the recipients of these efforts, we surveyed research staff (n = 52) and participants (n = 4,144) affiliated with SPARK (Simons Foundation Powering Autism for Knowledge) - the largest study of autism in the U.S. - to understand their perceptions of effective recruitment strategies. Methods In Study 1, research personnel were asked to report recruitment strategies that they tried for SPARK and to indicate which ones they would and would not repeat/recommend. In Study 2, SPARK participants were asked to indicate all the ways they heard about the study prior to enrollment and which one was most influential in their decisions to enroll. Results Staff rated speaking with a SPARK-study-team member (36.5%), speaking with a medical provider (19.2%), word of mouth (11.5%), and a live TV news story (11.5%) as the most successful strategies. Participants most often heard about SPARK via social media (47.0%), speaking with a medical provider (23.1%), and an online search (20.1%). Research personnel's and participants' views on effective recruitment strategies often differed, with the exception of speaking with a medical provider. Conclusion Results suggest that a combination of strategies is likely to be most effective in reaching diverse audiences. Findings have implications for the selection of strategies that meet a study's specific needs, as well as recruitment-strategy "combinations" that may enhance the influence of outreach efforts.
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Affiliation(s)
- Robin P. Goin-Kochel
- Baylor College of Medicine, Houston, TX, USA
- Texas Children’s Hospital, Houston, TX, USA
| | - Ivana Lozano
- Baylor College of Medicine, Houston, TX, USA
- Texas Children’s Hospital, Houston, TX, USA
| | - Gabrielle Duhon
- Baylor College of Medicine, Houston, TX, USA
- Texas Children’s Hospital, Houston, TX, USA
| | - Gabriela Marzano
- Baylor College of Medicine, Houston, TX, USA
- Texas Children’s Hospital, Houston, TX, USA
| | - Amy Daniels
- Simons Foundation, New York, NY, USA
- Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA
| | - J. Kiely Law
- Simons Foundation, New York, NY, USA
- Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Katharine Diehl
- Simons Foundation, New York, NY, USA
- Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA
| | | | - Pamela Feliciano
- Simons Foundation, New York, NY, USA
- Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Wendy K. Chung
- Simons Foundation, New York, NY, USA
- Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA
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Kost RG, Devine RK, Fernands M, Gottesman R, Kandpal M, MacArthur RB, O’Sullivan B, Romanick M, Ronning A, Schlesinger S, Tobin JN, Vaughan R, Neville-Williams M, Krueger JG, Coller BS. Building an infrastructure to support the development, conduct, and reporting of informative clinical studies: The Rockefeller University experience. J Clin Transl Sci 2023; 7:e104. [PMID: 37250985 PMCID: PMC10225266 DOI: 10.1017/cts.2023.521] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 03/30/2023] [Indexed: 05/31/2023] Open
Abstract
Introduction Clinical trials are a vital component of translational science, providing crucial information on the efficacy and safety of new interventions and forming the basis for regulatory approval and/or clinical adoption. At the same time, they are complex to design, conduct, monitor, and report successfully. Concerns over the last two decades about the quality of the design and the lack of completion and reporting of clinical trials, characterized as a lack of "informativeness," highlighted by the experience during the COVID-19 pandemic, have led to several initiatives to address the serious shortcomings of the United States clinical research enterprise. Methods and Results Against this background, we detail the policies, procedures, and programs that we have developed in The Rockefeller University Center for Clinical and Translational Science (CCTS), supported by a Clinical and Translational Science Award (CTSA) program grant since 2006, to support the development, conduct, and reporting of informative clinical studies. Conclusions We have focused on building a data-driven infrastructure to both assist individual investigators and bring translational science to each element of the clinical investigation process, with the goal of both generating new knowledge and accelerating the uptake of that knowledge into practice.
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Affiliation(s)
- Rhonda G. Kost
- Center for Clinical and Translational Science, Rockefeller University, New York, NY, USA
| | - Rita K. Devine
- Center for Clinical and Translational Science, Rockefeller University, New York, NY, USA
| | - Mark Fernands
- Center for Clinical and Translational Science, Rockefeller University, New York, NY, USA
| | - Riva Gottesman
- Center for Clinical and Translational Science, Rockefeller University, New York, NY, USA
| | - Manoj Kandpal
- Center for Clinical and Translational Science, Rockefeller University, New York, NY, USA
| | - Robert B. MacArthur
- Center for Clinical and Translational Science, Rockefeller University, New York, NY, USA
| | - Barbara O’Sullivan
- Center for Clinical and Translational Science, Rockefeller University, New York, NY, USA
| | - Michelle Romanick
- Center for Clinical and Translational Science, Rockefeller University, New York, NY, USA
| | - Andrea Ronning
- Center for Clinical and Translational Science, Rockefeller University, New York, NY, USA
| | - Sarah Schlesinger
- Center for Clinical and Translational Science, Rockefeller University, New York, NY, USA
| | - Jonathan N. Tobin
- Center for Clinical and Translational Science, Rockefeller University, New York, NY, USA
- Clinical Directors Network, Inc. (CDN), New York, NY, USA
| | - Roger Vaughan
- Center for Clinical and Translational Science, Rockefeller University, New York, NY, USA
| | - Maija Neville-Williams
- Center for Clinical and Translational Science, Rockefeller University, New York, NY, USA
| | - James G. Krueger
- Center for Clinical and Translational Science, Rockefeller University, New York, NY, USA
| | - Barry S. Coller
- Center for Clinical and Translational Science, Rockefeller University, New York, NY, USA
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Serum Aldosterone and Urine Electrolytes Dynamics in Response to DASH Diet Intervention – an Inpatient Mechanistic Study. J Clin Transl Sci 2022; 6:e84. [PMID: 35949658 PMCID: PMC9305085 DOI: 10.1017/cts.2022.394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 04/17/2022] [Accepted: 04/18/2022] [Indexed: 11/07/2022] Open
Abstract
Background: Methods: Results: Conclusion:
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5
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Vaughan R, Romanick M, Brassil D, Kost R, Neville-Williams M, Gottesman R, Devine R, Manukonda P, Ronning A, O’Sullivan B, Capili B, Macarthur R, Tobin JN, Johnson T, Shapiro ED, Meagher E, Krueger J, Schlesinger S, Coller BS. The Rockefeller Team Science Leadership training program: Curriculum, standardized assessment of competencies, and impact of returning assessments. J Clin Transl Sci 2021; 5:e165. [PMID: 34733542 PMCID: PMC8532180 DOI: 10.1017/cts.2021.838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 08/05/2021] [Accepted: 08/08/2021] [Indexed: 11/06/2022] Open
Abstract
The ability to effectively lead an interdisciplinary translational team is a crucial component of team science success. Most KL2 Clinical Scholars have been members of scientific teams, but few have been team science leaders. There is a dearth of literature and outcome measures of effective Team Science Leadership in clinical and translational research. We focused our curriculum to emphasize Team Science Leadership, developed a list of Team Science Leadership competencies for translational investigators using a modified Delphi method, and incorporated the competencies into a quantitative evaluation survey. The survey is completed on entry and annually thereafter by the Scholar; the Scholar's primary mentor and senior staff who educate and interact with the Scholar rate the Scholar at the end of each year. The program leaders and mentor review the results with each Scholar. The survey scales had high internal consistency and good factor structure. Overall ratings by mentors and senior staff were generally high, but ratings by Scholars tended to be lower, offering opportunities for discussion and career planning. Scholars rated the process favorably. A Team Science Leadership curriculum and periodic survey of attained competencies can inform individual career development and guide team science curriculum development.
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Affiliation(s)
- Roger Vaughan
- Center for Clinical and Translational Science, The Rockefeller University, New York, NY, USA
| | - Michelle Romanick
- Center for Clinical and Translational Science, The Rockefeller University, New York, NY, USA
| | - Donna Brassil
- Center for Clinical and Translational Science, The Rockefeller University, New York, NY, USA
| | - Rhonda Kost
- Center for Clinical and Translational Science, The Rockefeller University, New York, NY, USA
| | - Maija Neville-Williams
- Center for Clinical and Translational Science, The Rockefeller University, New York, NY, USA
| | - Riva Gottesman
- Center for Clinical and Translational Science, The Rockefeller University, New York, NY, USA
| | - Rita Devine
- Center for Clinical and Translational Science, The Rockefeller University, New York, NY, USA
| | - Prasanth Manukonda
- Center for Clinical and Translational Science, The Rockefeller University, New York, NY, USA
| | - Andrea Ronning
- Center for Clinical and Translational Science, The Rockefeller University, New York, NY, USA
| | - Barbara O’Sullivan
- Center for Clinical and Translational Science, The Rockefeller University, New York, NY, USA
| | - Bernadette Capili
- Center for Clinical and Translational Science, The Rockefeller University, New York, NY, USA
| | - Robert Macarthur
- Center for Clinical and Translational Science, The Rockefeller University, New York, NY, USA
| | - Jonathan N. Tobin
- Center for Clinical and Translational Science, The Rockefeller University, New York, NY, USA
- Clinical Directors Network, Inc. (CDN), New York, NY, USA
| | - Tesheia Johnson
- Yale Center for Clinical Investigation, Yale University, New Haven, CT, USA
| | - Eugene D. Shapiro
- Yale Center for Clinical Investigation, Yale University, New Haven, CT, USA
| | - Emma Meagher
- Institute for Translational Medicine and Therapeutics, University of Pennsylvania, Philadelphia, PA, USA
| | - James Krueger
- Center for Clinical and Translational Science, The Rockefeller University, New York, NY, USA
| | - Sarah Schlesinger
- Center for Clinical and Translational Science, The Rockefeller University, New York, NY, USA
| | - Barry S. Coller
- Center for Clinical and Translational Science, The Rockefeller University, New York, NY, USA
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Navarra AMD, Handschuh C, Hroncich T, Jacobs SK, Goldsamt L. Recruitment of US Adolescents and Young Adults (AYA) into Human Immunodeficiency Virus (HIV)-Related Behavioral Research Studies: A Scoping Review. Curr HIV/AIDS Rep 2020; 17:615-631. [PMID: 33180246 PMCID: PMC7659422 DOI: 10.1007/s11904-020-00530-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
PURPOSE OF REVIEW The objective of this scoping review was to examine the range of published evidence on recruitment approaches and outcomes of US adolescents and young adults (AYA) ages (18-29 years) into human immunodeficiency virus (HIV)-related behavioral research studies during the past 10 years. RECENT FINDINGS Implementation of effective behavioral research strategies among HIV at-risk and infected AYA is key to ending the HIV epidemic and necessitates successful recruitment strategies. A comprehensive search was executed across four electronic databases. Of the 1697 identified studies, seven met inclusion criteria with six of these seven directed to HIV prevention. Most studies used online recruitment as part of a hybrid strategy, and combined field-based/in-person and online methods. Recruitment strategies and outcomes, resources and compensation, procedures for consent, and timelines varied among all seven studies. Our results highlight the need for development of recruitment models in alignment with behavioral strategies aimed to treat and prevent HIV among US AYA.
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Affiliation(s)
| | | | - Theresa Hroncich
- New York University Rory Meyers College of Nursing, New York, NY, USA
| | - Susan Kaplan Jacobs
- Elmer Holmes Bobst Library, New York University Libraries, New York, NY, USA
| | - Lloyd Goldsamt
- New York University Rory Meyers College of Nursing, New York, NY, USA
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Pung J, Rienhoff O. Key components and IT assistance of participant management in clinical research: a scoping review. JAMIA Open 2020; 3:449-458. [PMID: 33215078 PMCID: PMC7660951 DOI: 10.1093/jamiaopen/ooaa041] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 07/16/2020] [Accepted: 08/24/2020] [Indexed: 01/05/2023] Open
Abstract
Objectives Managing participants and their data are fundamental for the success of a clinical trial. Our review identifies and describes processes that deal with management of trial participants and highlights information technology (IT) assistance for clinical research in the context of participant management. Methods A scoping literature review design, based on the Preferred Reporting Items for Systematic Reviews and Meta-analyses statement, was used to identify literature on trial participant-related proceedings, work procedures, or workflows, and assisting electronic systems. Results The literature search identified 1329 articles of which 111 were included for analysis. Participant-related procedures were categorized into 4 major trial processes: recruitment, obtaining informed consent, managing identities, and managing administrative data. Our results demonstrated that management of trial participants is considered in nearly every step of clinical trials, and that IT was successfully introduced to all participant-related areas of a clinical trial to facilitate processes. Discussion There is no precise definition of participant management, so a broad search strategy was necessary, resulting in a high number of articles that had to be excluded. Nevertheless, this review provides a comprehensive overview of participant management-related components, which was lacking so far. The review contributes to a better understanding of how computer-assisted management of participants in clinical trials is possible.
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Affiliation(s)
- Johannes Pung
- Department of Medical Informatics, University Medical Center Göttingen, Göttingen, Germany
| | - Otto Rienhoff
- Department of Medical Informatics, University Medical Center Göttingen, Göttingen, Germany
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Batagello R. Recrutamento de sujeitos em ensaios clínicos multicêntricos internacionais financiados pela indústria. SAUDE E SOCIEDADE 2018. [DOI: 10.1590/s0104-12902018180292] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Resumo Este estudo trata do recrutamento de sujeitos de pesquisa em ensaios clínicos multicêntricos internacionais financiados pela indústria executados em uma universidade pública brasileira entre janeiro de 2010 e dezembro de 2016. Analisou-se um conjunto de 63 contratos de ensaios clínicos, documentos administrativos e regulatórios. Os resultados demonstraram a participação de 75 países, dos quais 16% são latino-americanos. Foram obtidos dados sobre o recrutamento de sujeitos de pesquisa em âmbito local (356 sujeitos), nacional (3.774 sujeitos) e internacional (82.696 sujeitos), além de informações sobre o número de centros participantes no Brasil e o custo de cada ensaio. A maioria dos ensaios era de fase III (77,78% dos casos) e previa um recrutamento total nacional entre 18 e 80 sujeitos de pesquisa por ensaio (entre 4,42% e 11,46% do recrutamento internacional). Identificou-se forte correlação negativa entre os dados sobre contratos, orçamento e recrutamento e a cotação média anual do dólar. A totalidade dos ensaios adotou método competitivo de recrutamento associado ao pagamento por sujeito incluído na pesquisa. Isso é preocupante e demonstra uma contradição entre essa prática e as recomendações das diretrizes éticas nacionais. A ausência da informação sobre o número de sujeitos a serem recrutados no país revela, em 19% dos casos, um erro recorrente no processo regulatório. Conclui-se que a disponibilidade de informações detalhadas sobre o recrutamento nas pesquisas envolvendo seres humanos é importante para o correto dimensionamento e organização dos esforços de proteção dos sujeitos de pesquisa, e que atualmente essa premissa não está sendo cumprida de modo adequado.
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Abstract
Introduction and Methods The Rockefeller Clinical Scholars (KL2) program began in 1976 and transitioned into a 3-year Master’s degree program in 2006 when Rockefeller joined the National Institute of Health Clinical and Translational Science Award program. The program consists of ∼15 trainees supported by the Clinical and Translational Science Award KL2 award and University funds. It is designed to provide an optimal environment for junior translational investigators to develop team science and leadership skills by designing and performing a human subjects protocol under the supervision of a distinguished senior investigator mentor and a team of content expert educators. This is complemented by a tutorial focused on important translational skills. Results Since 2006, 40 Clinical Scholars have graduated from the programs and gone on to careers in academia (72%), government service (5%), industry (15%), and private medical practice (3%); 2 (5%) remain in training programs; 39/40 remain in translational research careers with 23 National Institute of Health awards totaling $23 million, foundation and philanthropic support of $20.3 million, and foreign government and foundation support of $6 million. They have made wide ranging scientific discoveries and have endeavored to translate those discoveries into improved human health. Conclusion The Rockefeller Clinical Scholars (KL2) program provides one model for translational science training.
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SMELL-S and SMELL-R: Olfactory tests not influenced by odor-specific insensitivity or prior olfactory experience. Proc Natl Acad Sci U S A 2017; 114:11275-11284. [PMID: 29073044 DOI: 10.1073/pnas.1711415114] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Smell dysfunction is a common and underdiagnosed medical condition that can have serious consequences. It is also an early biomarker of neurodegenerative diseases, including Alzheimer's disease, where olfactory deficits precede detectable memory loss. Clinical tests that evaluate the sense of smell face two major challenges. First, human sensitivity to individual odorants varies significantly, so test results may be unreliable in people with low sensitivity to a test odorant but an otherwise normal sense of smell. Second, prior familiarity with odor stimuli can bias smell test performance. We have developed nonsemantic tests for olfactory sensitivity (SMELL-S) and olfactory resolution (SMELL-R) that use mixtures of odorants that have unfamiliar smells. The tests can be self-administered by healthy individuals with minimal training and show high test-retest reliability. Because SMELL-S uses odor mixtures rather than a single molecule, odor-specific insensitivity is averaged out, and the test accurately distinguished people with normal and dysfunctional smell. SMELL-R is a discrimination test in which the difference between two stimulus mixtures can be altered stepwise. This is an advance over current discrimination tests, which ask subjects to discriminate monomolecular odorants whose difference in odor cannot be quantified. SMELL-R showed significantly less bias in scores between North American and Taiwanese subjects than conventional semantically based smell tests that need to be adapted to different languages and cultures. Based on these proof-of-principle results in healthy individuals, we predict that SMELL-S and SMELL-R will be broadly effective in diagnosing smell dysfunction.
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Ponda MP, Liang Y, Kim J, Hutt R, Dowd K, Gilleaudeau P, Sullivan-Whalen MM, Rodrick T, Kim DJ, Barash I, Lowes MA, Breslow JL. A randomized clinical trial in vitamin D-deficient adults comparing replenishment with oral vitamin D 3 with narrow-band UV type B light: effects on cholesterol and the transcriptional profiles of skin and blood. Am J Clin Nutr 2017; 105:1230-1238. [PMID: 28228421 PMCID: PMC5402037 DOI: 10.3945/ajcn.116.150367] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2016] [Accepted: 01/30/2017] [Indexed: 12/11/2022] Open
Abstract
Background: Vitamin D deficiency, defined as a serum 25-hydroxyvitamin D [25(OH)D] concentration <20 ng/mL, is correlated with a more atherogenic lipid profile. However, oral vitamin D supplementation does not lower LDL-cholesterol concentrations or raise HDL-cholesterol concentrations. This uncoupling between association and causation may result from a failure of oral vitamin D to mimic the effect of dermally synthesized vitamin D in response to ultraviolet type B (UVB) light.Objective: We tested the hypothesis that, in vitamin D-deficient adults, the replenishment of vitamin D with UVB exposure would lower LDL-cholesterol concentrations compared with the effect of oral vitamin D3 supplementation.Design: We performed a randomized clinical trial in vitamin D-deficient adults and compared vitamin D replenishment between subjects who received oral vitamin D3 (n = 60) and those who received narrow-band UVB exposure (n = 58) ≤6 mo.Results: There was no difference in the change from baseline LDL-cholesterol concentrations between oral vitamin D3 and UVB groups (difference in median of oral vitamin D3 minus that of UVB: 1.5 mg/dL; 95% CI: -5.0, 7.0 mg/dL). There were also no differences within groups or between groups for changes in total or HDL cholesterol or triglycerides. Transcriptional profiling of skin and blood, however, revealed significant upregulation of immune pathway signaling with oral vitamin D3 but significant downregulation with UVB.Conclusions: Correcting vitamin D deficiency with either oral vitamin D3 or UVB does not improve the lipid profile. Beyond cholesterol, these 2 modalities of raising 25(OH)D have disparate effects on gene transcription. This trial was registered at clinicaltrials.gov as NCT01688102.
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Affiliation(s)
| | - Yupu Liang
- Rockefeller University Hospital Center for Clinical and Translational Science, and
| | - Jaehwan Kim
- Laboratory of Investigative Dermatology, The Rockefeller University, New York, NY; and
| | - Richard Hutt
- Rockefeller University Hospital Center for Clinical and Translational Science, and
| | - Kathleen Dowd
- Rockefeller University Hospital Center for Clinical and Translational Science, and
| | - Patricia Gilleaudeau
- Laboratory of Investigative Dermatology, The Rockefeller University, New York, NY; and
| | | | - Tori Rodrick
- Laboratory of Biochemical Genetics and Metabolism
| | - Dong Joo Kim
- Laboratory of Investigative Dermatology, The Rockefeller University, New York, NY; and
| | - Irina Barash
- Division of Nephrology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Michelle A Lowes
- Laboratory of Investigative Dermatology, The Rockefeller University, New York, NY; and
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Stein MA, Shaffer M, Echo-Hawk A, Smith J, Stapleton A, Melvin A. Research START: A Multimethod Study of Barriers and Accelerators of Recruiting Research Participants. Clin Transl Sci 2015; 8:647-54. [PMID: 26643413 DOI: 10.1111/cts.12351] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Under-recruitment into clinical trials is a common and costly problem that undermines medical research. To better understand barriers to recruitment into clinical trials in our region, we conducted a multimethod descriptive study. We initially surveyed investigators who had conducted or were currently conducting studies that utilized an adult or pediatric clinical research center (n = 92). We then conducted focus groups and key informant interviews with investigators, coordinators, and other stakeholders in clinical and translational research (n = 32 individuals). Only 41% of respondents reported that they had or were successfully meeting recruitment goals and 24% of the closed studies actually met their targeted recruitment goals. Varied reasons were identified for poor recruitment but there was not a single investigator or study "phenotype" that predicted enrollment outcome. Investigators commonly recruited from their own practice or clinic, and 29% used a manual electronic medical record search. The majority of investigators would utilize a service that provides recruitment advice, including feasibility assessment and consultation, easier access to the electronic health record and assistance with institutional review board and other regulatory requirements. Our findings suggest potential benefits providing assistance across a range of services that can be individualized to the varied needs of clinical and translational investigators.
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Affiliation(s)
- Mark A Stein
- Seattle Children's Hospital, University of Washington, Seattle, Washington, USA
| | - Michele Shaffer
- Seattle Children's Research Institute, University of Washington, Seattle, Washington, USA
| | - Abigail Echo-Hawk
- Institute of Translational Health Sciences, University of Washington, Institute of Translational Health Sciences, Seattle, Washington, USA
| | - Jody Smith
- Institute of Translational Health Sciences, University of Washington, Institute of Translational Health Sciences, Seattle, Washington, USA
| | - Ann Stapleton
- Institute of Translational Health Sciences, University of Washington, Institute of Translational Health Sciences, Seattle, Washington, USA
| | - Ann Melvin
- Seattle Children's Hospital, University of Washington, Seattle, Washington, USA
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Corregano L, Bastert K, Correa da Rosa J, Kost RG. Accrual Index: A Real-Time Measure of the Timeliness of Clinical Study Enrollment. Clin Transl Sci 2015; 8:655-61. [PMID: 26573223 DOI: 10.1111/cts.12352] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Achieving timely accrual into clinical research studies remains a challenge for clinical translational research. We developed an evaluation measure, the Accrual Index (AI), normalized for sample size and study duration, using data from the protocol and study management databases. We applied the AI retrospectively and prospectively to assess its utility. METHODS Accrual Target, Projected Time to Accrual Completion (PTAC), Evaluable Subjects, Dates of Recruitment Initiation, Analysis, and Completion were defined. AI is (% Accrual Target accrued/% PTAC elapsed). Changes to recruitment practices were described, and data extracted from study management databases. RESULTS December 2014 (or final) AI was analyzed for 101 studies initiating recruitment from 2007 to 2014. Median AI was ≥1 for protocols initiating recruitment in 2011, 2013, and 2014. The AI varied widely for studies pre-2013. Studies with AI > 4 utilized convenience samples for recruitment. Data-justified PTAC was refined in 2013-2014 after which the AI range narrowed. Protocol characteristics were not associated with study AI. CONCLUSION Protocol AI reflects the relative agreement between accrual feasibility assessment (PTAC), and accrual performance, and is affected by recruitment practices. The AI may be useful in managing accountability, modeling accrual, allocating recruitment resources, and testing innovations in recruitment practices.
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Affiliation(s)
- Lauren Corregano
- Clinical Research Support Office, The Rockefeller University Center for Clinical and Translational Science, New York, New York, USA
| | - Katelyn Bastert
- Clinical Research Support Office, The Rockefeller University Center for Clinical and Translational Science, New York, New York, USA
| | - Joel Correa da Rosa
- Department of Research Design and Biostatistics, The Rockefeller University Center for Clinical and Translational Science, New York, New York, USA
| | - Rhonda G Kost
- Clinical Research Support Office, The Rockefeller University Center for Clinical and Translational Science, New York, New York, USA
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Kost RG, Mervin-Blake S, Hallarn R, Rathmann C, Kolb HR, Himmelfarb CD, D'Agostino T, Rubinstein EP, Dozier AM, Schuff KG. Accrual and recruitment practices at Clinical and Translational Science Award (CTSA) institutions: a call for expectations, expertise, and evaluation. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2014; 89:1180-1189. [PMID: 24826854 PMCID: PMC4116452 DOI: 10.1097/acm.0000000000000308] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
PURPOSE To respond to increased public and programmatic demand to address underenrollment of clinical translational research studies, the authors examined participant recruitment practices at Clinical and Translational Science Award (CTSA) sites and make recommendations for performance metrics and accountability. METHOD The CTSA Recruitment and Retention taskforce in 2010 invited representatives at 46 CTSAs to complete an online 48-question survey querying accrual and recruitment outcomes, practices, evaluation methods, policies, and perceived gaps in related knowledge/practice. Descriptive statistical and thematic analyses were conducted. RESULTS Forty-six respondents representing 44 CTSAs completed the survey. Recruitment conducted by study teams was the most common practice reported (78%-91%, by study type); 39% reported their institution offered recruitment services to investigators. Respondents valued study feasibility assessment as a successful practice (39%); desired additional resources included feasibility assessments (49%) and participant registries (44%). None reported their institution systematically required justification of feasibility; some indicated relevant information was considered prior to institutional review board (IRB) review (30%) or contract approval (22%). All respondents' IRBs tracked study progress, but only 10% of respondents could report outcome data for timely accrual. Few reported written policies addressing poor accrual or provided data to support recruitment practice effectiveness. CONCLUSIONS Many CTSAs lack the necessary frame work to support study accrual. Recom men dations to enhance accrual include articulating institutional expectations and policy for routine recruitment plan ning; providing recruitment expertise to inform feasibility assessment and recruit ment planning; and developing interdepartmental coordination and integrated informatics infrastructure to drive the conduct, evaluation, and improvement of recruitment practices.
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Affiliation(s)
- Rhonda G Kost
- Dr. Kost is clinical research officer and director, Regulatory Knowledge and Support Core, Rockefeller University Center for Clinical and Translational Science, New York, New York. She was co-chair of the CTSA Consortium's Regulatory Knowledge and Support Key Function Committee and Recruitment and Retention Taskforce at the time the work was conducted. Ms. Mervin-Blake is assistant director for recruitment and special projects, Duke University Clinical Translational Science Institute, Chapel Hill, North Carolina. She was director of operational programs and research recruitment, University of North Carolina Translational and Clinical Sciences Institute, Chapel Hill, North Carolina, at the time the research was conducted. Ms. Hallarn is program director, Clinical Trials Recruitment Center, Clinical and Translational Science, Ohio State University, Columbus, Ohio. Mr. Rathmann was director, Recruitment Enhancement Core, Institute of Clinical and Translational Science Regulatory Support Center, Center for Clinical Studies, Washington University School of Medicine in St. Louis, St Louis, Missouri, at the time the research was conducted. Mr. Kolb is research participant advocate, Clinical and Translational Science Institute, University of Florida, Gainesville, Florida. Dr. Dennison Himmelfarb is associate professor, Department of Health Systems and Outcomes, Johns Hopkins University School of Nursing, and Division of Health Sciences Informatics, Johns Hopkins University School of Medicine, Baltimore, Maryland. Ms. D'Agostino is assistant vice president, Sponsored Programs and Pre-Award Management, and assistant director, Clinical and Translational Science Award Regulatory Knowledge and Support Resource, University of Texas Medical Branch at Galveston, Galveston, Texas. Mr. Rubinstein is executive director for research services, University of Rochester Clinical Translational Science Institute, Rochester, New York. Dr. Dozier is associate professor, Department of Public He
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