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Pillai GS, Sheeba CS, Barman M, Sen A, Sundaram N, Dickson M, Joyal S, Choudhury M, Joy MM, Deepthi KG, Jangid P, Dani S. Knowledge and awareness of clinical trials among trial participants in India: A multicentric questionnaire-based cross-sectional study. Indian J Ophthalmol 2024; 72:275-280. [PMID: 38099356 PMCID: PMC10941919 DOI: 10.4103/ijo.ijo_3041_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 09/18/2023] [Accepted: 09/28/2023] [Indexed: 12/19/2023] Open
Abstract
PURPOSE The knowledge and attitude of participants toward clinical trials (CTs) are a key determinant in successful recruitment and retention. This study aimed to evaluate knowledge and awareness-attitude among the recruited CT participants about CTs. METHODS This was a cross-sectional face-to-face survey comprising CT participants involved in the past or currently a part of a CT during this study within the Indian Ophthalmology Clinical Trial Network (IOCTN). A previously validated questionnaire was used, and data regarding demographics, knowledge, and awareness-attitude about CTs were collected. The total awareness-attitude score was used to determine the knowledge and awareness of the participants. RESULTS A total of 121 subjects had participated in the study who were part of ongoing trials, of which only five participants had prior experience of CTs. The majority (90%) had knowledge about CTs, whereas only 7% had confirmed signing consent forms. The total awareness-attitude score significantly varied across locations (27% for the southern zone, 53% for the central zone, and 52% for the western zone), and this was negatively associated with education. The most negative attitude (38.6%) was observed regarding adequate information sharing among participants, whereas non-disruption of their routine family life (60.7%) and financial stability (67.6%) were the top most positive attitudes revealed during their participation. The participants' pre- and post-participation attitude toward CTs revealed a positive attitude. CONCLUSION The factors influencing a participant's knowledge and attitudes toward CTs were revealed in the study. Furthermore, the need for awareness regarding benefits of CTs to the public, participant's rights, and their voluntary power were the major highlights.
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Affiliation(s)
- Gopal S Pillai
- Department of Ophthalmology and Chief of Vitreo‐ Retinal Services, Amrita Institute of Medical Sciences, Kochi, India
| | - C S Sheeba
- Department of Ophthalmology, Regional Institute of Ophthalmology, Thiruvananthapuram, Kerala, India
| | - Manabjyoti Barman
- Department of Vitreo‐Retina, Sri Sankaradeva Nethralaya, Guwahati, Assam, India
| | - Alok Sen
- Head of Department of Vitreo-Retina and Uvea, Sri Sadguru Netra Chikitsalaya (SNC), Chitrakoot, Madhya Pradesh, India
| | - Natarajan Sundaram
- Department of Vitreo-Retinal Services, Aditya Jyot Eye Hospital Pvt. Ltd. (AJEH), Mumbai, Maharashtra, India
| | - Merin Dickson
- IOCTN-BIRAC Project, AIMS Kochi, Amrita Institute of Medical Sciences, Kochi, Kerala, India
| | - Shamilin Joyal
- IOCTN-BIRAC Project, AIMS Kochi, Amrita Institute of Medical Sciences, Kochi, Kerala, India
| | - Manjisa Choudhury
- IOCTN - BIRAC Project, Sri Sankaradeva Nethralaya, Guwahati, Sri Sankaradeva Nethralaya, Guwahati, Assam, India
| | - Merlin M Joy
- IOCTN-BIRAC Project, AIMS Kochi, Amrita Institute of Medical Sciences, Kochi, Kerala, India
| | - K G Deepthi
- IOCTN - BIRAC Project, RIO Thiruvanthapuram, Regional Institute of Ophthalmology, Thiruvananthapuram, Kerala, India
| | - Poonam Jangid
- IOCTN - BIRAC Project, SNC Chitrakoot, Shri Sadguru Netra Chikitsalaya, Chitrakoot, Madhya Pradesh, India
| | - Samrudhi Dani
- IOCTN-BIRAC Project, AJEH, Mumbai, Aditya Jyot Eye Hospital Pvt. Ltd., Mumbai, Maharashtra, India
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Pillai GS, Sheeba CS, Barman M, Sen A, Sundaram N, Dickson M, Joyal S, Choudhury M, Joy MM, Deepthi KG, Jangid P, Abhilash A. Attitude and perception toward clinical trials in India among patients and patient bystanders visiting the Indian Ophthalmology Clinical Trial Network: A multi-centric, cross-sectional survey. Indian J Ophthalmol 2023; 71:3335-3342. [PMID: 37787231 PMCID: PMC10683704 DOI: 10.4103/ijo.ijo_3035_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 06/16/2023] [Accepted: 06/22/2023] [Indexed: 10/04/2023] Open
Abstract
Purpose Advances in patient treatment depend heavily on clinical trials (CTs). Patient volunteers for CT are tougher to recruit and retain. In order to administer CTs effectively, it is necessary to comprehend how the public views and perceives participating in them. The study assessed the perception and attitudes of patients and bystanders toward CTs in India. Methods This was a multi-centric, cross-sectional study among patients and bystanders using a questionnaire that consisted of socio-demographic characteristics and questions on knowledge and attitude toward participation in CTs. The minimum sample size estimated for the survey was 750. Results A total of 1260 respondents (patients and bystanders) had participated in the survey. 42% of total respondents were aware about CTs. Unawareness regarding (i) voluntary power of an individual to participate in a CT (only 47%), (ii) entitled benefits of free treatment and medical insurance during enrolment in a CT (only 47%), and (iii) only 16% of the respondents knew involvement of human subjects in CT were the major highlights among those who had prior knowledge about CTs. Education was the most pervasive factor in shaping positive perception among the respondents. Occupation was another ubiquitous factor in shaping their perception regarding CTs. Conclusion The majority of respondents were not aware of CTs. The major concerns observed were time consumption and harmful nature of CTs that influenced their unwillingness to participate in CTs. Initiatives such as awareness campaigns and survey assessments that would result in scientifically effective health service policies would be strategic methods to enhance CT participation.
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Affiliation(s)
- Gopal S Pillai
- Department of Ophthalmology and Chief of Vitreo- Retinal Services, Amrita Institute of Medical Sciences, Kochi, Kerala, India
| | - CS Sheeba
- Department of Ophthalmology, Regional Institute of Ophthalmology, Thiruvananthapuram, Kerala, India
| | - Manabjyoti Barman
- Department of Vitreo-Retina, Sri Sankaradeva Nethralaya, Guwahati, Assam, India
| | - Alok Sen
- Head of Department of Vitreo-Retina and Uvea, Sri Sadguru Netra Chikitsalaya (SNC), Chitrakoot, Madhya Pradesh, India
| | - Natarajan Sundaram
- Chief of Vitreo-Retinal Services Department, Aditya Jyot Eye Hospital Pvt. Ltd. (AJEH), Mumbai, Maharashtra, India
| | - Merin Dickson
- IOCTN-BIRAC Project, AIMS Kochi, Kerala, Amrita Institute of Medical Sciences, Kochi, Kerala, India
| | - Shamilin Joyal
- IOCTN-BIRAC Project, AIMS Kochi, Kerala, Amrita Institute of Medical Sciences, Kochi, Kerala, India
| | - Manjisa Choudhury
- IOCTN - BIRAC Project, Sri Sankaradeva Nethralaya, Guwahati, Assam, Sri Sankaradeva Nethralaya, Guwahati, Assam, India
| | - Merlin M Joy
- IOCTN-BIRAC Project, AIMS Kochi, Kerala, Amrita Institute of Medical Sciences, Kochi, Kerala, India
| | - KG Deepthi
- IOCTN - BIRAC Project, RIO Thiruvanthapuram, Kerala, Regional Institute of Ophthalmology, Thiruvananthapuram, Kerala, India
| | - Poonam Jangid
- IOCTN - BIRAC Project, SNC Chitrakoot, Madhya Pradesh, Shri Sadguru Netra Chikitsalaya, Chitrakoot, Madhya Pradesh, India
| | - Anjana Abhilash
- IOCTN - BIRAC Project, AJEH, Mumbai, Maharashtra, Aditya Jyot Eye Hospital Pvt. Ltd., Mumbai, Maharashtra, India
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Chakraborty D. Commentary on 'Attitude and perception toward clinical trials in India among patients and patient bystanders visiting Indian ophthalmology clinical trial network: A multicentric, cross-sectional survey'. Indian J Ophthalmol 2023; 71:3342-3343. [PMID: 37787232 PMCID: PMC10683698 DOI: 10.4103/ijo.ijo_1743_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023] Open
Affiliation(s)
- Debdulal Chakraborty
- Department of Vitreo-Retinal Services, Disha Eye Hospitals, Kolkata, West Bengal, India
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Pillai GS, Sheeba CS, Barman M, Sen A, Sundaram N, Dickson M, Joyal S, Choudhury M, Joy MM, Deepthi KG, Jangid P, Dudwadkar S. Knowledge and perception of health-care professionals on clinical trials in India: A pan-Indian cross-sectional survey. Indian J Ophthalmol 2023; 71:2866-2872. [PMID: 37417136 PMCID: PMC10491074 DOI: 10.4103/ijo.ijo_3048_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Revised: 04/03/2023] [Accepted: 04/06/2023] [Indexed: 07/08/2023] Open
Abstract
Purpose The purpose of the study was to evaluate the knowledge and perception of health-care professionals (HCPs), such as doctors/surgeons, pharmacists, nurses, optometrists, and lab technicians, on clinical trials (CTs) in India. Methods The study was a pan-Indian cross-sectional survey initiated by the Indian Ophthalmology Clinical Trial Network (IOCTN) by using a previously validated questionnaire for three months of data collection. An online survey was used to record information regarding demographics, CT knowledge, and CT perception among HCPs. Results A total of 630 responses were recorded from HCPs: 207 doctors and surgeons, 159 pharmacists, and 264 laboratory technicians, nurses, and optometrists across India. Over 90% of HCPs had a clear knowledge on the purpose of CTs, the informed consent (IC) process, ethical approval by the Drugs Controller General of India (DCGI). About 80% and 90% were aware of confidentiality of patients, voluntariness of participation, and good clinical practice. Surprisingly, less than 50% had lesser knowledge regarding monetary incentives of CT participants (CTPs). A slightly positive perception was observed regarding the potential benefits of CTPs, compensation related to injury, and importance of obtaining IC. Less than 50% had a negative perception that monetary compensation to CTPs led to bias and deprivation of standard treatments. However, no significant difference was observed between other aspects of demographics and perception regarding CTs. Conclusion We observed doctors and surgeons to be having the highest regarding CTs, followed by pharmacists. The survey highlighted the necessity of scheduling awareness programs among the HCPs, which would improve their misconceptions and perception of CTs while interacting with patients for CT enrollment.
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Affiliation(s)
- Gopal S Pillai
- Head of Department of Ophthalmology and Chief of Vitreo-Retinal Services, Amrita Institute of Medical Sciences (AIMS), Kochi, Kerala, India
| | - C S Sheeba
- Director and Head of Department of Opthalmology, Regional Institute of Ophthalmology, RIO Thiruvanthapuram, Kerala, India
| | - Manabjyoti Barman
- Head of Department of Vitreo-Retina, Sri Sankaradeva Nethralaya, Guwahati, Assam, India
| | - Alok Sen
- Head of Department of Vitreo-Retina and Uvea, Shri Sadguru Netra Chikitsalaya (SNC), Chitrakoot, Madhya Pradesh, India
| | - Natarajan Sundaram
- Chief of Vitreo-Retinal Services Department, Aditya Jyot Eye Hospital Pvt. Ltd. (AJEH), Mumbai, Maharashtra, India
| | | | | | - Manjisa Choudhury
- IOCTN-BIRAC Project, Sri Sankaradeva Nethralaya, Guwahati, Assam, India
| | | | - K G Deepthi
- IOCTN-BIRAC Project, RIO Thiruvanthapuram, Kerala, India
| | - Poonam Jangid
- IOCTN-BIRAC Project, SNC, Chitrakoot, Madhya Pradesh, India
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Boisvert-Huneault C, Trigos Herraez D, Pinter A, Kobayashi S, Bell S, Kallsen K, Gloede T, Yagi N, Brunette S, Datsenko Y, Baehner F, Clerisme-Beaty E, Van de Kerkhof P. Understanding potential participation barriers to improve trial design and outcomes: clinical trial simulation in palmoplantar pustulosis as a case study. BMJ Open 2023; 13:e064159. [PMID: 37094891 PMCID: PMC10151841 DOI: 10.1136/bmjopen-2022-064159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 03/09/2023] [Indexed: 04/26/2023] Open
Abstract
OBJECTIVES Evaluate the experiences and perceptions of patients participating in a simulated clinical trial and identify ways to enhance future patient-centric trial designs. DESIGN International, multicentre, non-interventional, virtual clinical trial visits with patient debriefs and advisory boards. SETTING Virtual clinic visits and accompanying advisory boards. PARTICIPANTS Nine patients with palmoplantar pustulosis for simulated trial visits; 14 patients and patient representatives for advisory boards. MAIN OUTCOME MEASURES Qualitative responses to trial documentation, visit schedule and logistics, and trial design were collected during patient debriefs. Results were discussed at two virtual advisory board meetings. RESULTS Patients identified key barriers to participation and potential difficulties encountered when attending trial visits and completing assessments. They also proposed recommendations to overcome these challenges. Patients recognised the need for comprehensive informed consent forms, but recommended use of non-technical language, brevity and additional support to aid understanding. Other trial documentations should be relevant to the disease and include known efficacy and safety of the study drug. Patients were concerned about receiving placebo, stopping existing medications and being unable to receive the study drug after trial completion; therefore, patients and physicians recommended an open-label extension following trial completion. Trial visits were too numerous (n=20) and too long (3-4 hours each); patients recommended improvements to the design to make best use of their time and reduce unnecessary waiting. They also requested financial and logistical support. Patients expressed a desire for study outcomes that matter to them, related to their ability to undertake normal daily activities and not be a burden to others. CONCLUSIONS Simulated trials are an innovative method for assessing trial design and acceptance from a patient-centric perspective, enabling specific improvements to be made prior to trial initiation. Incorporation of recommendations from simulated trials could enhance trial recruitment and retention, and optimise trial outcomes and data quality.
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Affiliation(s)
| | - David Trigos Herraez
- EUROPSO, European Umbrella Federation for Psoriasis Associations, Polzela, Slovenia
| | - Andreas Pinter
- Department of Dermatology, Venereology and Allergology, University Hospital Frankfurt am Main, Frankfurt am Main, Germany
| | - Satomi Kobayashi
- Department of Dermatology, Seibo International Catholic Hospital, Tokyo, Japan
| | - Stacie Bell
- National Psoriasis Foundation, Portland, Oregon, USA
| | | | - Tristan Gloede
- Boehringer Ingelheim Pharmaceuticals Inc, Ridgefield, Connecticut, USA
| | | | - Steven Brunette
- Boehringer Ingelheim Pharmaceuticals Inc, Ridgefield, Connecticut, USA
| | - Yakov Datsenko
- Boehringer Ingelheim International GmbH, Biberach, Germany
| | - Frank Baehner
- Boehringer Ingelheim International GmbH, Ingelheim, Germany
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Chatio ST, Ganle JK, Adongo PB, Beisel U. Factors affecting trust in clinical trials conduct: Views of stakeholders from a qualitative study in Ghana. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001178. [PMID: 36963012 PMCID: PMC10022335 DOI: 10.1371/journal.pgph.0001178] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 02/20/2023] [Indexed: 03/17/2023]
Abstract
Evidence exists that scientists' dehumanization and exploitation of people in the name of science led to suspicion and mistrust in clinical trials conduct. In Ghana, there are equally signs of public distrust in the conduct of biomedical research. Typical examples are the unsuccessful conduct of the Ebola vaccine trial and the initial refusal of parents to allow their children to receive the recently piloted malaria vaccine in Ghana. Therefore, this study explored participants' views on factors affecting trust in clinical trials conduct in Ghana. This was a cross-sectional exploratory study using qualitative research approach. Forty-eight in-depth interviews and Key informant interviews were conducted with stakeholders. Purposive sampling technique was used to select participants. All the interviews were recorded, transcribed and coded into themes using QSR Nvivo 12 software to aid thematic analysis. Overall, participants saw the need for the conduct of clinical trials in Ghana because clinical trial studies enable scientists to come out with effective medicines for the management of diseases. Pre-implementation factors such as inadequate stakeholder engagement, rumours and negative influence affected trust. Implementation factors such as perceived risks about clinical trials medicines, apprehensions on drawing and use of blood samples, poor informed consent administration and perceived no illness all negatively affected trust in clinical trials conduct. Trust is a fundamental factor affecting a successful conduct of clinical trials. Thus, there is need for collective efforts by all stakeholders including research institutions and clinical trial regulatory bodies to take the issue of trust in clinical trials conduct seriously.
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Affiliation(s)
- Samuel Tamti Chatio
- Department of Social Science, Navrongo Health Research Centre, Navrongo, Ghana
| | - John Kuumuori Ganle
- School of Public Health, Colleague of Health Sciences, University of Ghana, Legon, Accra, Ghana
| | - Philip Baba Adongo
- School of Public Health, Colleague of Health Sciences, University of Ghana, Legon, Accra, Ghana
| | - Ulrike Beisel
- Department of Geography, University of Berlin, Berlin, Germany
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Paramasivan S, Davies P, Richards A, Wade J, Rooshenas L, Mills N, Realpe A, Raj JP, Subramani S, Ives J, Huxtable R, Blazeby JM, Donovan JL. What empirical research has been undertaken on the ethics of clinical research in India? A systematic scoping review and narrative synthesis. BMJ Glob Health 2021; 6:e004729. [PMID: 34006518 PMCID: PMC8137180 DOI: 10.1136/bmjgh-2020-004729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Revised: 02/13/2021] [Accepted: 02/24/2021] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION The post-2005 rise in clinical trials and clinical research conducted in India was accompanied by frequent reports of unethical practices, leading to a series of regulatory changes. We conducted a systematic scoping review to obtain an overview of empirical research pertaining to the ethics of clinical trials/research in India. METHODS Our search strategy combined terms related to ethics/bioethics, informed consent, clinical trials/research and India, across nine databases, up to November 2019. Peer-reviewed research exploring ethical aspects of clinical trials/research in India with any stakeholder groups was included. We developed an evidence map, undertook a narrative synthesis and identified research gaps. A consultation exercise with stakeholders in India helped contextualise the review and identify additional research priorities. RESULTS Titles/Abstracts of 9699 articles were screened, full text of 282 obtained and 80 were included. Research on the ethics of clinical trials/research covered a wide range of topics, often conducted with little to no funding. Studies predominantly examined what lay (patients/public) and professional participants (eg, healthcare staff/students/faculty) know about topics such as research ethics or understand from the information given to obtain their consent for research participation. Easily accessible groups, namely ethics committee members and healthcare students were frequently researched. Research gaps included developing a better understanding of the recruitment-informed consent process, including the doctor-patient interaction, in multiple contexts and exploring issues of equity and justice in clinical trials/research. CONCLUSION The review demonstrates that while a wide range of topics have been studied in India, the focus is largely on assessing knowledge levels across different population groups. This is a useful starting point, but fundamental questions remain unanswered about informed consent processes and broader issues of inequity that pervade the clinical trials/research landscape. A priority-setting exercise and appropriate funding mechanisms to support researchers in India would help improve the clinical trials/research ecosystem.
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Affiliation(s)
- Sangeetha Paramasivan
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- University Hospitals Bristol NHS Foundation Trust, NIHR ARC West, Bristol, UK
| | - Philippa Davies
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- Medical Research Council (MRC) ConDuCT-II Trials Methodology Hub, Bristol Medical School, University of Bristol, Bristol, UK
| | - Alison Richards
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- Medical Research Council (MRC) ConDuCT-II Trials Methodology Hub, Bristol Medical School, University of Bristol, Bristol, UK
| | - Julia Wade
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Leila Rooshenas
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- University Hospitals Bristol NHS Foundation Trust, NIHR ARC West, Bristol, UK
| | - Nicola Mills
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- University Hospitals Bristol NHS Foundation Trust, NIHR ARC West, Bristol, UK
| | - Alba Realpe
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- University Hospitals Bristol NHS Foundation Trust, NIHR ARC West, Bristol, UK
| | - Jeffrey Pradeep Raj
- Department of Clinical Pharmacology, Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, India
| | - Supriya Subramani
- Institute of Biomedical Ethics and History of Medicine, University of Zurich, Zurich, Switzerland
| | - Jonathan Ives
- Centre for Ethics in Medicine, University of Bristol, Bristol, UK
| | - Richard Huxtable
- Centre for Ethics in Medicine, University of Bristol, Bristol, UK
| | - Jane M Blazeby
- University Hospitals Bristol NHS Foundation Trust, NIHR ARC West, Bristol, UK
- University Hospitals Bristol NHS Foundation Trust, NIHR Bristol Biomedical Research Centre, Bristol, UK
| | - Jenny L Donovan
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- University Hospitals Bristol NHS Foundation Trust, NIHR ARC West, Bristol, UK
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Figer BH, Lamture SS, Gandhi T, Chauhan A, Gvalani A, Gogtay NJ, Thatte UM. A survey of knowledge and variables influencing perceptions about clinical research: A cross-sectional study from Mumbai. Perspect Clin Res 2020; 12:93-99. [PMID: 34012906 PMCID: PMC8112328 DOI: 10.4103/picr.picr_97_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Revised: 06/24/2019] [Accepted: 09/24/2019] [Indexed: 11/04/2022] Open
Abstract
Purpose Clinical research in India has been besieged by controversies. While studies have addressed other stakeholders, few have addressed the patient. The present study was conducted to assess the extent of awareness and understanding about the nature and conduct of CR among people of Mumbai. Methods Institutional Ethics Committee approval was taken (EC/OA-12/15) and written informed consent was obtained. Adults who were residents of Mumbai were enrolled. A prevalidated and published 48-item questionnaire based on six themes, namely awareness and participation, voluntariness and autonomy, compensation, confidentiality, safety, and involvement in CR were administered. Perception based on themes and association of variables such as age, gender, socioeconomic class, and education on this perception was assessed. Descriptive statistics along with Chi-square test/Chi-square test for trend and crude odds ratio (cOR) were assessed. Results Of the 453 participants approached, 400 (age 32 [18-96]) consented. Only 210/400 (52.5%) were aware of CR and 194/400 (48.5%) said they needed permission for participation. Only 226/400 (56.5%) were aware of their rights and 111/400 (27.75%) felt that clinical trial participants received compensation. The socioeconomic class influenced awareness of CR (P < 0.00001; r 2= 0.495) as did the age (P < 0.0001; r 2= 0.82). Men were less likely to need permission to participate relative to women (cOR [95% confidence interval (CI)] 2.47 [1.6, 3.6] [P < 0.00001]). Those who had heard of CR were twice more willing to participate (cOR [95% CI] 1.72 (1.2, 2.6); P = 0.008). Conclusions There is a greater need to improve awareness, especially about safety, compensation, and confidentiality in CR.
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Affiliation(s)
- Brinal H Figer
- Department of Clinical Pharmacology, Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, India
| | - Swastika S Lamture
- Department of Clinical Pharmacology, Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, India
| | - Tanmay Gandhi
- Department of Clinical Pharmacology, Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, India
| | - Ashnik Chauhan
- Department of Clinical Pharmacology, Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, India
| | - Anchal Gvalani
- Department of Clinical Pharmacology, Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, India
| | - Nithya Jaideep Gogtay
- Department of Clinical Pharmacology, Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, India
| | - Urmila Mukund Thatte
- Department of Clinical Pharmacology, Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, India
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Attitude of Asian Parkinson Patients towards Clinical Research and Tissue Donation. PARKINSONS DISEASE 2020; 2020:2542756. [PMID: 32148750 PMCID: PMC7049864 DOI: 10.1155/2020/2542756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 01/23/2020] [Accepted: 01/29/2020] [Indexed: 11/18/2022]
Abstract
Objective The success of clinical research and tissue donation programs are highly dependent on recruitment of willing volunteers. A comprehensive survey of patient preferences and attitudes can help identify and address barriers hindering the recruitment for research. Method This is a cross-sectional study on 105 Parkinson's disease patients who completed an interviewer-administered questionnaire. Results Out of 105 respondents, 48% of patients had either already participated in clinical research or were keen to participate. About 80% believed clinical research to be safe for their health and privacy. More than 70% of participants were willing to donate blood, urine, or stool, while 16% were agreeable for cerebrospinal fluid sample donation. Motivating factors for clinical research included altruism (64%) and contribution to advance medical knowledge (64%). Common reasons for unwillingness towards clinical research included the risks involved (43%), time constraints (33%), and mobility challenges (24%). Conclusion The attitude of Singaporean Parkinson patients toward clinical research and tissue donation is encouraging with about half of the participants willing to support clinical research. Three-quarters of patients would support tissue donations. Participation in research may be further increased with greater patient and public education to overcome misconceptions and also by limiting the demands of studies.
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Al-Rawashdeh N, Damsees R, Al-Jeraisy M, Al Qasim E, Deeb AM. Knowledge of and attitudes toward clinical trials in Saudi Arabia: a cross-sectional study. BMJ Open 2019; 9:e031305. [PMID: 31641002 PMCID: PMC6830621 DOI: 10.1136/bmjopen-2019-031305] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES Clinical trials (CTs) are considered an important method for developing new treatments and providing access to potentially effective drugs that are still under investigation. Measuring the public's knowledge of and attitudes toward CTs is important for assessing their readiness for and acceptance of human drug testing, which has previously not been assessed in the Kingdom of Saudi Arabia (KSA). The objective of this study is to explore the Saudi public's knowledge of and attitudes toward CTs as well as participation in trials to test new or approved drugs. DESIGN Cross-sectional. SETTING The 2016 Al Jenadriyah cultural/heritage festival in Riyadh, KSA. PARTICIPANTS Participating booths and exhibition halls, as well as festival visitors, were approached to participate in the study. PRIMARY AND SECONDARY OUTCOME MEASURES Knowledge of and attitudes toward CTs. RESULTS The final number of participants was 938. The responses were converted to a percentage mean score (out of 100) for each knowledge-related response and attitude. The total mean knowledge score was 56.8±24.8 and the attitude-related score was 61.5±28.0. Although most of the participants supported testing approved or off-label and new drugs on adult and paediatric patients, only a third (30.5%) agreed that new drugs could be tested on healthy volunteers. The results indicated that gender, educational level, income, medical background, age and health insurance were independently associated with the level of knowledge of CTs. In terms of attitudes toward CTs, the factors that were independently associated were gender, educational level and medical background. CONCLUSIONS The Saudi public has a low level of knowledge and a moderately positive attitude toward CTs. There is a moderate positive correlation between the two factors such that as knowledge of CTs increases, the Saudi public will hold more positive attitudes toward CTs.
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Affiliation(s)
- Nedal Al-Rawashdeh
- Research Office, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
- The Office of Scientific Affairs and Research, King Hussein Cancer Center, Amman, Jordan
- King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- Ministry of the National Guard - Health Affairs, Riyadh, Saudi Arabia
| | - Rana Damsees
- Research Office, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
- The Office of Scientific Affairs and Research, King Hussein Cancer Center, Amman, Jordan
- King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- Ministry of the National Guard - Health Affairs, Riyadh, Saudi Arabia
| | - Majed Al-Jeraisy
- Research Office, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
- King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- Ministry of the National Guard - Health Affairs, Riyadh, Saudi Arabia
| | - Eman Al Qasim
- Research Office, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
- King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- Ministry of the National Guard - Health Affairs, Riyadh, Saudi Arabia
| | - Ahmad M Deeb
- Research Office, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
- King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- Ministry of the National Guard - Health Affairs, Riyadh, Saudi Arabia
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11
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Abstract
INTRODUCTION: Clinical trials are integral to innovation in the treatment modalities and are conducted to assess the safety and efficacy of novel drugs. Clinical trials of modern era have evolved through stern consequences and tragedies in the past. This study was designed to know knowledge on ethics, adverse drug reactions (ADRs), and tragedies in clinical trials among interns and postgraduates (PGs). METHODOLOGY: A cross-sectional study was carried out on graduates undergoing internship (interns) and PG residents of a medical college and a dental college from Punjab. This descriptive cross-sectional study was conducted on 151 professionals of medical college and 100 professionals of dental colleges in Punjab with the help of a prevalidated questionnaire. The data were then analyzed using descriptive statistics. RESULTS: There was no significant difference between dental and medical doctors regarding ethics and ADRs, but a significant difference was observed among interns and PG residents, with interns having higher awareness regarding ethics and ADRs. There was no significant difference (P = 0.941) in knowledge among dental and medical doctors as well as among interns and PG residents, with P = 0.264 about tragedies in clinical trials. CONCLUSION: From the study, it can be concluded that interns and PGs do not get enough exposure to basics in clinic research such as research ethics, ADRs, and tragedies in clinical trials. It is suggested that there is a requirement for suitable modifications in the teaching curriculum at undergraduate level and regular training must be provided to professionals.
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Affiliation(s)
- Sonu Gupta
- Department of Clinical Research, Dasmesh Institute of Research and Dental Sciences, Faridkot, Punjab, India
| | - Ravinder Nath Bansal
- Department of Hospital Management, Guru Gobind Singh Medical Hospital, Faridkot, Punjab, India
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12
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McCaughan E, Curran C, Northouse L, Parahoo K. Evaluating a psychosocial intervention for men with prostate cancer and their partners: Outcomes and lessons learned from a randomized controlled trial. Appl Nurs Res 2018; 40:143-151. [PMID: 29579490 DOI: 10.1016/j.apnr.2018.01.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Revised: 01/08/2018] [Accepted: 01/19/2018] [Indexed: 10/18/2022]
Abstract
AIM This study evaluated the process and outcome of a psychosocial intervention for men with prostate cancer and their partners. As more men survive prostate cancer, they and their partners need help and support to help them cope with the physical and psychosocial effects of the disease and treatment. There is a lack of psychosocial interventions for men with prostate cancer and their partners. METHODS A randomized controlled trial was conducted with 34 participants to measure the effects of the intervention on selected psychosocial outcomes, post-intervention and at one month' follow-up. The nine-week program (CONNECT) consisted of three group and two telephone sessions. It focused on symptom management, sexual dysfunction, uncertainty management, positive thinking and couple communication. The outcomes, measured by validated tools were: self-efficacy, quality of life, symptom distress, communication, uncertainty and illness benefits. RESULTS The men in the intervention group did better on two outcomes (communication and support) than controls. Partners in the intervention group did better than controls on most outcomes. Less participants than expected participated in the trial. The reasons for non-participation included partners not wishing to participate, men not interested in group work, and not understanding the core purpose of the intervention. The cost of training facilitators and for delivering the intervention appeared to be low. CONCLUSION The knowledge generated from this study will be beneficial for all those grappling with the challenges of developing, implementing and evaluating complex psychosocial interventions. This study has also highlighted the difficulties in recruiting men and their partners in clinical trials.
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Affiliation(s)
- Eilis McCaughan
- Institute of Nursing and Health Research, University of Ulster, Newtownabbey, UK.
| | - Carol Curran
- Faculty of Life Sciences, Ulster University, Newtownabbey, UK.
| | | | - Kader Parahoo
- Institute of Nursing and Health Research, University of Ulster, Newtownabbey, UK.
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13
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Choudhury S, Pradhan R, Dubey L, Barman L, Biswas T, Das M, Chatterjee S. Knowledge and perception regarding clinical trials among doctors of government medical colleges: A questionnaire-based study. Perspect Clin Res 2016; 7:94-9. [PMID: 27141476 PMCID: PMC4840798 DOI: 10.4103/2229-3485.179433] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
AIMS By virtue of being a specialized field by itself, the science of clinical trials (CTs) may not be well understood by doctors who are not specifically trained in it. A lack of knowledge may translate to a negative perception toward CT. With the idea of getting a situational snapshot, we estimated the knowledge and perception of CTs among doctors from government medical colleges of West Bengal who are not trained on CT in their postgraduate curriculum. Several determinants of knowledge and perception regarding CT were also evaluated. METHODS We have quantified the knowledge and perception of CTs by a structured validated questionnaire. Development and validation of the questionnaire was performed prior to the study. RESULTS Among 133 participants, 7.5% received focused training on CT and 16.5% participated in CTs as investigators. Majority of the doctors were unfamiliar with the basic terminologies such as, "adverse event" and "good clinical practice." Encouragingly, 93.3% doctors advised that a detailed discussion of CT methodology should be incorporated in the under graduate medical science curriculum. They had an overall positive attitude toward CTs conducted in India, with a mean score that is 72.6% of the maximum positive score. However, a large number of the doctors were skeptical about the primary motivation and operations of pharmaceutical industry sponsored CTs, with 45% of them believing that patients are exploited in these sponsored CTs. CONCLUSION Participant doctors had a basic knowledge of CT methodology. The study has revealed specific areas of deficient knowledge, which might be emphasized while designing focused training on CT methodology.
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Affiliation(s)
- Supriyo Choudhury
- Department of Pharmacology, College of Medicine and Sagore Dutta Hospital, Kolkata, West Bengal, India
| | - Richeek Pradhan
- Department of Pharmacology, Institute of Postgraduate Medical Education and Research Kolkata, West Bengal, India
| | - Lily Dubey
- Department of Pharmacology, Institute of Postgraduate Medical Education and Research Kolkata, West Bengal, India
| | - Lisa Barman
- Department of Pharmacology, College of Medicine and Sagore Dutta Hospital, Kolkata, West Bengal, India
| | - Tanmoy Biswas
- Department of Pharmacology, Murshidabad Medical College and Hospital, Berhampore, West Bengal, India
| | - Manisha Das
- Department of Pharmacology, College of Medicine and Sagore Dutta Hospital, Kolkata, West Bengal, India
| | - Suparna Chatterjee
- Department of Pharmacology, Institute of Postgraduate Medical Education and Research Kolkata, West Bengal, India
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14
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Akazili J, Chatio S, Achana FS, Oduro A, Kanmiki EW, Baiden F. Factors influencing willingness to participate in new drug trial studies: a study among parents whose children were recruited into these trials in northern Ghana. BMC Res Notes 2016; 9:139. [PMID: 26936043 PMCID: PMC4776433 DOI: 10.1186/s13104-016-1951-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2015] [Accepted: 02/23/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND During the last decade, the number of clinical trials conducted in sub-Saharan Africa has increased significantly which has helped to address priority health problems in the region. Navrongo health research centre since it was established in 1989, has conducted several trial studies including rectal artesunate trial in the Kassena-Nankana districts. However, there is little evidence-based for assessing the impact of new drug trials. This study explored factors that motivate parents to allow their children to participate in new drug trials in northern Ghana. METHOD The study used both quantitative and qualitative methods. The participants were randomly selected from among parents whose children were enrolled in a new drug trial conducted in the Kassena-Nankana districts between 2000 and 2003. QSR Nvivo 9 software was used to code the qualitative data into themes before analysis while STATA software Version 11.2© was used to analyze the quantitative data. RESULTS The results showed that majority (95.9%) of the parents were willing to allow their children to be enrolled in future new drug trials. The main factors motivating their willingness to allow their children to be enrolled in these trials were quality of health care services offered to trial participants (92.9%), detail medical examination (90.8%), promptness of care provided (94.4%) and quality of drugs (91.9%). Other factors mentioned included disease prevention (99.5%) and improved living standard (96.1%). Parents reported that the conduct of these trials had reduced the frequency of disease occurrences in the communities because of the quality of health care services provided to the children recruited into these trial studies. CONCLUSION Though the implementation of clinical trials in the study area is believed to have positive impact on health status of people particularly trial participants, measures should however be taken to address safety and likely side effects of new drugs given to trial participants during these trial studies.
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Affiliation(s)
- James Akazili
- Navrongo Health Research Centre, P.O Box 114, Navrongo, Ghana.
| | - Samuel Chatio
- Navrongo Health Research Centre, P.O Box 114, Navrongo, Ghana.
| | | | - Abraham Oduro
- Navrongo Health Research Centre, P.O Box 114, Navrongo, Ghana.
| | | | - Frank Baiden
- Ensign College of Public Health, ER, Kpong, Ghana.
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15
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Ciurtin C, Leandro M, Fitz-Clarence H, Nguyen H, Walsh SB, Isenberg DA. Clinical trials perception in rheumatology patients: experience from a single rheumatology tertiary center. J Rheumatol 2015; 42:988-93. [PMID: 25834209 DOI: 10.3899/jrheum.141091] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/06/2015] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To investigate the perception and willingness of rheumatology patients to participate in clinical trials. No previous similar studies are available. METHODS We conducted a cross-sectional survey of rheumatology patients using a questionnaire, which comprised 2 demographic questions, two 5-point Likert opinion questions, 19 true/false/unsure knowledge questions, and 1 open question addressing what would help the participant to gain a better understanding about clinical trials. RESULTS Eighty-five patients returned the questionnaires (response rate 84.1%). The mean number of correct answers to the 19 knowledge questions was 10.5 ± 2.87. Patients with higher versus lower levels of education had significantly higher knowledge scores (mean correct answers 59.4 ± 13.1 vs 39.8 ± 20.4, p = 0.013). They also expressed greater willingness to take part in research (87.5% vs 48.2%, p < 0.001). The patients who agreed to participate in research provided significantly more correct answers (59.4 ± 15.3% vs 47.7 ± 27.2%, p = 0.032). Poor disease control as the main reason to join a clinical trial correlated well with patients' previous participation in research (r = 0.71; p < 0.05) and the lack of understanding of research principles (defined as less than 50% correct answers to the knowledge questions) correlated with the lack of willingness to participate in clinical trials (r = 0.72; p < 0.05). CONCLUSION The results of our study revealed that patients lack information about clinical trials (the correct response rate was only slightly above 50%), and that they had a moderate willingness to take part in clinical trials. The need for educational programs about clinical research was highlighted by the participants to the survey.
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Affiliation(s)
- Coziana Ciurtin
- From the Department of Rheumatology, University College London Hospitals National Health Service (NHS) Foundation Trust; Centre for Nephrology, University College London, London, UK.C. Ciurtin, PhD, Consultant Rheumatologist; M. Leandro, PhD, Consultant Rheumatologist; H. Fitz-Clarence, PhD, Consultant Rheumatologist; H. Nguyen, MSc, Rheumatology Researcher; D.A. Isenberg, MD, Academic Director, Centre for Rheumatology Research, Department of Rheumatology, University College London Hospitals NHS Foundation Trust; S.B. Walsh, PhD, Senior Lecturer in Experimental Medicine and Honorary Consultant Nephrologist, Centre for Nephrology, University College London.
| | - Maria Leandro
- From the Department of Rheumatology, University College London Hospitals National Health Service (NHS) Foundation Trust; Centre for Nephrology, University College London, London, UK.C. Ciurtin, PhD, Consultant Rheumatologist; M. Leandro, PhD, Consultant Rheumatologist; H. Fitz-Clarence, PhD, Consultant Rheumatologist; H. Nguyen, MSc, Rheumatology Researcher; D.A. Isenberg, MD, Academic Director, Centre for Rheumatology Research, Department of Rheumatology, University College London Hospitals NHS Foundation Trust; S.B. Walsh, PhD, Senior Lecturer in Experimental Medicine and Honorary Consultant Nephrologist, Centre for Nephrology, University College London
| | - Halina Fitz-Clarence
- From the Department of Rheumatology, University College London Hospitals National Health Service (NHS) Foundation Trust; Centre for Nephrology, University College London, London, UK.C. Ciurtin, PhD, Consultant Rheumatologist; M. Leandro, PhD, Consultant Rheumatologist; H. Fitz-Clarence, PhD, Consultant Rheumatologist; H. Nguyen, MSc, Rheumatology Researcher; D.A. Isenberg, MD, Academic Director, Centre for Rheumatology Research, Department of Rheumatology, University College London Hospitals NHS Foundation Trust; S.B. Walsh, PhD, Senior Lecturer in Experimental Medicine and Honorary Consultant Nephrologist, Centre for Nephrology, University College London
| | - Hanh Nguyen
- From the Department of Rheumatology, University College London Hospitals National Health Service (NHS) Foundation Trust; Centre for Nephrology, University College London, London, UK.C. Ciurtin, PhD, Consultant Rheumatologist; M. Leandro, PhD, Consultant Rheumatologist; H. Fitz-Clarence, PhD, Consultant Rheumatologist; H. Nguyen, MSc, Rheumatology Researcher; D.A. Isenberg, MD, Academic Director, Centre for Rheumatology Research, Department of Rheumatology, University College London Hospitals NHS Foundation Trust; S.B. Walsh, PhD, Senior Lecturer in Experimental Medicine and Honorary Consultant Nephrologist, Centre for Nephrology, University College London
| | - Stephen B Walsh
- From the Department of Rheumatology, University College London Hospitals National Health Service (NHS) Foundation Trust; Centre for Nephrology, University College London, London, UK.C. Ciurtin, PhD, Consultant Rheumatologist; M. Leandro, PhD, Consultant Rheumatologist; H. Fitz-Clarence, PhD, Consultant Rheumatologist; H. Nguyen, MSc, Rheumatology Researcher; D.A. Isenberg, MD, Academic Director, Centre for Rheumatology Research, Department of Rheumatology, University College London Hospitals NHS Foundation Trust; S.B. Walsh, PhD, Senior Lecturer in Experimental Medicine and Honorary Consultant Nephrologist, Centre for Nephrology, University College London
| | - David A Isenberg
- From the Department of Rheumatology, University College London Hospitals National Health Service (NHS) Foundation Trust; Centre for Nephrology, University College London, London, UK.C. Ciurtin, PhD, Consultant Rheumatologist; M. Leandro, PhD, Consultant Rheumatologist; H. Fitz-Clarence, PhD, Consultant Rheumatologist; H. Nguyen, MSc, Rheumatology Researcher; D.A. Isenberg, MD, Academic Director, Centre for Rheumatology Research, Department of Rheumatology, University College London Hospitals NHS Foundation Trust; S.B. Walsh, PhD, Senior Lecturer in Experimental Medicine and Honorary Consultant Nephrologist, Centre for Nephrology, University College London
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