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Better Reporting of Clinical Trial Results
One centralized source of access
“Universal prospective registration of trials in a publicly accessible
repository is a crucial mechanism for ensuring that trials are known about
at the start, to uniquely identify them and to reveal the existence of
unpublished trials.”(5) There is growing support in the scientific and
advocacy communities to require research sponsors to publicly list all
clinical trials — not just treatment trials for serious and life-threatening
conditions — including the outcomes, in a centralized, standardized
database. This would provide information to more patients and give
physicians access to the most complete information they need to practice
evidence-based medicine. It would also inform and speed the development of
new trials and enhance the safety of research participants.
“We really need something that everyone participates in, where we have a
register in a single place and you don't need to go multiple places to try
find the information that you need,” said Dickersin PhD, the
director-designate of the Johns Hopkins Department of Epidemiology’s Center
for Clinical Trials.(1)
"We are told that the information is accessible to us and it is in
peer-reviewed journals which are good vehicles or media for this
information. But what we find is that information is very difficult for us
to access, and in some cases impossible,” said Sharon Terry, President and
CEO of the Genetic Alliance, a patient advocacy organization comprised of
600 nonprofit groups.(9)
"We are told that we could go to medical libraries. Those are not always
easy to get to or accessible from Middletown, Ohio, or [wherever patients]
live,” she said. “We are told we can get these articles by the article from
the publisher. Often the price on those articles is $35, $25, onerous when
you are looking at the number of articles that we need. The ivory tower
mentality of putting the fences around the information is something that we
look forward to being dispersed soon.”(9)
Legislation
Fair Access to Clinical Trials (FACT) Act of 2005
The Fair Access to Clinical Trials (FACT) Act of 2005 (S. 470, H.R. 196) has
been languishing in Congressional committees since February 2005. The
legislation would require expansion of the ClinicalTrials.gov database to
create “a publicly accessible national data bank of information comprised of
a clinical trial registry and clinical trials results database. The database
would include a clinical trials registry accessible to patients and health
care practitioners seeking information related to ongoing clinical trials
for serious or life-threatening diseases and conditions.”(12) The FDA would
also be required to develop a second database — accessible to the scientific
community, health care practitioners, and members of the public —
highlighting all publicly and privately funded clinical trial results,
regardless of outcome. Additionally, the FDA would have to make internal
drug approval and safety reviews publicly available. In order to obtain
approval from a U.S. Institutional Review Board, all clinical trials for
drugs, biologics, and medical devices would have to be registered in the
database before they begin enrollment.(4) Harsh penalties could be imposed
for noncompliance.
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