Transforming Clinical Research in the United States

Transforming Clinical Research in the United States

Author: Institute of Medicine

Publisher: National Academies Press

Published: 2010-10-22

Total Pages: 151

ISBN-13: 0309163358

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An ideal health care system relies on efficiently generating timely, accurate evidence to deliver on its promise of diminishing the divide between clinical practice and research. There are growing indications, however, that the current health care system and the clinical research that guides medical decisions in the United States falls far short of this vision. The process of generating medical evidence through clinical trials in the United States is expensive and lengthy, includes a number of regulatory hurdles, and is based on a limited infrastructure. The link between clinical research and medical progress is also frequently misunderstood or unsupported by both patients and providers. The focus of clinical research changes as diseases emerge and new treatments create cures for old conditions. As diseases evolve, the ultimate goal remains to speed new and improved medical treatments to patients throughout the world. To keep pace with rapidly changing health care demands, clinical research resources need to be organized and on hand to address the numerous health care questions that continually emerge. Improving the overall capacity of the clinical research enterprise will depend on ensuring that there is an adequate infrastructure in place to support the investigators who conduct research, the patients with real diseases who volunteer to participate in experimental research, and the institutions that organize and carry out the trials. To address these issues and better understand the current state of clinical research in the United States, the Institute of Medicine's (IOM) Forum on Drug Discovery, Development, and Translation held a 2-day workshop entitled Transforming Clinical Research in the United States. The workshop, summarized in this volume, laid the foundation for a broader initiative of the Forum addressing different aspects of clinical research. Future Forum plans include further examining regulatory, administrative, and structural barriers to the effective conduct of clinical research; developing a vision for a stable, continuously funded clinical research infrastructure in the United States; and considering strategies and collaborative activities to facilitate more robust public engagement in the clinical research enterprise.


Cardiovascular Disability

Cardiovascular Disability

Author: Institute of Medicine

Publisher: National Academies Press

Published: 2010-12-04

Total Pages: 304

ISBN-13: 030915698X

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The Social Security Administration (SSA) uses a screening tool called the Listing of Impairments to identify claimants who are so severely impaired that they cannot work at all and thus immediately qualify for benefits. In this report, the IOM makes several recommendations for improving SSA's capacity to determine disability benefits more quickly and efficiently using the Listings.


Translational Research in Coronary Artery Disease

Translational Research in Coronary Artery Disease

Author: Wilbert S. Aronow

Publisher: Academic Press

Published: 2015-10-29

Total Pages: 246

ISBN-13: 0128026057

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Translational Research in Coronary Artery Disease: Pathophysiology to Treatment covers the entire spectrum of basic science, genetics, drug treatment, and interventions for coronary artery disease. With an emphasis on vascular biology, this reference fully explains the fundamental aspects of coronary artery disease pathophysiology. Included are important topics, including endothelial function, endothelial injury, and endothelial repair in various disease states, vascular smooth muscle function and its interaction with the endothelium, and the interrelationship between inflammatory biology and vascular function. By providing this synthesis of current research literature, this reference allows the cardiovascular scientist and practitioner to access everything they need from one source. - Provides a concise summary of recent developments in coronary and vascular research, including previously unpublished data - Summarizes in-depth discussions of the pathobiology and novel treatment strategies for coronary artery disease - Provides access to an accompanying website that contains photos and videos of noninvasive diagnostic modalities for evaluation of coronary artery disease


Fundamentals of Clinical Trials

Fundamentals of Clinical Trials

Author: Lawrence M. Friedman

Publisher: Springer Science & Business Media

Published: 1998

Total Pages: 384

ISBN-13: 9780387985862

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This classic reference, now updated with the newest applications and results, addresses the fundamentals of such trials based on sound scientific methodology, statistical principles, and years of accumulated experience by the three authors.


Clinical Trials

Clinical Trials

Author: Curtis L. Meinert

Publisher: Oxford University Press, USA

Published: 1986

Total Pages: 502

ISBN-13: 9780195035681

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The definitive reference work on clinical trials, this book presents a wealth of detailed, practical information on the design, conduct, and analysis of both single center and multicenter trials. No other book on clinical trials offers as much detail as Meinert does on such issues as sample size calculation, stratification and randomization, data systems design, consent form development, publication policies, preparation of funding requests, and reporting procedures.


Registries for Evaluating Patient Outcomes

Registries for Evaluating Patient Outcomes

Author: Agency for Healthcare Research and Quality/AHRQ

Publisher: Government Printing Office

Published: 2014-04-01

Total Pages: 385

ISBN-13: 1587634333

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This User’s Guide is intended to support the design, implementation, analysis, interpretation, and quality evaluation of registries created to increase understanding of patient outcomes. For the purposes of this guide, a patient registry is an organized system that uses observational study methods to collect uniform data (clinical and other) to evaluate specified outcomes for a population defined by a particular disease, condition, or exposure, and that serves one or more predetermined scientific, clinical, or policy purposes. A registry database is a file (or files) derived from the registry. Although registries can serve many purposes, this guide focuses on registries created for one or more of the following purposes: to describe the natural history of disease, to determine clinical effectiveness or cost-effectiveness of health care products and services, to measure or monitor safety and harm, and/or to measure quality of care. Registries are classified according to how their populations are defined. For example, product registries include patients who have been exposed to biopharmaceutical products or medical devices. Health services registries consist of patients who have had a common procedure, clinical encounter, or hospitalization. Disease or condition registries are defined by patients having the same diagnosis, such as cystic fibrosis or heart failure. The User’s Guide was created by researchers affiliated with AHRQ’s Effective Health Care Program, particularly those who participated in AHRQ’s DEcIDE (Developing Evidence to Inform Decisions About Effectiveness) program. Chapters were subject to multiple internal and external independent reviews.