“Curiosity is more important than knowledge.”
― Albert Einstein
Today, May 20th is International Clinical Trials’ Day. The aim is to raise awareness and celebrate the research studies that test whether medical treatments are safe and effective. The Irish Times published the winning article for the Health Research Board – Trials Methodology Research Network writing competition yesterday. The winner was Frank Moriarty, a pharmacist undertaking a PhD through the HRB PhD Scholars Programme in Health Services Research (now the SPHeRE programme). You can read his article here.
To celebrate Clinical Trials’ Day here is our two-cents on why clinical trials matter.
We are curious about the world we live in. We can pose a thousand questions and receive a thousand different responses. Depending on our perspectives, we can also ask countless questions about the same topic. Luckily, in our technology driven world, answers are never too far from reach.
Within seconds, Google can answer any question we pose. Using “Boolean operators” and “wildcard” functions, Google hunts for documents, databases, books and any online data, so that we don’t have to. In turn, they not only provide the answer to the question asked, but also to a complex web of possible related questions that Google infers based on how we phrased the query, and our history of online activity. We do not need to go to the library in search of information; Google has the power to provide the answers faster than traditional methods and surveys.
However, sometimes we phrase the question in a strange way. Sometimes Google’s algorithms for prioritising certain answers fail us, by placing popular rather than accurate information at the top of the list. Google does not always necessarily provide the best answers or the correct answers. While this is fine most of the time, when it comes to medical knowledge… the Google-method is simply not sufficient. A best guess won’t do. A popular response isn’t necessarily the best answer. In a curious society bombarded with information, we need a structured means of questioning.
Clinical trials ask questions with the goal of adding to medical knowledge. They answer questions posed by researchers and have led to very important findings relating to the treatment, diagnosis, and prevention of diseases or conditions. Clinical trials allow researchers to answer questions and delve into complex issues in order to discover new ways to improve the quality of life of people with acute and chronic illness, as well as preventing illness in those who are healthy.
Clinical trials are important because they add to our knowledge. A team of researchers, led by a primary investigator or “PI”, develop a plan of action or protocol that outlines the content of the intervention. These interventions may involve medical products, such as testing drugs or devices; procedures; or changes to participants’ behaviour, such as diet, or education to improve doctor-patient communication. Trials can compare a new approach to a standard one that already exists, or to another intervention. Sometimes these novel interventions can be compared to a placebo that contains no active ingredients, or to no intervention.
Clinical trials are necessary because sometimes the Google-method gets it wrong. Unlike a Google search, clinical trials are not conducted by a single individual. The questions are posed by teams of researchers, healthcare professionals, and increasingly, members of the community who are stakeholders in the research in question. Clinical trials do not take mere seconds to return an answer. They often involve an arduous process of discovery. They are the cumulative effort of expertise of those seeking to add to medical knowledge.
Clinical trials can tell us if a different way of doing things could be helpful, harmful, or no different to currently available methods and approaches. They tell us if an intervention is safe. They also tell us if the intervention works, by measuring specific outcomes that are decided on from the beginning. These might include outcomes such as weight, or blood pressure. Clinical trial protocols are plans put together by the research team at the beginning of a project. These protocols ask researchers to outline what they are going to do before they start the research, and make sure that the trial uses an approach that makes sense based on what we already know to answer the question. This helps to explain how an intervention works (or doesn’t!). Statistical analyses tell us more about why it works (or doesn’t!). Researchers are held to universal standards that encourage best practice and govern clinical trials.
Clinical trials answer our questions. However, unlike the “best guess” approach of Google, clinical trial methodologies seek to tell us what works and how. Like Google, the trials are only as good as the questions posed and the methods used. Communication and accountability at all levels of the clinical trial process are necessary to ensure that the right questions are answered in the most appropriate way possible.
We must constantly examine the knowledge we have, but we are more than the questions we ask. Clinical trial research is valuable because it does so much more than churning out a response to a given question. It constantly strives to scrutinise every element of why and how those answers were found to build what we know, and highlight the questions we need to ask in the future.