• Title/Summary/Keyword: Trials

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The Assessment of Risk of Bias on Clinical Trials of Korean Medicine for Alopecia (탈모증의 한약제제 임상연구에 대한 비뚤림 위험 평가)

  • Ryu, Deok-hyun;Roh, Seok-sun
    • Journal of Haehwa Medicine
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    • v.24 no.1
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    • pp.25-36
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    • 2015
  • Objective : This study aims to evaluate a risk of bias by Risk of Bias tool and RoBANS(Risk of Bias Assessment tool for Non-randomized Study) tool for clinical trial papers proving treatment effect of herbs to alopecia and provides the newest reason of effectiveness of herbs to alopecia. Methos : Data were collected through electronic database including NDSL, KISS, KMBASE, Koreantk, OASIS, KoreaMed, KISTI, Pubmd, Cochrane CENTRAL and CINAHL. Two experts in Oriental Medince assessed risk of bias of randomized controlled trials by Cochrane group's Risk of Bias tool and non-randomized controlled trials by RoBANS tool after searching, reviewing and selecting papers. Results : Total number of selected trials is 20 including 4 randomized controlled trials, 13 non-randomized controlled trials and 3 case reports. This study evaluates the risk of bias of 17 papers including 4 randomized controlled trials and 13 non-randomized controlled trials except 3 case reports by risk of bias tool and RoBANS tool. All papers of randomized controlled trials are evaluated unclear for random sequence generation and allocation concealment as there are no word on them. And all papers of non-randomized controlled trials are evaluated unclear for blinding of outcome assessments and relatively low for others. Conclusion : We must try to specify concretely methods of allocation concealment after planning and practicing it for reducing a selection bias in randomized controlled trials. Also report a reason of missing value and blinding outcome assessments. And we have to agonize and mention methods of blinding of researchers for reducing a detection bias in non-randomized controlled trials.

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Assessing Methodological Quality of Acupuncture Clinical Trials of Korea (한국 침 임상시험의 질 평가 및 분석)

  • Park, Ji-Eun;Kang, Kyung-Won;Choi, Sun-Mi
    • Journal of Acupuncture Research
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    • v.24 no.1
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    • pp.127-135
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    • 2007
  • Objectives: To evaluate the methodological quality of Korean Acupuncture Clinical trials Methods : Two independent researchers reviewed 12 protocols of Acupuncture clinical trials which were conducted in Korea 2006. Also, Survey Principal Investigator of those was conducted. We compare the results of protocol review with investigator reponses of actual practice. Quality assessment consisted of 5 items including random sequence generation, randomization method, allocation concealment, subject blinding, assessor blinding. Results : Randomization was performed using the proper procedure to insure that treatment assignment is unbiased and concealed from subjects in all clinical trials, According to protocols, 6(50%) of 12 clinical trials used computer-generated random numbers, 6(50%) remaining trials didn't describe the randomization method. Also all trials used appropriate randomization methods on the basis of the survey results: 8 trials used computer-generated random number, 2 used random table. Of 7 protocols in which allocation concealment was stated, 5(71%) reported appropriate method (Calling a central office or statisticians, Sealed opaque envelopes). However according to survey, 5(42%) of 12 trials used inappropriate allocation concealment (Keeping a master randomization list and referring to when subject entered the trial). In addition, the result of protocol review and survey response was not coincident in 5(42%) trials. Subject blinding was conducted in all except 1 clinical trials. Although 11(92%) of 12 trials were conducted using assessor blinding in actual practice, only 7(58%) reported that in protocol. Conclusion : Although randomization and blinding were conducted adequately, allocation concealment was used inadequately, Not only appropriate allocation concealment, but also every quality assessment item including randomization, blinding should be stated in more detail in protocol.

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Review of Randomized Controlled Trials on Pharmacopuneture Treatment for Musculoskeletal Diseases (무작위대조군연구(RCT)를 중심으로 한 근.골격계 질환의 약침 치료에 관한 고찰)

  • Jang, Min-Ki;Yoon, Eun-Hye;Jung, Chan-Yung;Kim, Eun-Jung;Lee, Seung-Deok;Hwang, Min-Seop;Kim, Kap-Sung
    • Journal of Acupuncture Research
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    • v.26 no.3
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    • pp.149-163
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    • 2009
  • Objectives : The purpose of this study is to review RCTs on pharmacopuncture treatment for musculoskeletal diseases and to establish standards of pharmacopuncture treatment model. Methods : We searched articles up to date of March 2009 via computerized databases of Pubmed, The Journal of Korean Acupuncture & Moxibustion, Journal of Korean institute of Herbal Acupuncture, Journal of Oriental Rehabilitation and Journal of Korean Oriental Medicine. Only Randomized Controlled Trials (RCT) concerning the effects of pharmacopuncture on musculoskeletal diseases. The pharmacopuncture treatment methods were assessed based on STRICTA and items considering the feature of pharmacopuncture. And the methodological quality of the trials was assessed by FEAS and modified Jadad score. Results : Eighteen trials of pharmacopuncture on musculoskeletal diseases were analyzed. Except for 4 trials comparing the effect of SBV and BV, positive outcome was reported in ten trials. Among eighteen trials; most of the trials were about Bee Venom acupuncture, and most of the trials used about five acupuncture points, mainly local acupuncture points. But, the amount of injection to each point and total injection were various. And most of trials were lack in the information about method of stimulation. The adjusted FEAS score ranged from 0 to 12, and modified Jadad scoreranged from 1 to 5. Conclusions: To standardize pharmacopuncture treatment, we need more well-designed, high quality clinical trials. And methodological assessment tools designed for pharmacopuncture treatment are also needed.

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DESIGN AND ANALYSIS OF RANDOMIZED CLINICAL TRIALS REQUIRING PROLONGED OBSERVATION OF EACH PATIENT I. INTRODUCTION AND DESIGN

  • Peto R.;Pike M.C.;Armitage P.;Breslow N.E.;Cox D.R.;Howard S.V.;Mantel N.;Mcpherson K.;Peto J.;Smith P.G.
    • 대한예방의학회:학술대회논문집
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    • 1994.02b
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    • pp.206-233
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    • 1994
  • The Medical Research Council has for some years encouraged collaborative clinical trials in leukaemia and other cancers, reporting the results in the medical literature. One unreported result which deserves such publication is the development of the expertise to design and analyse such trials. This report was prepared by a group of British and American statisticians, but it is intended for people without any statistical expertise. Part!, which appears in this issue, discusses the design of such trials; Part II, which will appear separately in the January 1977 issue of the Journal, gives full instructions for the statistical analysis of such trials by means of life tables and the logrank test, including a worked example, and discusses the interpretation of trial results, including brief reports of particular trials. Both parts of this report are relevant to all clinical trials which study time to death, and would be equally relevant to clinical trials which study time to other particular classes of untoward event: first stroke, perhaps, or first relapse, metastasis, disease recurrence, thrombosis, transplant rejection, or death from a particular cause. Part I, in this issue, collects together ideas that have mostly already appeared in the medical literature, but Part II, next month, is the first simple account yet published for non-statistical physicians of how to analyse efficiently data from clinical trials of survival duration. Such trials include the majority of all clinical trials of cancer therapy; in cancer trials, however, it may be preferable to use these statistical methods to study time to local recurrence of tumour, or to study time to detectable metastatic spread, in addition to studying total survival. Solid tumours can be staged at diagnosis; if this, or any other available information in some other disease is an important determinant of outcome, it can be used to make the overall logrank test for the whole heterogeneous trial population more sensitive, and more intuitively satisfactory, for it will then only be necessary to compare like with like, and not, by chance, Stage I with Stage III.

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Trends in Artificial Intelligence Applications in Clinical Trials: An analysis of ClinicalTrials.gov (임상시험에서 인공지능의 활용에 대한 분석 및 고찰: ClinicalTrials.gov 분석)

  • Jeong Min Go;Ji Yeon Lee;Yun-Kyoung Song;Jae Hyun Kim
    • Korean Journal of Clinical Pharmacy
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    • v.34 no.2
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    • pp.134-139
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    • 2024
  • Background: Increasing numbers of studies and research about artificial intelligence (AI) and machine learning (ML) have led to their application in clinical trials. The purpose of this study is to analyze computer-based new technologies (AI/ML) applied on clinical trials registered on ClinicalTrials.gov to elucidate current usage of these technologies. Methods: As of March 1st, 2023, protocols listed on ClinicalTrials.gov that claimed to use AI/ML and included at least one of the following interventions-Drug, Biological, Dietary Supplement, or Combination Product-were selected. The selected protocols were classified according to their context of use: 1) drug discovery; 2) toxicity prediction; 3) enrichment; 4) risk stratification/management; 5) dose selection/optimization; 6) adherence; 7) synthetic control; 8) endpoint assessment; 9) postmarketing surveillance; and 10) drug selection. Results: The applications of AI/ML were explored in 131 clinical trial protocols. The areas where AI/ML was most frequently utilized in clinical trials included endpoint assessment (n=80), followed by dose selection/optimization (n=15), risk stratification/management (n=13), drug discovery (n=4), adherence (n=4), drug selection (n=1) and enrichment (n=1). Conclusion: The most frequent application of AI/ML in clinical trials is in the fields of endpoint assessment, where the utilization is primarily focuses on the diagnosis of disease by imaging or video analyses. The number of clinical trials using artificial intelligence will increase as the technology continues to develop rapidly, making it necessary for regulatory associates to establish proper regulations for these clinical trials.

Assessment of therapeutic clinical trials for proximal humeral fractures

  • Jonathan Koa;Mohamad Y. Fares;Mohammad Daher;Joseph A. Abboud
    • Clinics in Shoulder and Elbow
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    • v.27 no.2
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    • pp.237-246
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    • 2024
  • Proximal humeral fractures (PHFs) are a common injury among the older population. An ideal therapeutic protocol has yet to be developed, and numerous clinical trials are being conducted to find the best therapeutic approach. The purpose of this study is to evaluate the current body of knowledge available via interventional clinical trials. In December 2022, interventional clinical trials relating to PHFs on Clinicaltrials.gov were screened. Trial characteristics included duration, status, intervention, phase, outcomes, location, and study design. Publications associated with each trial were searched on PubMed/Medline using the ClinicalTrials.gov registry number. The final dataset comprised 64 trials. The most common trial status was completed (36%). The majority did not have a Food and Drug Administration-defined phase (67%), was randomized (81%), involved a single facility (72%), used a parallel assignment intervention model (80%), and used an open-label approach (45%). Eleven trials were associated with a publication, and the publication rate was 17%. Average enrollment was 86 participants, and mean trial duration was 51.4 months. Europe/UK/Russia/Turkey participated in the most trials (70%). Most of the trials were initiated after 2010 (87.5%). Procedure-related interventions (55%) were most common. Disability/function was the most common primary outcome assessed (61%). The low publication rate and the multitude of trials conducted after 2010 highlight the urgency and need for trial results to be published to establish an ideal therapeutic protocol. Since the majority of the trials involved a single institution and an open-label approach, reinforcing blinding and establishing multi-centered trials can improve the validity of the clinical trial results.

Review of Clinical Trials on Aromatherapy in PubMed (PubMed 검색을 통해 살펴본 Aromatherapy의 임상연구동향에 관한 고찰)

  • Han, Eun-Jeung;Kim, Yoon-Bum
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.15 no.1
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    • pp.276-284
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    • 2002
  • Aromatherapy is becoming increasingly popular, however there are few clear indications for its use. To systematically review the clinical studies on aromatherapy, computcrized literature searches were performed from PubMed. Fourteen trials were located. The conclusions were as follows: 1. All the trials were published after 1993. 2. To analyze the publication journals, five of fourteen trials were on nursing, three of them on neuropsychiatry and one on dermatology. 3. Most widely used indications of aromatherapy were on general physical, psychological and physiological field. 4. On the procedure of aromatherapy, eight of them were by massage, three by inhalation, one by massage & inhalation and one by bath additive. 5. To analyze the publication type, all fourteen trials were clinical trials. Twelve of them were randomized controlled trials. Two of them were using single subject design. 6. To observe the sample size, five of them were under 10, four from 10 to 50, two from 50 to 100 and three above 100. 7. Eleven of fourteen trials were using inferential statistics. Eight of the eleven trials were significantly effective, but three had no statistical significance.

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On Sample Size Calculation in Bioequivalence Trials

  • Kang, Seung-Ho
    • Proceedings of the PSK Conference
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    • 2003.04a
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    • pp.90-90
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    • 2003
  • Sample size calculations play an important role in bioequivalence trials. In almost all clinical trials sample size is determined by considering power under the alternative hypothesis. The alternative hypothesis is the hypothesis that we wish to prove with experiments. Hence, in bioequivalence trials the alternative hypothesis is that two formulations are bioequivalent, while the null hypothesis is that the two formulations are not bioequivalent. (omitted)

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Study on the Clinical Trial Practice of Drugs at the Designated Hospitals (국내 임상시험 실시기관의 의약품 임상시험 관리현황 분석)

  • Lee Eui-Kyoung;Jang Sun-Mee;Huh Soon-Im
    • Korean Journal of Clinical Pharmacy
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    • v.5 no.2
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    • pp.33-49
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    • 1995
  • The purpose of this study is to understand present situation of clinical trials, and evaluate the preparedness of the desiRnated institutions to abide by GCP(Good Clinical Practice) standards during clinical trials. Survey on the status of clinical trials was conducted for the desienated 83 clinical trial hospitals, and response rate was $95.2\%$. The results showed that 39 hospitals have conducted clinical trials to obtain drug manufacturing approval from 1990 to 1994. Most of them were trials on Phase III. Only $46.8\%$ of the institutions had sufficient human resources to perform the clinical trials. Institutions which established IRB(Institutional Review Board) accounted for 41 or $51.9\%$, but those who have a protocol evaluation guideline, or Adverse Drug Reaction(ADR) reporting system were only 12, and 21 Places, respectively. Regarding supervision of the investigational drugs, less than 30 institutions designated pharmacist as a supervisor. In conducting clinical trials, $97.4\%$ of trials had high rates of prior consent of testees, but only part of them-$61.7\%$-gave written consent. The level of conducting GCP is found to be unsatisfactory. Institutions must build the appropriate infrastructure and government must prepare in order to protect testees' rights as well as to ensure validity of the results.

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Patient Attitudes and Considerations in Decision toward Participation in Clinical Trials of Chronic Diseases (만성질환 임상시험 참여 대상자의 금전적 보상에 대한 태도와 참여결정 시 고려사항)

  • Yi, Jooyon;Jang, Hongwon;Yoon, Jeong-Hyun;Rhie, Sandy Jeong
    • Korean Journal of Clinical Pharmacy
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    • v.27 no.1
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    • pp.30-37
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    • 2017
  • Background: We investigated the impact of financial compensation on patients' decision of participation in clinical trials and the related factors with patients' attitudes and considerations. Methods: A survey questionnaire was placed from October 31 to November 16, 2017 to the subjects who were enrolled in the trials of chronic diseases. Patients' socio-demographic characteristics were collected and the potential reasons for participating in the trials were assessed using 5-likert scores. Results: Sixty eight of 110 respondents (61.8%) indicated to participate clinical trials regardless of financial compensation. The differences were found between patients who were unwilling to participate without compensation and those who were willing to participate regardless of compensation in mean ages (43.9 years vs. 52.0 years, p<0.05), marital status (married, 47.6% vs 79.4%, p<0.01), religions (yes, 45.2% vs 67.6%, p<0.05) and monthly income (${\geq}3$ million won, 19.0% vs 45.6%, p<0.01). The potential reasons for participation in the trials between two groups were doctor's suggestion (52.4% vs. 77.9%, p<0.01), the expectation of health improvement (54.8% vs. 73.5%, p<0.05), the types and numbers of procedure (33.3% vs. 16.2%, p<0.05) and the duration of clinical trials (59.5% vs. 27.9%, p=0.001). In regression analysis, the monthly income of ${\geq}3$ million won (odd ratio, OR=3.221, p=0.026,) and the duration of trials (OR=0.290, p=0.017) were related to the group with the willingness to participate regardless of compensation. Conclusion: This stady showed that more than half of study subjects would participate in the clinical trials of chronic diseases regardless of financial compensation.