以患者为中心的临床试验的伦理审查挑战OA北大核心CSTPCD
Challenges of ethical review in patient-centered clinical trials
以患者为中心的临床试验是指以研究参与者需求为出发点、视研究参与者为主动参与者、以临床价值为最终目的而进行的临床试验.该理念已成为当前医药研发的核心指导思想,以患者为中心的临床试验模式将逐步成为医药研发的主流模式.中国以患者为中心的临床试验面临试验思维方式转变困难、质量控制困难、研究参与者隐私保护难度加大、研究各方培训缺乏、研究参与者招募的不公平等挑战.通过从相关部门给予更多政策支持、申办者和相关第三方及时转变研发思路、研究者和研究参与者加强认知 3 个方面对中国以患者为中心的临床试验提出建议,并从试验设计已囊括患者偏好信息和考虑临床结局评估、研究参与者安全和权益的保护、基于研究参与者需求的招募、易于接受的知情同意、选用去中心化临床试验元素的合理性、研究参与者的隐私保护、研究人员和研究参与者的培训和教育、研究参与者的补偿和赔偿八个方面提出了以患者为中心的临床试验的伦理审查要点,以规范以患者为中心的临床试验的伦理审查,确保以患者为中心的临床试验质量.
Patient-centered clinical trials refer to clinical trials that take participant'needs as the starting point,regard participant as active participants,and take clinical values as the ultimate goals.This concept has become the core guiding ideology of current pharmaceutical research and development,and the model of the patient-centered clinical trial will gradually become the mainstream model of pharmaceutical research and development.Patient-centered clinical trials in China have challenges such as difficulty in changing the way of trial thinking and quality control,increased difficulty in participant'privacy protection,lack of training for all research parties,and unfair recruitment of research participants.Then suggestions were proposed for patient-centered clinical trials in China from three aspects,including relevant departments provide more policy support,sponsors and relevant third parties timely transform ideas of research and development,as well as researchers and research participants strengthen awareness.This paper also put forward the key points of ethical review of patient-centered clinical trials from 8 aspects,including the trial design that incorporated preference information on patients and took into account the assessment of clinical outcomes,protection of the safety and rights of research participants,recruitment based on the needs of research participants,acceptable informed consent,the rationality of selection of decentralssed clinical trials elements,privacy protection of research participants,training and education of researchers and research participants,and compensation and indemnity of research participants,so as to standardize the ethics review of patient-centered clinical trials and ensure the quality of patient-centered clinical trials.
张增瑞;周吉银
西南医科大学附属医院临床试验伦理委员会,四川 泸州 646000陆军军医大学第二附属医院临床医学研究中心,重庆 400037
以患者为中心临床试验伦理审查隐私保护
patient-centeredclinical trialethical reviewprivacy protection
《中国医学伦理学》 2024 (005)
556-563 / 8
2022年西南医科大学社科重点项目"药物临床试验受试者保护体系的规范化研究"(2022SK001);2022陆军军医大学人文社会科学基金重点项目"我市涉及人的健康相关研究伦理治理的现状与对策研究"(2022XRW05)
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