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Clearly, placebo‑controlled trials are a very important factor in determining the effectiveness of the medicine. But what are the reasons most patients join these trials and what stages do they need to go through to be accepted? You are going to be presented with a multimedia presentation with testimonies of some patients who have taken part in medical trials.

Niewątpliwie badania kliniczne z wykorzystaniem placebo stanowią bardzo ważny czynnik w procedurze potwierdzania skuteczności leku. Jakie są powody, dla których pacjenci dołączają do testów, i jakie etapy muszą przejść, aby móc wziąć w nich udział? Zapoznaj się z prezentacją multimedialną zawierającą relacje osób, które brały udział w badaniach klinicznych.

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Volunteering in medical trials.
Dobrowolny udział w testach medycznych.
Źródło: dostępny w internecie: www.unsplash.com [dostęp 24.05.2022], domena publiczna.
Exercise 1

Match the definitions with the words related to medical trials.

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The process of identifying the disease from a particular set of symptoms. Możliwe odpowiedzi: 1. compensation, 2. diagnosis, 3. effectiveness, 4. surgery, 5. admission The treatment of disease by manual or instrumental interventions. Możliwe odpowiedzi: 1. compensation, 2. diagnosis, 3. effectiveness, 4. surgery, 5. admission A medical decision for qualifying a patient for hospital treatment. Możliwe odpowiedzi: 1. compensation, 2. diagnosis, 3. effectiveness, 4. surgery, 5. admission The ability to cause a beneficial result by applying a specific drug of treatment. Możliwe odpowiedzi: 1. compensation, 2. diagnosis, 3. effectiveness, 4. surgery, 5. admission Benefits (including money) for participating in the early trials of experimental treatments. Możliwe odpowiedzi: 1. compensation, 2. diagnosis, 3. effectiveness, 4. surgery, 5. admission
Źródło: GroMar Sp. z o.o., licencja: CC BY-SA 3.0.
Exercise 1
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Match the definitions with the recorded words related to medical trials.
Źródło: GroMar Sp. z o.o., licencja: CC BY-SA 3.0.

Study the presentation of patients’ testimonies related to medical trials and then do the exercises.

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Finding A Trial To Join

If people suffer from a medical condition and are considering taking part in a medical trial, it is important for them to remember that there may not be a trial they will find suitable. Immediately after the diagnosis of an acute illness may not be the best moment for them to think about clinical research for the first time or find out what trials are running. There is always standard treatment to try out first. Nevertheless, some patients decide to search for a suitable trial on their own.

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Źródło: GroMar Sp. z o.o., licencja: CC BY-SA 3.0.
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Being Asked About Taking Part In A Trial

How people are asked to take part will depend on the type of trial. At one end of the spectrum, there are trials advertised in newspapers, newsletters and on notice boards, which people may themselves actively look for and join if they fit the criteria. At the other end, there are trials people can get into only through their GP who may place them in a trial by sending a letter on their behalf. Some trials are based in GP surgeries directly, in which case a patient becomes part of a trial automatically, as his doctor’s patient. Also, some patients are encouraged to join a trial in hospital at a time when they feel vulnerable and worried, for example after a serious diagnosis or an urgent admission.

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Krótki filmik przedstawia młodą kobietę w białym fartuchu lekarskim, która siedzi na sofie i przeprowadza wywiad z osobą siedzącą po prawej stronie. Kobieta ma okulary, stetoskop zawieszony na szyi, w prawej ręce trzyma długopis, a w lewej niebieską podkładkę z przypiętymi kartkami. Kobieta co jakiś czas coś tłumaczy, pyta, gestykuluje, a następnie notuje na kartce.
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Reasons For Wanting To Take Part In A Clinical Trial

People agree to take part in clinical trials for a range of reasons. Some think mainly about their own personal health, while others are willing to help other patients and support the advancement of medical research. Usually, the ‘healthy volunteers’ are paid compensation for taking part in early trials of experimental treatments whether they do it for the sake of medicine or out of their own interest and curiosity.

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Źródło: GroMar Sp. z o.o., licencja: CC BY-SA 3.0.
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Why People May Not Be Eligible To Join A Trial

All trials have guidelines about who can take part. These so‑called eligibility criteria are used to ensure that trials include the people who may benefit from the treatment, and to make sure that people who take part are not exposed to avoidable risks. Inclusion criteria help the researchers to decide who can join the trial. Some trials only include people in a certain age group, of one sex, or at a particular stage of their illness. The exclusion criteria state who cannot take part in the trial. For example, people who are already taking particular medicines may be excluded as these may affect the trial treatment.

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Źródło: GroMar Sp. z o.o., licencja: CC BY-SA 3.0.
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Feelings About Being In A Placebo‑controlled Trial

In some medical trials everyone who takes part gets the treatment. However, many trials compare a new treatment with the standard or usual treatment by setting up two groups of trial patients. One group, the experimental group, is given the new treatment. The other group, the so‑called control group, is given the standard treatment. If no standard treatment is available, the control group may not be given any specific treatment or may be given a placebo. A placebo is a treatment with no active ingredient which is designed to appear very much like the treatment being tested. By comparing patients’ responses to the placebo and to the tested treatment, researchers can tell whether the treatment has any real benefit for patients’ health.

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Krótki filmik przedstawia dwie osoby. Po lewej stronie widoczna jest stojąca kobieta, ubrana w strój pielęgniarki – zielonkawą bluzkę z krótki rękawem i spodnie. Na prawo od dniej widoczny jest siedzący starszy mężczyzna. Kobieta najpierw patrzy w obiektyw, a  następnie zwraca głowę w kierunku mężczyzny i kładzie mu lewą rękę na lewym barku. Mężczyzna unosi głowę w kierunku kobiety, a następnie kładzie lewą rękę na dłoni kobiety.
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Pros And Cons Of Being In A Medical Trial

Clinical trials are carefully designed to minimise the risks and maximise the benefits to every participant, whatever treatment they receive. Researchers should explain to you what they already know about possible side effects to help you decide whether to take part or not. Also, some trials make great demands on patients for long periods of time: participants have to think about a range of practical implications, such as travelling, time off work, holidays and money.

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Źródło: GroMar Sp. z o.o., licencja: CC BY-SA 3.0.
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Blind Trials

There are several ways in which the results of trials can be made as reliable and accurate as possible. One of these is to make the trial a ‘blind trial.’ In a blind trial, the participants are not told which group – experimental or control group – they are in. If they knew which treatment they were getting, it could influence how they feel or report their symptoms. Some trials are double‑blind, which means that neither participants nor the doctors treating them know which people are getting which treatments. This also prevents the doctors from influencing the results of the trial with their hopes and expectations.

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Źródło: GroMar Sp. z o.o., licencja: CC BY-SA 3.0.
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Thinking About Withdrawing From A Trial

It is important to know that anyone can withdraw from a trial at any point, without giving a reason, and without affecting your medical care. Many people who took part in a trial remember staff making a special point of this to get it across to patients thinking about a trial. Although knowing that you can drop out is reassuring, some people feel strongly they have made a personal commitment and ought not to withdraw. This might be from a sense of responsibility to staff or a general feeling of duty, or because they worry about wasting resources or damaging the research.

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Krótki filmik przedstawia młodą dziewczynę i chłopaka, którzy stoją przy blacie w recepcji. Po drugie stronie widać młodą kobietę, ubraną w biały fartuch, która udziela im wskazówek. Następnie wskazuje lewą ręką kierunek, w którym powinna udać się para. Dziewczyna i chłopak zwracają się w kierunku obiektywu, chwytają się za ręce i idą korytarzem, w którym po prawej i lewej stronie widoczne są drzwi oznaczone numerami.
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Feelings When A Trial Ends

Sometimes trials involve only a one‑off or fairly short commitment from patients, and for these people the end of their involvement is not much of an issue. However, in other trials patients are involved for a longer time, and the trial becomes quite a part of their lives. In the end, you are left with mixed feelings. This often depends partly on the kind of relationship between the research team and the patient.

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Źródło: GroMar Sp. z o.o., licencja: CC BY-SA 3.0.
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Feedback Of Trial Results

Current guidance is that at the end of a trial everyone can see the results if they want to. The results should also be published so that they are used to guide decisions about treatment and care by the wider community. Most patients claim that this is important, and some give examples of good practices. For instance, some people are glad to see that they have contributed to advancements in healthcare.

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Źródło: GroMar Sp. z o.o., licencja: CC BY-SA 3.0.
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Exercise 2

Get familiar with the presentation and choose the correct answers. Sometimes, more than one answer may be correct.

According to the presentation:

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Źródło: GroMar Sp. z o.o., licencja: CC BY-SA 3.0.
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Źródło: GroMar Sp. z o.o., licencja: CC BY-SA 3.0.
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Źródło: GroMar Sp. z o.o., licencja: CC BY-SA 3.0.
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Źródło: GroMar Sp. z o.o., licencja: CC BY-SA 3.0.
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Źródło: GroMar Sp. z o.o., licencja: CC BY-SA 3.0.
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Źródło: GroMar Sp. z o.o., licencja: CC BY-SA 3.0.
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Źródło: GroMar Sp. z o.o., licencja: CC BY-SA 3.0.
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Źródło: GroMar Sp. z o.o., licencja: CC BY-SA 3.0.
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Źródło: GroMar Sp. z o.o., licencja: CC BY-SA 3.0.
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Źródło: GroMar Sp. z o.o., licencja: CC BY-SA 3.0.
Exercise 3
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You are creating a quiz on medical trials for students from your class. Select the correct endings to the sentences describing the participation in a medical trial. Doctors being aware which people are getting which treatments Możliwe odpowiedzi: 1. may help patients guide their further decisions about treatment and care., 2. involve travelling, time off work, holidays, and money., 3. encourage building relationships between the research team and the patient., 4. may influence the results of a trial., 5. is possible without giving a reason although it’s not a light decision to make. The practical implications of the participation in a trial Możliwe odpowiedzi: 1. may help patients guide their further decisions about treatment and care., 2. involve travelling, time off work, holidays, and money., 3. encourage building relationships between the research team and the patient., 4. may influence the results of a trial., 5. is possible without giving a reason although it’s not a light decision to make. Withdrawing from a trial by a patient Możliwe odpowiedzi: 1. may help patients guide their further decisions about treatment and care., 2. involve travelling, time off work, holidays, and money., 3. encourage building relationships between the research team and the patient., 4. may influence the results of a trial., 5. is possible without giving a reason although it’s not a light decision to make. Some longer medical trials Możliwe odpowiedzi: 1. may help patients guide their further decisions about treatment and care., 2. involve travelling, time off work, holidays, and money., 3. encourage building relationships between the research team and the patient., 4. may influence the results of a trial., 5. is possible without giving a reason although it’s not a light decision to make. Feedback of a completed medical trial Możliwe odpowiedzi: 1. may help patients guide their further decisions about treatment and care., 2. involve travelling, time off work, holidays, and money., 3. encourage building relationships between the research team and the patient., 4. may influence the results of a trial., 5. is possible without giving a reason although it’s not a light decision to make.
Źródło: GroMar Sp. z o.o., licencja: CC BY-SA 3.0.
Exercise 4

Based on the information from the presentation, answer the following questions:

  1. What are two reasons why people decide to take part in medical trials?

  2. What are inclusion and exclusion criteria?

  3. What are two advantages and two disadvantages of taking part in medical trials?

Write 2‑3 sentences to each question.

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(Uzupełnij).
Źródło: GroMar Sp. z o.o., licencja: CC BY-SA 3.0.