{"id":61382,"date":"2015-11-12T10:59:20","date_gmt":"2015-11-12T15:59:20","guid":{"rendered":"http:\/\/1boringoldman.com\/?p=61382"},"modified":"2015-11-12T11:29:32","modified_gmt":"2015-11-12T16:29:32","slug":"voices-2","status":"publish","type":"post","link":"https:\/\/1boringoldman.com\/index.php\/2015\/11\/12\/voices-2\/","title":{"rendered":"voices&#8230;"},"content":{"rendered":"<br \/>\n<table width=\"95%\" cellspacing=\"0\" cellpadding=\"5\" border=\"0\" align=\"center\">\n<tr>\n<td align=\"center\"><a target=\"_blank\" href=\"http:\/\/1boringoldman.com\/wp-admin\/An open letter to all US Presidential candidates\">An open letter to all US Presidential candidates<\/a>         <\/p>\n<hr size=\"1\" \/><\/td>\n<\/tr>\n<tr>\n<td>\n<p align=\"justify\" class=\"small\"><font color=\"#200020\">Medical experiments on humans [clinical trials] are carried out in the hope of improving health and furthering science. By their very nature they entail uncertainty about potential harms and benefits of a treatment or a procedure. This is why following WWII, prior ethics review by an independent committee has gradually been introduced as a key condition.<\/font><\/p>\n<p align=\"justify\" class=\"small\"><font color=\"#200020\">No benefit can be derived from trials which are either invisible or reported partially or selectively.<\/font><\/p>\n<p align=\"justify\" class=\"small\"><font color=\"#200020\">To avoid this risk, a growing number of organisations have made efforts to allow access to clinical trial results in a detail hitherto unknown.<\/font><\/p>\n<p align=\"justify\" class=\"small\"><font color=\"#200020\">Despite the growing international effort and a notable legislative effort in the EU, the US lags behind.<\/font><\/p>\n<p align=\"justify\" class=\"small\"><font color=\"#200020\">Study results posted on clinicaltrials.gov are, by definition, incomplete and unverified. Even so, eight years after the introduction of federal law FDAAA 2007 a very small number of results of registered trials have been made available and updated.<\/font><\/p>\n<p align=\"justify\" class=\"small\"><font color=\"#200020\">No detailed regulatory documents are available from the FDA. Physicians and patients require access to clinical study reports and anonymized individual patient data from trials of approved drugs and biologics.<\/font><\/p>\n<p align=\"justify\" class=\"small\"><font color=\"#200020\">US law and regulations globally affect organizational and professional behaviors with huge impact on health worldwide. The international composition of this letter&#8217;s signatories reflect this reality.<\/font><\/p>\n<p align=\"justify\" class=\"small\"><font color=\"#200020\">We call for a statement by all US presidential candidates on whether they support access to clinical trial data held by federal agencies, irrespective of topic, sponsor, country in which the trial was run or results.<\/font><\/p>\n<div align=\"justify\" class=\"small\"><font color=\"#200020\">We ask that they state what measures they would put forward, if elected, to address the scandal of invisible and distorted clinical trials.<\/font><\/div>\n<\/td>\n<\/tr>\n<\/table>\n<p align=\"justify\" class=\"small\">Kudos to Tom Jefferson for drafting our consensus letter to the presidential candidates published today in the <font color=\"#0066ff\">British Medical Journal<\/font>. I feel honored to be included in this list of heavyweights. Some may think that such gestures are ineffective, but I disagree. We&#8217;ve had years of silence and the results speak for themselves. Now people are speaking out, there&#8217;s movement &#8211; actually fairly rapid movement for the usual pace of things in medicine and science. <\/p>\n<div align=\"justify\" class=\"small\">For example, here&#8217;s recent article in the PLoS <a target=\"_blank\" href=\"http:\/\/blogs.plos.org\/mindthebrain\/2015\/11\/11\/why-the-scientific-community-needs-the-pace-trial-data-to-be-released\/\">Mind the Brain Blog<\/a> by&nbsp; James Coyne that says:<\/div>\n<blockquote>\n<ul>\n<div align=\"justify\"><em>A university and clinical trial investigators must release data  to a citizen-scientist patient, according to a landmark decision in the  UK. But the decision could still be overturned if the University and  investigators appeal. The scientific community needs the decision to be  upheld. I&rsquo;ll argue that it&rsquo;s unwise for any appeal to be made. The  reasons for withholding the data in the first place were archaic.  Overturning of the decision would set a bad precedent and would remove  another tooth from almost toothless requirements for data sharing.<\/em><\/div>\n<\/ul>\n<div align=\"justify\">We didn&rsquo;t need Francis Collins, Director of National Institutes of Health to <a href=\"http:\/\/www.nature.com\/news\/policy-nih-plans-to-enhance-reproducibility-1.14586\" target=\"_blank\">tell us<\/a> what we already knew, the scientific and biomedical literature is untrustworthy.<\/div>\n<p>And there is the <a href=\"http:\/\/www.acmedsci.ac.uk\/policy\/policy-projects\/reproducibility-and-reliability-of-biomedical-research\/\">new report<\/a> from the UK Academy of Medical Sciences, <em>Reproducibility and reliability of biomedical research: improving research practice.<\/em><\/p>\n<p align=\"justify\">There has been a growing unease about the reproducibility of much  biomedical research, with failures to replicate findings noted in  high-profile scientific journals, as well as in the general and  scientific media. Lack of reproducibility hinders scientific progress  and translation, and threatens the reputation of biomedical science.<\/p>\n<div align=\"justify\"><strong><font color=\"#200020\">Among the report&rsquo;s recommendations<\/font><\/strong>:<\/div>\n<ul>\n<li>\n<div align=\"justify\"><strong><font color=\"#200020\">Journals mandating that the data underlying findings are made available in a timely manner<\/font><\/strong>.  This is already required by certain publishers such as the Public  Library of Science (PLOS) and it was agreed by many participants that it  should become more common practice.<\/div>\n<\/li>\n<li>\n<div align=\"justify\"><strong><font color=\"#200020\">Funders requiring that data be released in a timely fashion<\/font><\/strong>.  Many funding agencies require that data generated with their funding be  made available to the scientific community in a timely and responsible  manner<\/div>\n<\/li>\n<\/ul>\n<div align=\"justify\">A consensus has been reached: The crisis in the trustworthiness of  science can be only overcome only if scientific data are routinely  available for reanalysis. Independent replication of socially  significant findings is often unfeasible, and unnecessary if original  data are fully available for inspection.<\/div>\n<p align=\"justify\"><strong><font color=\"#200020\">Numerous governmental funding agencies and regulatory bodies are endorsing routine data sharing<\/font><\/strong>.<\/p>\n<div align=\"justify\"><strong><font color=\"#200020\">The UK Medical Research Council<\/font><\/strong> (MRC) 2011 policy on data sharing and preservation&nbsp; has endorsed principles laid out by the <a target=\"_blank\" href=\"http:\/\/www.mrc.ac.uk\/research\/research-policy-ethics\/data-sharing\/data-sharing-population-and-patient-studies\/\">Research Councils UK<\/a> including:<\/div>\n<ul>\n<div align=\"justify\">Publicly funded research data are a public good, produced  in the public interest, which should be made openly available with as  few restrictions as possible in a timely and responsible manner. To enable research data to be discoverable and effectively re-used by  others, sufficient metadata should be recorded and made openly  available to enable other researchers to understand the research and  re-use potential of the data. Published results should always include  information on how to access the supporting data.<\/div>\n<\/ul>\n<div align=\"justify\"><strong><font color=\"#200020\">The Wellcome Trust<\/font><\/strong> Policy On Data Management and Sharing <a href=\"http:\/\/www.wellcome.ac.uk\/About-us\/Policy\/Policy-and-position-statements\/WTX035043.htm\">opens with:<\/a><\/div>\n<ul>\n<div align=\"justify\">The Wellcome Trust is committed to ensuring that the  outputs of the research it funds, including research data, are managed  and used in ways that maximise public benefit. Making research data  widely available to the research community in a timely and responsible  manner ensures that these data can be verified, built upon and used to  advance knowledge and its application to generate improvements in  health.<\/div>\n<\/ul>\n<div align=\"justify\"><strong><font color=\"#200020\">The Cochrane Collaboration<\/font><\/strong> has weighed in that there should be <a target=\"_blank\" href=\"http:\/\/community.cochrane.org\/organisational-policy-manual\/27-access-data-all-trials\">ready access to all clinical trial data:<\/a><\/div>\n<ul>\n<div align=\"justify\">Summary results for all protocol-specified outcomes, with  analyses based on all participants, to become publicly available free  of charge and in easily accessible electronic formats within 12 months  after completion of planned collection of trial data; Raw, anonymised, individual participant data to be made available  free of charge; with appropriate safeguards to ensure ethical and  scientific integrity and standards, and to protect participant privacy  (for example through a central repository, and accompanied by suitably  detailed explanation).<\/div>\n<\/ul>\n<div align=\"justify\">Many similar statements can be found on the web. I&rsquo;m unaware of credible counterarguments gaining wide acceptance. Yet,  endorsements of routine sharing of data are only a promissory reform  and depend on enforcement that has been spotty, at best. Those of us who  request data from previously published clinical trials quickly realize  that requirements for sharing data have no teeth. In light of that,  scientists need to watch closely whether a landmark decision concerning  sharing of data from a publicly funded trial is appealed and overturned&#8230;<\/div>\n<\/blockquote>\n<div align=\"justify\" class=\"small\">And he goes on to describe several important cases to follow as the voices for Data Transparency grow stronger&#8230; <\/div>\n","protected":false},"excerpt":{"rendered":"<p>An open letter to all US Presidential candidates Medical experiments on humans [clinical trials] are carried out in the hope of improving health and furthering science. By their very nature they entail uncertainty about potential harms and benefits of a treatment or a procedure. This is why following WWII, prior ethics review by an independent [&hellip;]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_bbp_topic_count":0,"_bbp_reply_count":0,"_bbp_total_topic_count":0,"_bbp_total_reply_count":0,"_bbp_voice_count":0,"_bbp_anonymous_reply_count":0,"_bbp_forum_subforum_count":0,"footnotes":""},"categories":[5],"tags":[],"class_list":["post-61382","post","type-post","status-publish","format-standard","hentry","category-opinion"],"_links":{"self":[{"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/posts\/61382","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/comments?post=61382"}],"version-history":[{"count":16,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/posts\/61382\/revisions"}],"predecessor-version":[{"id":61420,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/posts\/61382\/revisions\/61420"}],"wp:attachment":[{"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/media?parent=61382"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/categories?post=61382"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/tags?post=61382"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}