BMC Medical Ethics | |
Assessing the detection, reporting and investigation of adverse events in clinical trial protocols implemented in Cameroon: a documentary review of clinical trial protocols | |
Pierre Watcho2  Marceline Ngounoue Djuidje1  Martin Ndinakie Yakum3  Jerome Ateudjieu3  Akoh Walter Ebile3  | |
[1] Ethics Committee for Research and Health in Central Africa, Yaoundé, Cameroun;Department of Biomedical Sciences, University of Dschang, Dschang, Cameroon;M.A. SANTE (Meilleure Access aux soins de Santé), Yaoundé, Cameroon | |
关键词: Cameroon; Protocols; Clinical trial; Adverse events; Investigation; Reporting; Detection; | |
Others : 1229738 DOI : 10.1186/s12910-015-0061-5 |
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received in 2015-01-30, accepted in 2015-09-22, 发布年份 2015 | |
【 摘 要 】
Background
International guidelines recommend ethical and scientific quality standards for managing and reporting adverse events occurring during clinical trials to competent research ethics committees and regulatory authorities. The purpose of this study was to determine whether clinical trial protocols in Cameroon are developed in line with national requirements and international guidelines as far as detecting, reporting and investigating of adverse events is concerned.
Methods
It was a documentary review of all approved clinical trial protocols that were submitted at the Cameroon National Ethics Committee for evaluation from 1997 through 2012. Data were extracted using a preconceived and validated grid. Protocol review process targeted the title, abstract, objectives, methodology, resources, and the chapter on safety.
Results
In total, 106 (4.9 %) clinical trial protocols were identified from 2173 protocols seen in the archive and 104 (4.8 %) included for review. Seventy six (73.1 %) trials did not include the surveillance of adverse events as part of their objective. A total of 91 (87.5 %) protocols did not budget for adverse event surveillance, 76 (73.1 %) did not have a data safety management board (DSMB), 11(10.6 %) included insurance for participants, 47 (45.2 %) did not include a case definition for serious adverse events, 33 (31.7 %) described procedures to detect adverse events, 33 (31.7 %) described procedure for reporting and 22 (21.2 %) described procedure for investigating adverse events.
Discussions
Most clinical trial protocols in Cameroon are developed to focus on benefits and pay little attention to harms. The development of national guidelines can improve the surveillance of adverse events in clinical trial research conducted in Cameroon. Adverse events surveillance tools and a budget are critical for an adequate planning for adverse event surveillance when developing trial protocols.
Conclusion
Clinical trial protocols submitted in the Cameroon National Ethics Committee do not adequately plan to assess adverse events in clinical trial protocols. In order to improve on the safety of participants and marketed drug, there is a need to develop national guidelines for clinical trials by the government, and to improve evaluation procedures and monitoring of ongoing trials by the ethics committee.
【 授权许可】
2015 Ebile et al.
【 预 览 】
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20151031021526677.pdf | 780KB | download | |
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Fig. 2. | 34KB | Image | download |
Fig. 1. | 53KB | Image | download |
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【 参考文献 】
- [1]Lesko SM, Mitchell AA. An assessment of the safety of pediatric ibuprofen. A Practitioner-Based Randomized Clinical Trial. JAMA. 1995;273(12):929-33.
- [2]Castle W, Fuller R, Hall J, Palmer J. Serevent nationwide surveillance study: comparison of salmeterol with salbutamol in asthmatic patients who require regular bronchodilator treatment. Br Med J. 1993; 306:1034-7.
- [3]Cuervo LG, Clarke M. Balancing benefits and harms in health care. Br Med J. 2003; 327:656.
- [4]Goldacre B. How Drug Companies Mislead Doctors and Harm Patients. Bad Pharma. 4th Estate, London: 2012.
- [5]Lundh A, Sismondo S, Lexchin J, Busuioc OA, Bero L. Industry sponsorship and research outcome. Cochrane Database Syst Rev. 2012; 12: Article ID MR000033
- [6]European Medicines Agency, CAT Secretariat & US Food and Drug Administration. International Coference on Harmonization of Good Clinical Practice “A”. Regenerative medicine. 2011.
- [7]Ioannidis JP, Evans SJ, Gøtzsche PC, O'Neill RT, Altman DG, Schulz K et al.. Better reporting of harms in randomized trials: an extension of the CONSORT statement. Am Coll Physicians. 2004; 141:781-788.
- [8]World Health Organization. Safety Monitoring of Medicinal Products. Reporting System for General Public; 2012.
- [9]World Health Organization Strategy on Research for Health; ISBN 978 92 4 150325 9; 2012.
- [10]Décision Nº 0689/D/MINSANTE/SG/DROS. Portant Conditions de délivrance de l'Autorisation Administrative de Recherche en Santé Humaine au Cameroun, du 29 juillet 2009.
- [11]Ministry of Public Health, Cameroon. Arrete Nº 079/A/MSP/DS. For the creation and organization of the Cameroon National Ethics Committee. October 22, 1997.
- [12]La décision Nº 0977/A/MINSANTE/SESP/SG/DROS. The restructure in the creation, organization and functioning of Research Ethics Committees for human health within the structures of the Ministry in charge of Public Health; 2012.
- [13]World Medical Association. Declaration of Helsinki - Ethical Principles for Medical Research Involving Human Subjects. Fortaleza: JAMA (The journal of the American Medical Association). 2013.
- [14]Council for International Organizations of Medical Sciences (CIOMS) in collaboration with the World Health Organization (WHO). International Ethical Guidelines for Biomedical Research Involving Human Subjects. Geneva: 2002.
- [15]Bompart F, Hirsch F, Bertoye PH, Vray M. Good clinical practice in developing countries: applying recommendations. Therapie. 2008; 63(2):83-88.
- [16]Stéphanie Bou-Fleurot;Virginie Pautre. Contrefaçon de médicaments. LEEM. 2010 mai; 1: 9.
- [17]Toma M, McAlister FA, Bialy L, Adams D, Vandermeer B, Armstrong PW. Transition from meeting abstract to full-length journal article for randomized controlled trials. JAMA. 2006;295:1281–7.
- [18]Harlow SD, Linet MS. Agreement between questionnaire data and medical records. The evidence for accuracy of recall. Am J Epidemiol. 1989; 129:233-48.
- [19]Begg C, Cho M, Eastwood S, Horton R, Moher D, Olkin I, Pitkin R, Rennie D, Schulz KF, Simel D, Stroup DF. Improving the quality of reporting of randomized controlled trials. The CONSORT statement. JAMA. 1996; 276:637-639.
- [20]Moher D, Schulz KF, Altman D. The CONSORT statement: revised recommendations for improving the quality of reports of parallel-group randomized trials. JAMA. 2001; 285:1987-199.
- [21]Montori VM, Devereaux PJ, Adhikari NK, Burns KE, Eggert CH, Briel M et al.. Randomized trials stopped early for benefits: a systematic review. JAMA. 2005; 294(17):2203-2209.
- [22]Vray M, Simon F, Bompart F. Guidelines for clinical research in developing countries. Therapie. 2007; 62(3):217-27.