Clinical trials: from policy to participation
After years funding, overseeing and monitoring clinical trials, our Director of Corporate Affairs Dr Tony Peatfield has found himself on the other side of a trial ― as a participant. Here he reflects on how his medical care has benefited from clinical trials, and why the opportunity to sign up to one was not to be missed.
Life is full of surprises, some more welcome than others. My most recent was to find myself in A&E with a heart attack. I consider(ed) myself generally healthy – I have a good diet, drink moderately, have never smoked, and do a reasonable amount of exercise (though I admit nothing too vigorous). Indeed until now, during my 30 years working for the MRC, I had taken only one day off sick.
I had excellent treatment and care in hospital, and having to spend a lot of time on my back with tubes and wires attached to me gave me some time to reflect on what was happening to me!
My immediate treatment was to have two stents inserted into one of my coronary arteries. These small wire-mesh tubes will allow the blood to flow more freely. This was followed by a cocktail of drugs (of the pharmaceutical sort), some of which I will be on for life.
All these treatments had at some point been the subject of large clinical trials. So I was a beneficiary of the altruism of previous patients who had participated in these studies.
Before the doctor asked me what I did for a living, he mentioned an international clinical trial for which St George’s was one of the participating centres. Might I want to join the trial?
The doctor explained that during my treatment, it had been discovered that one other coronary artery had a narrowing, and there was uncertainty as to whether opening this additional artery would help improve my chances of living longer or avoiding a future heart attack. The trial thus involved randomisation either to a further procedure (stent) or to treatment with medication only, with follow-up for five years. The trial, ‘COMPLETE’, aims to recruit 3,900 patients in around 120 sites.
I was given some patient information and time to consider my decision. This was not the most exciting trial scientifically, but it was clearly an important question in helping doctors decide what further treatment to offer to patients such as myself.
My decision to take part was easy. During my career at the MRC I have been closely involved in funding very many clinical trials and in running Trial Steering Committees and Data & Safety Monitoring Committees. I also helped produce some of the MRC’s early guidance on clinical trials. I am still involved in advising colleagues and in producing press releases announcing the results of MRC-funded trials.
So the opportunity to be a participant was not to be missed – how could I not!? At the end of the day, I shall of course be an anonymous statistic in a publication but, having spent so long promoting the importance of clinical trials, I shall be pleased to have been involved directly myself.
Who knows what the overall outcome of the COMPLETE trial will be, but it will surely be of benefit to many future patients who have one surprise more than they wanted.