Thinking Harder

Volunteering for a Clinical Trial: Have You? Would You?

By Ben Harder

Posted: July 10, 2009

I once came very close to receiving an experimental vaccine that, let's face it, could conceivably have killed me. In retrospect, I'm glad the researchers running the trial decided that I wasn't eligible to be a study subject. But at the time I was actually disappointed when they turned me down.

I'm planning to write a feature about people who volunteer for clinical trials, why they do it, and what they get out of it. In my case, I was just doing my job; I was a reporter chasing a good story.

The vaccine I was willing to get injected into my shoulder was an experimental vaccine against West Nile virus. The experimental elixir wasn't made from West Nile virus itself, but it did contain snippets of DNA identical to those found in the virus, which can kill people, birds, and other animals. DNA vaccines are a relatively new type of vaccine, and it's not yet clear how safe or how efficacious they tend to be. (In theory, they're safer than live-virus vaccines, which can cause low-level infections in recipients.)

[Read A Parent's Guide to Managing Vaccines]

It turned out that I wasn't a useful subject for the trial because I had received a yellow fever vaccine several years earlier. Yellow fever and West Nile cause similar immune responses, which meant it would have been difficult for the researchers to determine, through follow-up blood testing, whether I had developed immunity to West Nile or whether I was simply immune to yellow fever.

In the end, I contacted another study volunteer (a guy who proved to be eligible and did receive the experimental shot) and wrote the story about him rather than about my own personal experience, which had been my original plan.

On another occasion, I considered participating in a so-called phase 1 trial, which was designed to test the safety of a medicine researchers hoped could prevent malaria. But I never volunteered for that one. Several of my family members talked me out of it, and I'm glad they did. Drugs can sometimes cause severe damage to the liver, kidneys, or other organs, and that particular drug had never been tested in humans. It seems half-crazy to me now that I almost took that risk. As my wife put: "I guess you were young then, and feeling invincible."

Invincible or not, some people volunteer for clinical trials again and again. In at least one area of Switzerland, medical researchers have created a registry of healthy volunteers in order to "encourage responsible participation in medical research." That's code for "make sure overzealous volunteers aren't participating in multiple trials at once," since that could foul up researchers' conclusions. In the first three years of the registry's existence, they identified almost 200 "habitual or regular volunteers." Some volunteers join study after study because they like the level of attention that medical researchers lavish on study subjects. Others do it for the cash compensation that some trials offer, although there are ethical restrictions on how much researchers can pay their volunteers.

I did eventually join a clinical trial, but the treatment being tested was about as innocuous as you can imagine. Researchers recruited volunteers who were suffering from insomnia (which I had at the time) and tested whether those who were given a little device started to get better sleep. That experimental device told volunteers when to sleep and when to do certain other activities. But I never got to try it out; I was assigned to the study's control group and all I got was a book, titled No More Sleepless Night, that I was told might help me beat insomnia. Maybe it did help. I can't be sure.

Have you ever volunteered, or even considered volunteering, to participate in a trial? What would it take to get you to do it—cash, better care, the knowledge that you'd be serving humanity?

Clinical trials

I was a particpant in a inhaled insulin trial by Squibb for diabetics Luckily I was in the control group and did not use the inhaled insulin since some that did had lung problems but I have to say I was given far better care and monitoring than I had ever been given by my primary physician and as a result of the intensive monitoring I dropped 2.5 pts with my A1C level while being paid to do so added to this all my regular medications were provided or paid for in full during the trial.

Phil Carpentier of GA @ Sep 25, 2009 12:41:20 PM

I am in a clinical trial now

I am currently in a clinical trial for flu vaccine. The vaccine being tested was made using dog tissue instead of eggs. Currently eggs are one of the limiting factors in producing flu vaccines. I consider this particular trial to be very low risk for me and of potentially great benefit to humankind. I will be paid a nominal amount at the conclusion of the trial but my primary motivation is this opportunity to further scientific knowledge and benefit the world with minimal risk to myself.

PlainsJane of TN @ Aug 03, 2009 15:12:48 PM

Putting Experience to Work FOR REAL

I founded a new company, Clinical Ambassador LLC, with a focus on creative, cost-effective patient recruitment tactics. We design proactive marketing strategies that enroll the best (read "most informed and engaged") people to ensure completion. We partner with a principal investigator with a new contract to perform a clinical trial. We also work with agents of any of the small and mid size biotech/pharmaceutical, medical device companies and Contract Research Organizations (CROs) who need clinical trial results on time and within budget. For each of them, getting patients properly engaged is one of their biggest challenges.

I know this because I have been a volunteer on several trials myself. I dropped out of one of them because the fasting required gave me a monster headache and they wouldn't let me take Excedrin. But I digress. Truth is, I would not feel comfortable recruiting others full-time had I not walked a mile in their hospital slippers. Granted, each trial and related risks are unique. But just recalling what was swimming around in my head at the time, remembering the conversations I had with staff and those I overheard among fellow volunteers, has helped to keep things in perspective when seeking to enhance the experience from the patient perspective. The company relies heavily on the opinions and concerns of those in the community.

Sponsors often make the mistake of assuming that clinical trial sites can successfully complete patient enrollment on their own. NOT! I saw firsthand the fact that sites are consumed with a multitude of tasks and are rarely recruitment specialists. I saw the gaps in communication, from marketing to informed consent. For my clients, partnering with Clinical Ambassador LLC as early as possible offers a stronger bridge and hopefully, better outcomes for all. We provide additional transparency by "translating" trial-speak for those who may otherwise dismiss or misconstrue the opportunity. We also happen to specialize in difficult-to-reach patient populations, providing the unique perspective of cultural competence with the goal of eliminating health disparities. Visit www.clinicalambassador.com for more information.

Allison Winfield of FL @ Jul 13, 2009 14:06:01 PM

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Thinking Harder

This blog is the public workshop of U.S. News writer and editor Ben Harder. In articles published in the magazine, he has covered a range of sciences, including medicine, human behavior, prehistory, and evolution. Here, he can explore those and other scientific fields more fully and more informally than is possible in print. He'll share whatever seems noteworthy or potentially useful, and he invites readers to do the same.

WTOP Audio
On Feb. 24, 2008, Ben discussed the link between artificial light and cancer on WTOP radio. Listen to the interview at WTOP News. He again talked about light pollution on WTOP on March 22, exploring its environmental effects.

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