Citing national security concerns, the federal government has ordered TikTok to shutter its Canadian operations — but users will still be able to access the popular video app.

The National Accreditation Board for Testing and Calibration Laboratories (NABL), under the Quality Council of India (QCI), has announced a collaborative effort with Man─Made Textile Research Association (MANTRA) in Surat to deliver a specialized technical training programme on medical textiles testing.

Maybe those pesky sites are good for something after all. 

It's been six years since Pfizer boldly announced the launch of its "clinical trial in a box". The REMOTE trial was designed to be entirely online, and involved no research sites: study information and consent was delivered via the web, and medications and diaries were shipped directly to patients' homes.

Despite the initial fanfare, within a month REMOTE's registration on ClinicalTrials.gov was quietly reduced from 600 to 283. The smaller trial ended not with a bang but a whimper, having randomized only 18 patients in over a year of recruiting.

Still, the allure of direct to patient clinical trials remains strong, due to a confluence of two factors. First, a frenzy of interest in running "patient centric clinical trials". Sponsors are scrambling to show they are doing something – anything – to show they have shifted to a patient-centered mindset. We cannot seem to agree what this means (as a great illustration of this, a recent article in Forbes on "How Patients Are Changing Clinical Trials" contained no specific examples of actual trials that had been changed by patients), but running a trial that directly engages patients wherever they are seems like it could work.

The less-openly-discussed other factor leading to interest in these DIY trials is sponsors' continuing willingness to heap almost all of the blame for slow-moving studies onto their research sites. If it’s all the sites’ fault – the reasoning goes – then cutting them out of the process should result in trials that are both faster and cheaper. (There are reasons to be skeptical about this, as I have discussed in the past, but the desire to drop all those pesky sites is palpable.)

However, while a few proof-of-concept studies have been done, there really doesn't seem to have been another trial to attempt a full-blown direct-to-patient clinical trial. Other pilots have been more successful, but had fairly lightweight protocols. For all its problems, REMOTE was a seriously ambitious project that attempted to package a full-blown interventional clinical trial, not an observational study.

In this context, it's great to see published results of the TAPIR Trial in vasculitis, which as far as I can tell is the first real attempt to run a DIY trial of a similar magnitude to REMOTE.

TAPIR was actually two parallel trials, identical in every respect except for their sites: one trial used a traditional group of 8 sites, while the other was virtual and recruited patients from anywhere in the country. So this was a real-time, head-to-head assessment of site performance.

And the results after a full two years of active enrollment?

• Traditional sites: 49 enrolled
• Patient centric: 10 enrolled

Even though we’re six years later, and online/mobile communications are even more ubiquitous, we still see the exact same struggle to enroll patients.

Maybe it’s time to stop blaming the sites? To be fair, they didn’t exactly set the world on fire – and I’m guessing the total cost of activating the 8 sites significantly exceeded the costs of setting up the virtual recruitment and patient logistics. But still, the site-less, “patient centric” approach once again came up astonishingly short.
Krischer J, Cronholm PF, Burroughs C, McAlear CA, Borchin R, Easley E, Davis T, Kullman J, Carette S, Khalidi N, Koening C, Langford CA, Monach P, Moreland L, Pagnoux C, Specks U, Sreih AG, Ytterberg S, Merkel PA, & Vasculitis Clinical Research Consortium. (2017). Experience With Direct-to-Patient Recruitment for Enrollment Into a Clinical Trial in a Rare Disease: A Web-Based Study. Journal of medical Internet research, 19 (2) PMID: 28246067

By adopting a contingent workforce model and investing in the right data tools to power better informed decision-making and talent strategy, healthcare organizations can begin to address staffing challenges and turn their talent goals into reality. 

The post Closing Staffing Gaps in Healthcare by Utilizing Diverse Pipelines of Contingent Talent appeared first on MedCity News.

 We introduced a Topics tab in the online documentation a few releases ago, and there are corresponding pages in our focus area that briefly describe the topic areas and the procedures that perform analyses for those areas.

This paper provides an example that shows you how to use multiple RANDOM statements in PROC NLMIXED to fit nested nonlinear mixed models, and it provides details about the computation that is involved in fitting these models.

Shahbaz noted that Zardari appealed to the PML-N to avoid mentioning allegations that former Chief Justice Hamid Dogar had arranged preferential treatment for his daughter's school admission

Apr 9, 2024

The xz Utils backdoor incident reveals that the security of the global internet depends on countless obscure pieces of software written and maintained by even more obscure unpaid, distractible, and sometimes vulnerable volunteers. It’s an untenable situation, and one that is being exploited by malicious actors. Yet precious little is being done to remedy it.

May 22, 2024

Joseph Nye posits that an open civil society that allows protest can be a soft power asset.

National Dog Bite Prevention Week is May 18-24. Any dog can bite, regardless of breed. Be a responsible pet owner.

Volvo V90 Reveal

The Park Family�s Infertility Story

Sir,

Payments made for software license but hit by Circular No.21/2012, consequently, no tax deducted u/s 194J.

Whether the said amount would still be booked under royalty?

Is there anything more comforting on a cold, wet day than a steaming bowl of lentil soup? If there is, I haven’t found it yet. Other soups are also warm and inviting, but there’s something homey, something friendly, about lentil soup that warms me spiritually as well as physically. When cooler weather finally hit Louisiana,...

Read More

The post Lentil, Mushroom, and Farro Soup appeared first on FatFree Vegan Kitchen.

Allowing for moves that create quantum superpositions makes a quantum version of a Rubik’s cube incredibly complex, but not impossible to solve

“I was looking for a simple roasted carrot recipe on your site and couldn’t find one,” a friend told me a month ago and I immediately put “simple roasted carrot recipe” on my sprawling, decades-long To Cook list because sometimes I forget myself, too. Spoiler: I was never going to write a simple recipe for roasted carrots.

Read more »

Welcome back to Cover Snark! From Rachael: I have so many questions: Does she not want him to save her from what looks to be an alligator? Is that alligator okay? His hips seem off. Should his gun be that close to the water? Why are they casually having a moment in this clearly dangerous water??!! Did they keep their shoes on? Sarah: She’s a shifter. So is the gator. That’s her brother and she … Continue reading Cover Snark: Reptiles are an Unintentional Theme →

Full Article