Clinical Study Design
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Clinical study design is the formulation of trials and experiments, as well as observational studies in medical, clinical and other types of research (e.g., epidemiological) involving human beings. The goal of a clinical study is to assess the safety, efficacy, and / or the mechanism of action of an investigational medicinal product (IMP) or procedure, or new drug or device that is in development, but potentially not yet approved by a health authority (e.g. Food and Drug Administration). It can also be to investigate a drug, device or procedure that has already been approved but is still in need of further investigation, typically with respect to long-term effects or cost-effectiveness. Some of the considerations here are shared under the more general topic of design of experiments but there can be others, in particular related to patient confidentiality and ethics.


Outline of types of designs for clinical studies


Treatment studies

* Randomized controlled trial **
Blind trial In a blind or blinded experiment, information which may influence the participants of the experiment is withheld until after the experiment is complete. Good blinding can reduce or eliminate experimental biases that arise from a participants' expec ...
** Non-blind trial * Adaptive clinical trial ** Platform Trials * Nonrandomized trial (quasi-experiment) ** Interrupted time series design (measures on a sample or a series of samples from the same population are obtained several times before and after a manipulated event or a naturally occurring event) - considered a type of quasi-experiment


Observational studies

1. Descriptive * Case report * Case series *
Population study Population study is an interdisciplinary field of scientific study that uses various statistical methods and models to analyse, determine, address, and predict population challenges and trends from data collected through various data collection m ...
2. Analytical * Cohort study **
Prospective cohort A prospective cohort study is a longitudinal cohort study that follows over time a group of similar individuals (cohorts) who differ with respect to certain factors under study, to determine how these factors affect rates of a certain outcome. F ...
**
Retrospective cohort A retrospective cohort study, also called a historic cohort study, is a longitudinal cohort study used in medical and psychological research. A cohort of individuals that share a common exposure factor is compared with another group of equivalen ...
** Time series study * Case-control study ** Nested case-control study * Cross-sectional study ** Community survey (a type of cross-sectional study) *
Ecological study In epidemiology, ecological studies are used to understand the relationship between outcome and exposure at a population level, where 'population' represents a group of individuals with a shared characteristic such as geography, ethnicity, socio-ec ...


Important considerations

When choosing a study design, many factors must be taken into account. Different types of studies are subject to different types of bias. For example, recall bias is likely to occur in cross-sectional or case-control studies where subjects are asked to recall exposure to risk factors. Subjects with the relevant condition (e.g. breast cancer) may be more likely to recall the relevant exposures that they had undergone (e.g. hormone replacement therapy) than subjects who don't have the condition. The ecological fallacy may occur when conclusions about individuals are drawn from analyses conducted on grouped data. The nature of this type of analysis tends to overestimate the degree of association between variables.


Seasonal studies

Conducting studies in seasonal indications (such as allergies, Seasonal Affective Disorder,
influenza Influenza, commonly known as "the flu", is an infectious disease caused by influenza viruses. Symptoms range from mild to severe and often include fever, runny nose, sore throat, muscle pain, headache, coughing, and fatigue. These symptoms ...
, and others) can complicate a trial as patients must be enrolled quickly. Additionally, seasonal variations and weather patterns can affect a seasonal study.


Other terms

* The term ''retrospective study'' is sometimes used as another term for a case-control study. This use of the term "retrospective study" is misleading, however, and should be avoided because other research designs besides case-control studies are also retrospective in orientation. * ''Superiority trials'' are designed to demonstrate that one treatment is more effective than a given reference treatment. This type of study design is often used to test the effectiveness of a treatment compared to placebo or to the currently best available treatment. * ''Non-inferiority trials'' are designed to demonstrate that a treatment is at least not appreciably less effective than a given reference treatment. This type of study design is often employed when comparing a new treatment to an established medical standard of care, in situations where the new treatment is cheaper, safer or more convenient than the reference treatment and would therefore be preferable if not appreciably less effective. * ''Equivalence trials'' are designed to demonstrate that two treatments are equally effective. * When using "parallel groups", each patient receives one treatment; in a " crossover study", each patient receives several treatments but in different order. * A longitudinal study assesses research subjects over two or more points in time; by contrast, a cross-sectional study assesses research subjects at only one point in time (so case-control, cohort, and randomized studies are ''not'' cross-sectional).


See also

*
Conceptual framework A conceptual framework is an analytical tool with several variations and contexts. It can be applied in different categories of work where an overall picture is needed. It is used to make conceptual distinctions and organize ideas. Strong conceptu ...
*
Epidemiological methods The science of epidemiology has matured significantly from the times of Hippocrates, Semmelweis and John Snow. The techniques for gathering and analyzing epidemiological data vary depending on the type of disease being monitored but each study wi ...
* Epidemiology * Experimental control * Meta-analysis * Operationalization * Academic clinical trials * Design of experiments * Research design


References


External links


Some aspects of study design
Tufts University web site

Description of study designs from the National Cancer Institute {{Statistics, applications, state=collapsed Medical statistics Design of experiments Scientific method de:Forschungsdesign