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I'm Dr Steve Cummings I direct the San Francisco Coordinating Center, and I'm a senior investigator at the California Pacific Medical Center Research Institute and a professor of medicine and epidemiology at UC San Francisco We just wrote a paper in the New England Journal of Medicine about electronic informed consent and Internet-based clinical trials Doing consent electronically allows you a number of other capabilities; for example you can embed links in a consent form that allows a patient to check that link or click that link and go to a page where they learn more about the study It's important as well to understand that the patient really comprehends the research since you are not there talking to the patient in person Just as informed consent can be done electronically and done from home clinical trials can also be done remotely and done from patients' homes So the second part of our article is about Internet-based clinical trials Internet-based clinical research is now done commonly for things like smoking cessation or weight loss where patients sign on gets advice and then measures or reports their smoking history or weight later on But trials that involve drugs or nutritional supplements have been done much less commonly There are a few examples that have been successful and Internet-based clinical trials have a couple of important advantages one it allows the opportunity for patients to participate who don't live near traditional clinical sites where drug trials are done; and secondly since they're done from home without a clinical site such trials can be much less expensive than standard trials So I'm going to use an example of a clinical trial to illustrate Internet-based trials that is being done by a young faculty member at UC San Francisco It's a trial of melatonin an over-the-counter sleep aid to treat migraine headaches in adolescents So imagine in this case the first step is to reach your patients who might qualify; you can do that using medical records searching medical records for patients who may have the diagnosis and offering them the opportunity to go to a website for example to participate or reaching out to patient communities again online with a link to a website And on the website get more information about the proposed trial and if there is interest the patient may click on an opportunity to provide informed consent to then give name and address and some basic information to determine whether they would be eligible for the trial I think the future for Internet-based clinical trials is very bright However only a few have been published others are underway we need a lot more experience with how to do them how to do them efficiently and with issues that might arise in the course of doing drug-based clinical research online However I think that it has a lot of potential saving money making trials more accessible to a broader range of patients particularly those who can't get to clinical sites where such trials would be...
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