Assessing general side effects in clinical trials: reference data from the general population

Pharmacoepidemiology and Drug Safety - Tập 20 Số 4 - Trang 405-415 - 2011
Winfried Rief1, Arthur J. Barsky2, Julia Anna Glombiewski1, Yvonne Nestoriuc1, Heide Glaesmer3, Elmar Brähler3
1University of Marburg, Germany#TAB#
2Harvard Medical School, Brigham & Women's Hospital, Boston, MA, USA
3Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany

Tóm tắt

AbstractPurposeSide effects in clinical trials are frequently assessed in an unstructured fashion, using ascertainment strategies with unclear quality criteria. To improve the assessment and interpretation of general side effects, a structured approach is presented and validated (General Assessment of Side Effects, GASE). Base rates and reference data of the general population as well as quality criteria of this new side effect ascertainment method are provided.MethodsWe developed a screener assessing the most common subjective side effects of clinical trials (according to FDA statistics and others). The screener was evaluated in a general population survey including 2512 participants, 1276 of them taking drugs.ResultsWe present reference data of the general population that help to interpret and compare future results of clinical trials assessing general side effects. Highest scores for side effects were reported from users of psychopharmacological drugs, medium scores of people taking antihypertensives, and lower scores of people taking lipid‐lowering drugs, pain killers, and antidiabetics. If people take multiple drugs, more side effects are reported compared to single‐class drugs. This confirms GASE's validity to assess side effects.ConclusionWe suggest that a structured, patient‐based approach to assess general side effects could improve the detection of drug‐induced side effects. The problem of clinical studies being underpowered to detect side effects could be reduced by using more reliable approaches. Our plea is for side effect ascertainment with sophisticated approaches for expected side effects, systematic screening for general side effects, and open question methods for spontaneous reports. Copyright © 2010 John Wiley & Sons, Ltd.

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Tài liệu tham khảo

10.1001/archinternmed.2009.313

10.1001/archinternmed.2009.306

10.1001/jama.287.17.2215

10.1016/S0140-6736(05)79825-1

Bennett CL, 2005, The research on adverse drug events and reports (RADAR) project, JAMA, 293

10.1001/archinte.166.2.155

10.1001/jama.2008.723

10.1001/jama.292.21.2585

10.1176/pn.43.5.0023

10.1097/00042560-200112150-00006

10.1001/jama.288.4.462

10.1001/jama.288.4.455

10.1016/j.amjhyper.2006.04.006

10.1056/NEJMp058174

10.1056/NEJMp0907708

10.1176/appi.ajp.161.9.1692

10.2165/11316580-000000000-00000

10.1016/j.jpsychores.2006.07.004

10.2165/00002018-200730080-00003

Glombiewski JA, The course of unspecific chest pain in primary care: symptom persistence and health care utilization, Arch Intern Med, 170, 251, 10.1001/archinternmed.2009.474

Rief W, 2009, General Assessment of Side Effects: GASE

10.1001/archinte.165.12.1363

Levine J, 1986, SAFTEE: a technique for the systematic assessment of side effects in clinical trials, Psychopharmacol Bull, 22, 343

10.1016/S0140-6736(00)02799-9

10.1046/j.1472-8206.2002.00066.x

10.1097/00004714-199202000-00002

10.1016/j.pain.2009.07.010

10.1159/000069738

10.1056/NEJMp0911494