Incidental diagnosis in healthy clinical trial subjects.


Duncan, CJ; Rowland, R; Lillie, PJ; Meyer, J; Sheehy, SH; O'Hara, GA; Hamill, M; Donaldson, H; Dinsmore, L; Poulton, ID; Gilbert, SC; McShane, H; Hill, AV; (2012) Incidental diagnosis in healthy clinical trial subjects. Clinical and translational science, 5 (4). pp. 348-50. ISSN 1752-8054 DOI: https://doi.org/10.1111/j.1752-8062.2011.00393.x

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Abstract

Previously unrecognized medical conditions identified in volunteers for early phase clinical studies have significant clinical and ethical implications for the participant. It is therefore crucial that the potential for unexpected diagnosis is addressed during the informed consent process. But the frequency of incidental diagnosis in healthy volunteers who attend for clinical trial screening remains unclear. To assess this we retrospectively analyzed 1,131 independent screening visits for 990 volunteers at a single academic center over a 10-year period to describe the frequency and nature of new clinical findings. Overall 23 of 990 volunteers (2.3%) were excluded at screening for a newly diagnosed medical abnormality. Some clinically important conditions, such as nephrotic syndrome and familial hypercholesterolemia were identified. The frequency of abnormalities was associated with increasing age in males (p= 0.02 χ(2) for trend) but not females (p= 0.82). These data will assist those planning and conducting phase I/II vaccine trials in healthy volunteers, and importantly should strengthen the informed consent of future trial participants.

Item Type: Article
Faculty and Department: Faculty of Infectious and Tropical Diseases > Dept of Clinical Research
PubMed ID: 22883613
Web of Science ID: 307382000012
URI: http://researchonline.lshtm.ac.uk/id/eprint/2352367

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