What clinical trial of the past has inspired you or stands out to you as one of the most important studies?
Each month, Look Who’s Talking features voices from across BWH answering the same question. This month, BWHers share their thoughts on a clinical trial that has inspired them or stands out as important. If you would like to add your voice to the conversation, please submit a comment at the bottom of the page.
“While all of our studies inspire me in one way or another, I think a Hepatitis C study had the biggest impact on me. We were part of the drug study for the cure of hepatitis C virus. Some of my participants were desperate for a cure and traveled from afar. The drug was so successful that 100 percent of participants now carry on a life free of HCV. It was a big win for the world of infectious diseases. With continued support, we will to strive in our quest to cure other infectious diseases, including HIV.”
-Cheryl Keenan RN BC, Clinical Trials Study Coordinator, Division of Infectious Diseases
One of the most important clinical trials in my area of applied psychology was by Stanley Milgram, who first demonstrated the power of obedience to authority in a series of classic experiments in the 1960s at Yale. In one of these, an experimenter wearing a lab coat convinced participants to deliver 450-volt shocks to innocent people with simple instructions such as “you must proceed,” as punishment for incorrect answers on a general knowledge quiz. Of course, this was a simulation – they were not real electric shocks – but it demonstrated that under the right conditions, people are willing to do almost anything to please someone they perceive as powerful.”
-Steven Yule, PhD, MA, MSc, Director of Education & Research, STRATUS Center for Medical Simulation
“A clinical study we conducted in the Division of Sleep and Circadian Disorders illustrating that people do not allow enough time for sleep inspired me because everyone wants to know how much sleep they need. The protocol was a study of people’s sleep timing and duration. At first, study participants slept at their habitual time and duration. When additional sleep opportunities of up to 16 hours a day were added – twelve hours at night, and four hours midday (i.e, a nap) – people slept more, indicating that most people do not allow enough time for sleep.”
-Elizabeth Klerman, MD, PhD, Physician, Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology
“The study that has most influenced my clinical practice is the ACE Study (Adverse Child Experiences). This study was conducted by the Centers for Disease Control and Kaiser Permanente. Over 17,000 patients participated. The findings demonstrated an association of adverse childhood experiences (ACEs) with health and social problems as an adult. The study is frequently cited as a notable landmark in epidemiological research and has produced more than 60 scientific articles. The takeaway is that experiences of trauma, violence and abuse as a child adversely affect the health of adults. The study’s findings support universal screening for trauma. We should assume that everyone has experienced some form of trauma in their lives, some more than others, and that those experiences are highly correlated to poor health, such as mental health illnesses, substance use disorders, diabetes and weight disorders to name a few. Personally, I feel the evidence supports that all patients should be screened universally for trauma, violence and abuse.”
-Annie Lewis O’Connor, PhD, BC-NP, FAAN, nurse-scientist, founder and director of the Coordinated Approach to Recovery and Empowerment (C.A.R.E.) Clinic
“The clinical trial that stands out to me as one of the most transformative pieces of research is the Diabetes Control and Complications Trial (DCCT). The findings of DCCT completely changed how we treat patients with diabetes, firmly establishing lowering blood glucose levels as the primary means to reducing the risk of the feared complications of the disease. DCCT gave rise to the widespread adoption of glucose level targets in treatment of diabetes, which in turn led to the dramatic decrease in the risk of blindness, kidney failure, amputations and other complications. As if this was not sufficient, DCCT has also served as the foundation for a long-term epidemiological study of the same group of patients who participated in DCCT (Epidemiology of Diabetes Interventions and Complications study / EDIC) that over the last 30 years has provided crucial information on the effect of intensive blood glucose control on the more advanced stages of complications and cardiovascular disease. Few other studies can match DCCT in its breadth of impact on how we treat an illness.”
-Alexander Turchin, MD, MS, Director of Quality in Diabetes, Division of Endocrinology, Diabetes and Hypertension
“The NIMH RAISE trial stands out to me as one with a particularly high impact. It highlighted the need for a very comprehensive approach to treating patients early in the course of a psychotic illness and that this care can be provided by community clinics (e.g., does not require an academic/research setting). The need for a multidisciplinary team including personalized medication management alongside individual therapy, family psychoeducation and supportive employment services was emphasized. The societal impact of this trial is what makes it stand out from other trials, as the results were largely responsible for the implementation of a state-level specialty care program in New York (called OnTrackNY) which uses this model for early phase psychosis and is funded by the New York State Office of Mental Health. Initial funding for this program in New York led to the 2014 U.S. House of Representatives bill that increased funding for early psychosis treatment by 5 percent nationwide. Similar programs have now been implemented across the country. The importance of intervening early is clear, and the RAISE trial helped to push funding forward that will ultimately improve the quality of life for our patients.”
-Katherine Burdick, PhD, Director of Mood and Psychosis Research Program and Associate Vice Chair for Research, Department of Psychiatry