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      Configuring the patient as clinical research subject in the UK national health service

      research-article
      a , * , a
      Anthropology & Medicine
      Routledge
      patients in research, biomedicine, beliefs, UK

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          Abstract

          This paper examines a central image in UK academic clinical research – the patient as altruistic research subject – by means of an interpretive review of social science, bioethical and bioscience research and development policy literatures. The review examines this image as it is indicted in discussions about the nature of clinical science; is consolidated in the ethical regulation of this science; and is articulated in recent bioscience research and development government initiatives. Drawing on Strathern's notion of the virtual (public-sector) subject, the review identifies the anticipation of NHS patients as alternatively ‘available’ or ‘entitled’ to the expanding translational medicine industry.

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          Most cited references53

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          The meaning of translational research and why it matters.

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            What influences recruitment to randomised controlled trials? A review of trials funded by two UK funding agencies

            Background A commonly reported problem with the conduct of multicentre randomised controlled trials (RCTs) is that recruitment is often slower or more difficult than expected, with many trials failing to reach their planned sample size within the timescale and funding originally envisaged. The aim of this study was to explore factors that may have been associated with good and poor recruitment in a cohort of multicentre trials funded by two public bodies: the UK Medical Research Council (MRC) and the Health Technology Assessment (HTA) Programme. Methods The cohort of trials was identified from the administrative databases held by the two funding bodies. 114 trials that recruited participants between 1994 and 2002 met the inclusion criteria. The full scientific applications and subsequent trial reports submitted by the trial teams to the funders provided the principal data sources. Associations between trial characteristics and recruitment success were tested using the Chi-squared test, or Fisher's exact test where appropriate. Results Less than a third (31%) of the trials achieved their original recruitment target and half (53%) were awarded an extension. The proportion achieving targets did not appear to improve over time. The overall start to recruitment was delayed in 47 (41%) trials and early recruitment problems were identified in 77 (63%) trials. The inter-relationship between trial features and recruitment success was complex. A variety of strategies were employed to try to increase recruitment, but their success could not be assessed. Conclusion Recruitment problems are complex and challenging. Many of the trials in the cohort experienced recruitment difficulties. Trials often required extended recruitment periods (sometimes supported by additional funds). While this is of continuing concern, success in addressing the trial question may be more important than recruitment alone.
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              The Construction of Lay Expertise: AIDS Activism and the Forging of Credibility in the Reform of Clinical Trials

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                Author and article information

                Journal
                Anthropol Med
                Anthropol Med
                CANM
                canm20
                Anthropology & Medicine
                Routledge
                1364-8470
                1469-2910
                4 May 2015
                13 March 2015
                : 22
                : 2
                : 138-148
                Affiliations
                [ a ]King's College London, Primary Care and Public Health Research, King's College School of Medicine , Capital House 7th Floor, 42 Weston Street, London SE1 3QD, UK
                Author notes
                Article
                997192
                10.1080/13648470.2014.997192
                4566872
                25765178
                741cdf79-1670-4669-b32c-596ebd38e2de
                © 2015 The Author(s). Published by Taylor & Francis.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License ( http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited, and is not altered, transformed, or built upon in any way.

                History
                : 17 September 2013
                : 8 December 2014
                Page count
                Figures: 0, Tables: 0, References: 54, Pages: 11
                Categories
                Original Papers

                Anthropology
                patients in research,biomedicine,beliefs,uk
                Anthropology
                patients in research, biomedicine, beliefs, uk

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