Professor Louis Fiore from the Boston University School of Medicine will share his experience and knowledge of point of care clinical trials at the National Drug and Alcohol Research Centre (NDARC) on Monday, 8 October 2018.
Professor Fiore is a pioneer of point of care, or embedded, clinical trials where researchers and clinicians collaborate to compare treatments as they are delivered.
This approach is an alternative to traditional randomised controlled trials (RCT) where participants are enrolled and treated in a research ecosystem distinct from their healthcare environment.
RCTs are considered the gold standard of clinical research but are expensive and take many years before results are available and adopted by clinicians. Through collaboration with healthcare providers, point-of-care trials are less costly and their results are seamlessly implemented into clinical practice.
Professor Fiore has been developing the point of care approach for 10 years and believes it has huge potential for the community health and drug and alcohol sectors.
“As a care provider, I was all too aware that the majority of my clinical decisions were based on instinct rather than evidence,” Professor Fiore said.
“This disturbed me as I believed that we could do better if we were able to use data on treated patients to help guide us.
“Unfortunately, the only guidance available was published research and editorials that were spun from them. Couldn't we learn more by looking at our own patient data?”
Working with the US Department of Veterans Affairs, Professor Fiore initiated a program to allow the reuse of health record data to determine how clinicians were treating patients and what was working.
Armed with these data, researchers working with clinicians determined the most compelling clinical questions and designed observational or intervention studies in real world clinics to address them.
Point of care trials combine the statistical validity of a traditional clinical trial (largely due to randomisation) and the real-world applicability of an observational study.
Trials have been performed in clinical areas as varied as diabetes, hypertension, oncology and spinal surgery.
As well as contributing to improvements in health care delivery, a key outcome of this approach has been improved understanding and partnerships between researchers and clinicians.
“Clinicians and researchers work in a context where their cultural norms, motivations and expectations are not naturally aligned,” Professor Fiore said.
“To date, we have gone far in understanding how a clinical care and research partnership could work.
“Through our trials we have been able to pinpoint the overlapping interests of these two disparate groups.
“We learned that the foundation of the partnership is access and sharing of health record data, identification of common goals and forethought in how the knowledge generated would be put to use to further the interests of both partners.”
leads community intervention research at NDARC and said he was delighted to welcome Professor Fiore to the Symposium.
“Professor Fiore has been a pioneer and world leader in the development of embedded research for over a decade,” Professor Shakeshaft said.
“Research-clinical care partnerships, which are at the heart of point of care trials, have the potential to transform the delivery of community health care in Australia.
“Improved client, patient or community outcomes will not simply happen because of new knowledge generated in isolation from the systems that allow services and communities to function.
“Those who work in those systems or communities must be integral to the design, creation and application of new knowledge.”
Professor Fiore is an oncologist and research leader at the Boston University School of Medicine and first became interested in the potential of embedded clinical trials as a practicing oncologist.
He will present the keynote address, Embedding evaluation into the delivery of routine services at the NDARC Annual Research Symposium on Monday, 8 October 2018..
More information about the Symposium, including the full event program, is available on the .