Abstract
Defining the study population in the protocol is an integral part of posing the primary question. Additionally, in claiming an intervention is or is not effective it is essential to describe the type of participants on which the intervention was tested. Thus, the description requires two elements: specification of criteria for eligibility and description of who was actually enrolled. This chapter focuses on how to define the study population. In addition, it considers two questions. First, what impact does selection of eligibility criteria have on participant recruitment, or, more generally, study feasibility? Second, to what extent will the results of the trial be generalizable to a broader population? This issue is also discussed in Chap. 10.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Rothwell PM. External validity of randomized controlled trials: “To whom do the results of this trial apply?” Lancet 2005;365:82–93.
CONSORT. http://www.consort-statement.org
Van Spall HGC, Toren A, Kiss A, Fowler RA. Eligibility criteria of randomized controlled trials published in high-impact general medical journals: a systematic sampling review. JAMA 2007;297:1233–1240.
Douglas PS. Gender, cardiology, and optimal medical care. Circulation 1986;74:917–919.
Bennett JC, for the Board on Health Sciences Policy of the Institute of Medicine. Inclusion of women in clinical trials – policies for population subgroups. N Engl J Med 1993;329:288–292.
Freedman LS, Simon R, Foulkes MA, et al. Inclusion of women and minorities in clinical trials and the NIH Revitalization Act of 1993 – the perspective of NIH clinical trialists. Control Clin Trials 1995;16:277–285.
Lee PY, Alexander KP, Hammill BG, et al. Representation of elderly persons and women in published randomized trials of acute coronary syndromes. JAMA 2001;286:708–713.
NIH Policy and Guidelines on the Inclusion of Women and Minorities as Subjects in Clinical Research – Amended, October, 2001. http://grants.nih.gov/grants/funding/women_min/guidelines_amended_10_2001.htm
Diabetic Retinopathy Study Research Group: Preliminary report on effects of photocoagulation therapy. Am J Ophthalmol 1976;81:383–396.
Diabetic Retinopathy Study Research Group. Photocoagulation treatment of proliferative diabetic retinopathy: the second report of diabetic retinopathy study findings. Ophthalmol 1978;85:82–106.
Wooster R, Neuhausen SL, Mangion J, et al. Localization of a breast cancer susceptibility gene, BRCA2, to chromosome 13q12-13. Science 1994;265:2088–2090.
Patel MR, Mahaffey KW, Garg J, et al. for ROCKET AF investigators. Rivaroxaban versus warfarin in nonvalvular atrial fibrillation. N Engl J Med 2011;365:883–891.
Veterans Administration Cooperative Study Group on Antihypertensive Agents. Effects of treatment on morbidity in hypertension: results in patients with diastolic blood pressures averaging 115 through 129 mm Hg. JAMA 1967;202:1028–1034.
Veterans Administration Cooperative Study Group on Antihypertensive Agents. Effects of treatment on morbidity in hypertension: II. Results in patients with diastolic blood pressure averaging 90 through 114 mm Hg. JAMA 1970;213:1143–1152.
Hypertension Detection and Follow-up Program Cooperative Group. Five-year findings of the Hypertension Detection and Follow-up Program. 1. Reduction in mortality of persons with high blood pressure, including mild hypertension. JAMA 1979;242:2562–2571.
The CONSENSUS Trial Study Group. Effects of enalapril on mortality in severe heart failure. N Engl J Med 1987;316:1429–1435.
The SOLVD Investigators. Effect of enalapril on survival in patients with reduced left ventricular ejection fractions and congestive heart failure. N Engl J Med 1991;325:293–302.
The SOLVD Investigators. Effect of enalapril on mortality and the development of heart failure in asymptomatic patients with reduced left ventricular ejection fractions. N Engl J Med 1992;327:685–691.
Vollmer T. The natural history of relapses in multiple sclerosis. J Neurol Sci 2007;256:S5-S13.
Sondik EJ, Brown BW, Jr., Silvers A. High risk subjects and the cost of large field trials. J Chronic Dis 1974; 27:177–187.
Ridker PM, Danielson E, Fonseca FAH, et al. Rosuvastatin to prevent vascular events in men and women with elevated C-reactive protein. N Engl J Med 2008;359:2195–2207.
http://www.fda.gov/downloads/drugs/guidancecomplianceregulatoryinformation/guidances/ucm332181.pdf.
Darrow JJ, Avorn J, Kesselheim AS. New FDA breakthrough-drug category—implications for patients. N Engl J Med 2014;370:1252–1258.
McMurray JJV, Packer M, Desai AS, et al. Angiotensin-neprilysin inhibition versus enalapril in heart failure. N Engl J Med 2014;371:993–1004.
Tunis SR, Stryer DB, Clancy CM. Practical clinical trials: increasing the value of clinical research for decision making in clinical and health policy. JAMA. 2003;290:1624–1632.
Thorpe KE, Swarenstein M, Oxman AD, et al. A pragmatic-explanatory continuum indicator summary (PRECIS): a tool to help trial designers. J Clin Epidemiol 2009;62:464–475.
Ridker PM and PREVENT Investigators. Long-term, low does warfarin among venous thrombosis patients with and without factor V Leiden mutation: rationale and design for the Prevention of Recurrent Venous Thromboembolism (PREVENT) trial. Vasc Med 1998;3:67–73.
Mooney MM, Welch J, Abrams JS. Clinical trial design and master protocols in NCI clinical treatment trials. [abstract]. Clin Cancer Res 2014;20(2Suppl):Abstract IA08.
Hakonarson H, Thorvaldsson S, Helgadottir A, et al. Effects of a 5-lipoxygenase-activating protein inhibitor on biomarkers associated with risk of myocardial infarction: a randomized trial. JAMA 2005;293:2245–2256.
The U.S. Food and Drug Administration. Drugs. Table of pharmacogenomics biomarkers in labeling. www.fda.gov/drugs/scienceresearch/researchareas/pharmacogenetics/ucm083378.htm.
Mrazek DA. Psychiatric pharmacogenomics. New York: Oxford University Press, 2010.
Landrum MJ, Lee JM, Riley GR, et al. ClinVar: public archive of relationships among sequence variation and human phenotype. Nucleic Acids Res 2014;42 (Database issue):D980-5.
Mailman MD, Feolo M, Jin Y, et al. The NCBI dbGaP database of genotypes and phenotypes. Nat Genet 2007;39:1181–1186.
Wilhelmsen L, Ljungberg S, Wedel H, Werko L. A comparison between participants and non-participants in a primary preventive trial. J Chronic Dis. 1976;29:331–339.
Smith P, Arnesen H. Mortality in non-consenters in a post-myocardial infarction trial. J Intern Med 1990; 228:253–256.
Antithrombotic Trialists’ Collaboration. Collaborative meta-analysis of randomized clinical trials of antiplatelet therapy for prevention of death, myocardial infarction, and stroke in high risk patients. BMJ 2002;324:71–86; correction BMJ 2002;324:141.
Steering Committee of the Physicians’ Health Study Research Group. Final report on the aspirin component of the ongoing Physicians’ Health Study. N Engl J Med 1989;321:129–135.
Peto R, Gray R, Collins R, et al. Randomized trial of prophylactic daily aspirin in British male doctors. Br Med J 1988;296:313–316.
Ridker PM, Cook NR, Lee I-M, et al. A randomized trial of low-dose aspirin in the primary prevention of cardiovascular disease in women. N Engl J Med 2005;352:1293–1304.
Ikeda Y, Shimada K, Teramoto T, et al. Low-dose aspirin for primary prevention of cardiovascular events in Japanese patients 60 years or older with atherosclerotic risk factors. A randomized clinical trial. JAMA. Published online November 17, 2014. doi:10.1001/jama.2014.15690.
Berger JS, Roncaglioni MC, Avanzini F, et al. Aspirin for the primary prevention of cardiovascular events in women and men: a sex-specific meta-analysis of randomized controlled trials. JAMA 2006;295:306–313; correction JAMA 2006;295:2002.
Pedersen TR. The Norwegian Multicenter Study of timolol after myocardial infarction. Circulation 1983;67 (suppl 1):I-49-1-53.
CASS Principal Investigators and Their Associates. Coronary Artery Surgery Study (CASS): a randomized trial of coronary artery bypass surgery. Comparability of entry characteristics and survival in randomized patients and nonrandomized patients meeting randomization criteria. J Am Coll Cardiol 1984;3:114–128.
Kaariainen I, Sipponen P, Siurala M. What fraction of hospital ulcer patients is eligible for prospective drug trials? Scand J Gastroenterol 1991;186:73–76.
Benedict GW. LRC Coronary Prevention Trial: Baltimore. Clin Pharmacol Ther 1979;25:685–687.
Pitt B, Pfeffer MA, Assmann SF, et al. TOPCAT Investigators. Spironolactone for heart failure with preserved ejection fraction. N Engl J Med 2014;370:1383–1392.
Author information
Authors and Affiliations
Rights and permissions
Copyright information
© 2015 Springer International Publishing Switzerland
About this chapter
Cite this chapter
Friedman, L.M., Furberg, C.D., DeMets, D.L., Reboussin, D.M., Granger, C.B. (2015). Study Population. In: Fundamentals of Clinical Trials. Springer, Cham. https://doi.org/10.1007/978-3-319-18539-2_4
Download citation
DOI: https://doi.org/10.1007/978-3-319-18539-2_4
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-18538-5
Online ISBN: 978-3-319-18539-2
eBook Packages: Mathematics and StatisticsMathematics and Statistics (R0)