In several recent studies, researchers have pointed out that modern clinical research suffers from an awareness problem. A 2001 survey show that 85 percent of patients either unaware or unsure that clinical trial participation was an option for them at the time of their diagnosis. That's why we're especially appreciative of the all the efforts surrounding International Clinical Trials Day. We can help both current and future patients by spreading the word about the availability of clinical trials, and the possibilities of new and better treatments through research.
International Clinical Trials Day is celebrated each year around May 20, in honor of the day in 1747 that Dr. James Lind is credited for having conducted the first controlled clinical trial in an effort to determine an effective treatment for scurvy. The celebration was originally initiated by The European Clinical Research Infrastructures Network (ECRIN).
This year, we thought it would be fun to present the work of Dr. Lind through the modern lens of ClinicalTrials.gov. We imagined (with a healthy dose of satire), what Dr. Lind's famous scurvy trial would look like if it were listed on the site today. In addition to providing some entertainment and awareness about clinical research, we hope that the exercise also provides some insight into how information is organized in a typical CT.gov entry.
Click the image below to see the full interactive site. You'll find more information under each of the tabs, and in some of the hyperlinks.
Why Study Scurvy Treatments?
In 1747 it was quite common for sailors to come down with scurvy after spending some time at sea. There was no consensus on how to treat the disease, or even what caused it. In fact, the conventional wisdom at the time was that the humid air at sea caused scurvy.
It is certain, that such bad diet as has been mentioned, will corrupt the blood and humors; but nothing is clearer from the whole history of this voyage, than this, that the air is even more than any other agent, concerned in bringing on the mischief.
Dr. Richard Mead, A Discourse on The Scurvy, 1749
Although there was no consensus on what caused scurvy, there were earlier reports of lemons and oranges helping sailors afflicted with the disease. According to The Medical Works of Dr. Richard Mead (page 443-444), Sir Charles Wager, a British Admiral in the Royal Navy, told Lind that on a voyage in the Baltic in 1731 his men were badly afflicted with scurvy. He, "recollecting, from what he had often heard, how effectual [oranges and lemons] were in the cure of this distemper," took on "a great quantity of lemons and oranges." When his crew ate what they could and mixed the juice with their beer, they returned home "in good health."
Even though citrus fruits had been shown to have positive effects against scurvy, it wasn't until Dr. James Lind's 1747 voyage that a controlled trial with multiple treatment arms was used to definitively determine it as an effective treatment for the disease.
Dr. Lind's Impact
Dr. Lind's work had an important impact on health and medical research. By imagining what his study might have looked like in a modern setting like ClinicalTrials.gov, we hope to get a better understanding of how far we've come, and how far we still have to go. The James Linds of the world are very important in helping to advance medical treatments, but so too are the patients who give their time to participate in clinical research. The sailors' contributions to Dr. Lind's trial were not at all insignificant; they contributed greatly to the overall understanding of the disease and its treatment. The same is true of patients today.