We are promoting the concept of the Clinical Care Trial (CCT) to provide a way out of common clinical dilemmas.  CCTs are large, simple, pragmatic RCTs integrated into clinical practice.

These are their characteristics:

1.    CCTs ask simple questions, that are relevant to current practice and that will lead to valid answers.

2.    Follow-up visits in CCTs are the same as those performed as a part of routine care. No extra visits, no extra tests and no extra time...

3.    Endpoints are pre-defined, simple, meaningful and resistant to bias, and most importantly, kept to a minimum.

4.    Data are recorded on simple electronic forms and do not request data beyond those regularly collected during visits or interventions.

 Clinical Care Trials will ultimately lead to patients receiving care that is guided by evidence. In the meanwhile, before any definite answer is yet available, they offer treatment with as-yet unproven therapies under the protection of a well-designed randomized clinical trial. 


CCTs about intracranial aneurysms

The management of unruptured intracranial aneurysms is a true dilemma, whether entertained by neuroradiologists, neurosurgeons or neurologists. Once the decision has been made to treat the aneurysm, no easy decision in itself, the best treatment modality remains uncertain. New, supposedly more efficacious devices are increasingly available, but since most patients are asymptomatic, preventive treatment must be very safe.

Providing evidence for optimal medical care requires large-scale international Randomized Controlled Trials (RCTs). These are turning into almost impossible endeavors due to financial, regulatory, contractual and organizational hurdles. Yet, answers are desperately needed.  Hence, trials are often replaced by registries and observational studies.  These methodologies are not only scientifically weak when they are not misleading.  They are inappropriate for clinicians, since they basically involve treating patients claiming we know what to do, to later reveal the uncertainty, and  do biased research without the consent of participants.

Browse the different studies we are proposing in top horizontal navigation tab.  Do not hesitate to contact us for more information or if you wish to join those studies.

Guylaine Gevry,
Dec 3, 2015, 8:03 AM