The future direction of clinical trials.
BACKGROUND
A milestone in the acquisition of medical information was the development of the concept of clinical trials, which has permitted the documentation and codification of treatment results. This has led to significant advances in clinical medicine during the past few decades.


METHODS
This article addresses the future of clinical trials from several perspectives. What forces are present in the clinical world that would affect the continuation of clinical trials? What are the influences of cost and participants' attitudes on clinical trials? What developments in basic science may alter the direction of clinical trials?


RESULTS
The role of volunteers in the conduct of clinical trials is explored. The entry of gene transfer therapy into clinical trials is discussed.


CONCLUSIONS
Clinical trials hold the key to treatment decisions in medicine. Health care planners will look at clinical trial results for the basis of reimbursement or financing. Therefore, as medical professionals, we must be vigilant of the conduct and results of clinical trials. We must be sure of the validity of their results and ensure their applicability to the proper management of patients.
Department of Oncology and Hematology, Straub Clinic and Hospital, Honolulu, Hawaii 96813.
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D002986:Clinical Trials as Topic / Q000191:economics / Q000639:trends*; D003365:Costs and Cost Analysis; D005544:Forecasting; D018014:Gene Transfer Techniques; D018166:Health Care Reform; D006801:Humans; D009369:Neoplasms / Q000235:genetics / Q000517:prevention & control / Q000628:therapy; D011788:Quality of Life