REthinking Clinical Trials (REaCT) is a unique research program aimed at improving the lives of people with cancer through patient-centred, pragmatic clinical trials.
Based at The Ottawa Hospital, the REaCT program engages patients and their loved ones in research every step of the way, from generating ideas to setting priorities to designing studies and sharing results.
Unlike most cancer clinical trials, which are focused on evaluating experimental treatments in a very narrow patient population with very strict and limiting eligibility criteria, REaCT trials compare standard approved treatments in a real-world setting with patients who more closely represent those we see in clinical practice. In this way, REaCT trials can efficiently answer some of the most important questions for cancer patients and the health care system.
REaCT is a key component of The Ottawa Hospital’s Cancer Therapeutics Program and Divisions of Medical, Radiation and Surgical Oncology. REaCT is enabled by the Ottawa Methods Centre, which is supported by generous donors to The Ottawa Hospital Foundation. Individual REaCT studies are also supported by various external funders.
Patients, family members and health-care providers are surveyed to find out which questions are most important to them. REaCT questions typically focus on comparing commonly-used treatments, rather than testing new treatments.
The research team conducts a systematic review of the evidence to determine if the question has been answered in previous studies.
Clinicians, scientists, methodologists and health economists work together to design the trial, with input from patients and families. REaCT trials are typically designed so that a wide range of cancer patients can easily participate without the need for extra tests, hospital visits or lengthy consent forms. Pilot studies are often conducted to refine the trial design before moving on to a larger study.
Patients are enrolled during regular clinic appointments and are often randomized to a treatment arm immediately, using mobile technology. Data are typically gathered in real-time from electronic medical records and through quality of life surveys.
Findings are published in open-access journals, so that patients, clinicians and policy-makers around the world can freely access results. Findings are also actively communicated to patient groups and other stakeholders. Economic impact is also assessed.
The development of a REaCT trial typically involves a number of steps, including:
1. Develop a meaningful question
Patients, family members and health-care providers are surveyed to find out which questions are most important to them. REaCT questions typically focus on comparing commonly-used treatments, rather than testing new treatments.
2. Review evidence
The research team conducts a systematic review of the evidence to determine if the question has been answered in previous studies.
3. Design trial
Clinicians, scientists, methodologists and health economists work together to design the trial, with input from patients and families. REaCT trials are typically designed so that a wide range of cancer patients can easily participate without the need for extra tests, hospital visits or lengthy consent forms. Pilot studies are often conducted to refine the trial design before moving on to a larger study.
4. Enroll participants and collect data
Patients are enrolled during regular clinic appointments and are often randomized to a treatment arm immediately, using mobile technology. Data are typically gathered in real-time from electronic medical records and through quality of life surveys.
5. Analyze and publish results
Findings are published in open-access journals, so that patients, clinicians and policy-makers around the world can freely access results. Findings are also actively communicated to patient groups and other stakeholders. Economic impact is also assessed.
