Cy Pavlov ’24
EE Staff Writer
Medicine is not a one-size-fits-all game.
If you walk down the drug aisle at your local pharmacy, you will see Aspirin in all its derivations, yet there are separate drugs for relieving pain in children. This is because, unlike adults, children are dynamic, growing individuals who process the same substances differently. This is just one of the many examples of the world of clinical research.
Although many people do not give a second thought to clinical trials, they are the unsung heroes of the medical world responsible for putting the theory of medicine into practice. However, there is a problem within clinical research: there’s a serious lack of diversity, as a commission convened by the National Academies of Sciences, Engineering, and Medicine reports.
“Despite being important to collect data on all populations, there is unfortunately very low turn-out among many underrepresented groups” according to returning intern at the Yale Center for Clinical Investigations and current Yale student and Trumbull High alumni Gabriella Pavlov ’27 (THS ‘23).
How one reacts to medicine is not simply a function of one’s weight but is very multifactorial, as shown by several recent studies. Factors such as race, gender, and age can all play a major role in how effective certain treatments can be.
Drugs such as anti-coagulants — which free up the blood, preventing clots — become riskier to use as patients age due to a decline in kidney function according to a study published in Clinical Pharmacokinetics. And that’s just the tip of the iceberg: there are a myriad of ways similar processes can affect other groups that in turn affect which treatments can produce the best outcomes.
Pavlov continues, recalling how “a diverse population of participants can help analyze the effectiveness of different treatments among many different genotypes [the genetic variations of a human]”. The lack of diversity in clinical research is due to many factors such as a lack of access to care and discriminatory trials.
During the 19th and early 20th centuries, many clinical trials were done with little regard for patient safety or ethics due to a lack of established standards. Unfortunately, many of these offenses occurred against people of color. Furthermore, discrimination against racial minorities was instituted in the health system through segregation.
As a result, many underprivileged ethnic groups grew distrustful of the medical industry, fueled by these past abuses.
“The generational trauma endured has seriously reduced the participation we are seeing among people of color,” Pavlov added. “That needs to change”.
Although clinical research has had many difficulties, clinicians and the communities at large have been working toward solutions. For example, the Yale Cultural Ambassadors program employs local leaders to encourage participation in clinical research who otherwise do not trust medical personnel. Through advocating for research, the ambassadors serve as a crucial translational link between clinicians and the community.
Furthermore, federal laws such as the Common Rule have greatly increased the protections that research participants enjoy, making huge strides toward ethical treatment. With these protective measures, clinical research has never been easier to join and safer to participate in.
Although these issues may seem too monolithic for one to help make a change in, it is easy to start getting involved in public health.
“Keep in mind, clinical research is not possible without the help and participation of volunteers,” said Pavlov, recalling the importance of gathering a large sample size of research participants
Websites such as https://clinicaltrials.gov provide a valuable resource to locate and sign up for trials that are in progress and are accepting volunteers. These volunteers can gain early access to new pharmaceuticals and, in doing so, make a difference by ensuring treatments and medicines are properly tested for safety and efficacy in all groups of people.
Most volunteers receive some form of compensation for their participation in research studies.
Disclosure: Gabriella Pavlov, quoted here, is directly related to the author.