CardioNerds network aims to cultivate clinical trialists, address research challenges
Key takeaways:
- Incorporating fellows-in-training into clinical trials could benefit trainees and participants.
- Trainee involvement could boost minority representation among trial participants.
A networking group created for cardiology fellows-in-training has successfully engaged trainees with clinical trial programs, serving as a model to help diversify recruitment and representation in trials, researchers reported.
Many trainees aspire to work on clinical trials during their careers, but concerns among trainees regarding time constraints or feasibility of participating during fellowship may hinder these prospects, Jason Feinman, MD, cardiology fellow at Mount Sinai Medical Center, and colleagues wrote in the Journal of the American College of Cardiology.
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“There are many factors that can impact fellow involvement in clinical trials, and one is time constraints,” Feinman told Healio. “As part of training, clinical care and education come first. How research time is structured can vary depending on the program, and many fellows are studying for board exams, plus clinical responsibilities. Also, as trainees, we may feel large clinical trials are beyond our scope. These are trials we see presented at major medical meetings by prominent people in the field. It may be something we aspire to, but it feels bigger than us.”
Despite growing awareness of the lack of diversity in trial enrollment, several demographic groups continue to be significantly underrepresented, Feinman and colleagues wrote. Trainee involvement in previously conducted clinical trials has been demonstrated to increase the enrollment rates of people from underrepresented groups.
The researchers noted that the CardioNerds Clinical Trial Network, formed in 2022, matches fellows-in-training interested in clinical research with mentors at their institutions across North America and focuses on three goals: promoting early career research exposure through meaningful contribution to a multinational randomized clinical trial; fostering relationships between mentor and mentee as well as between trainees across institutions; and promoting equitable trial enrollment and representation in academic medicine. The PARAGLIDE-HF trial was the first large randomized clinical trial to formally engage fellows-in-training from the CardioNerds network, collaborating across 20 sites.
“Our direct roles allowed us to see firsthand the challenges of patient recruitment and enrollment,” the researchers wrote. “As fellows-in-training trialists, we were introduced to and incorporated into our sites’ research department and were responsible for spearheading a recruitment strategy with a particular focus on promoting equitable enrollment. We were entrusted with determining which departments in our institutions were most likely to be caring for potential enrollees, promoting awareness of our initiative and maximizing participation.”
During an 8-month period, the trainee trialists assisted in enrolling 72 participants, according to the researchers, with more than half of participants women and nearly three-quarters of participants from underrepresented groups.
"Trainees are sometimes the first people to interact with patients in the hospital,” Feinman said during an interview. “We can identify patients who might slip through the cracks otherwise, patients who would not have been referred or identified for a clinical trial. We wanted to make sure [the PARAGLIDE-HF] trial was applicable to patients in the general community. One major issue that many trials have had in the past is they did not necessarily represent the community at large. With fellows involved, trial participants looked a lot more like the general population."
The researchers also noted that trainees may be hesitant to commit to projects that may not be completed during their training or which are perceived to require time commitments beyond what can be managed with clinical responsibilities.
“Regrettably, these factors rob fellows-in-training of exposure early in their careers,” the researchers wrote. “The CardioNerds Clinical Trials Network helped overcome these issues. Fellows-in-training were given a clear, focused role that was appropriate for their experience level and time constraints. Patient identification and recruitment could be easily done even during non-research-dedicated weeks. Evening meetings allowed for continued mentorship from leadership and brought trainees into one room for expanded education beyond hands-on experiences.”
Including trainees in such key research can help “move the field forward” and address challenges in research, Feinman and colleagues wrote.
“We also learned that there are challenges along the way, but an integrated research effort that incorporates individuals at all levels of training can help to overcome some of these obstacles and provide the spark for a long and impactful career,” the researchers wrote.
The CardioNerds network is preparing to expand to additional CV trials across the field, Feinman said.
"We are incredibly grateful for the opportunities presented to us during this initiative and hope that this group serves as a model for future research endeavors to help train the next generation of trialists," the researchers wrote.
Reference:
- CardioNerds Clinical Trials Network. www.cardionerds.com/clinicaltrials. Accessed June 19, 2023.
For more information:
Jason Feinman, MD, can be reached at jason.feinman@mountsinai.org.
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