Enrichment of clinical study populations

Clin Pharmacol Ther. 2010 Dec;88(6):774-8. doi: 10.1038/clpt.2010.233. Epub 2010 Oct 13.

Abstract

Those who conduct clinical trials "enrich" study populations in a variety of ways in order to identify a population of patients in whom a drug effect, if present, is more likely to be demonstrable. The principal ways to do this are as follows: (i) practical enrichment, i.e., generally seeking to reduce noise (variability of measurement) and heterogeneity (by avoiding the enrollment of patients with other diseases and individuals in whom the disease disappears spontaneously), (ii) prognostic enrichment, i.e., finding patients who are likely to have the event of interest when enrolling for risk-reduction studies, and (iii) predictive enrichment, i.e., finding the individuals who are more likely to respond. Enrichment fits well into the growing interest in "individualization" of therapy but creates some tension with another trend, namely, the desire for "real-world studies" with less restrictive entry criteria and other requirements.

Publication types

  • Review

MeSH terms

  • Biomedical Research / methods*
  • Biomedical Research / standards
  • Clinical Protocols / standards
  • Clinical Trials as Topic / methods*
  • Clinical Trials as Topic / standards
  • Humans
  • Patient Selection*
  • Prognosis