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Published on: 11/26/2007
Last Visited: 12/6/2007
David Yankelevitz, MD, radiologist at New York-Presbyterian and Weill Cornell Medical College, both located in New York City, spoke about the need to standardize the terminology of the clinical trial.For instance, in the a positive result in the I-ECLAP trial is defined as a nodule 5mm or greater, whereas in the NLST trial, it is considered 4mm or greater.These small differences can produce very different results, he said.
Yankelevitz mentioned the technology drift that occurs while the time of the trial has elapsed, "screening trials are typically quite long, and technology changes rapidly."He said there is a potential for the imaging method to become obsolete before the trial is completed, and it can be difficult to adjust for changes in technology mid-trial.
"Technology can really potentially change results.I don't know where it will be five years from now, ten years from now.Technology is changing just so rapidly," he said.
Yankelevitz also pointed to regimen drifts, which he deemed as analogous to technology drifts because they can affect the trial outcomes.He said that "our understanding of techniques, methods and protocols change amidst trials," which complicates the process.
Both Chiles and Yankelevitz reminded the audience that no radiological method or trial is currently considered the gold-standard in lung cancer detection, but the field still is subject to many years of clinical trials that need to be considered when approaching their patients.