Symptomatic Volunteers: Another Patient Dimension for Clinical Trials

Comparison of descriptive variables for symptomatic volunteers and clinical patients with anxiety disorders

“…These studies identified few consistent differences between symptomatic volunteers and clinical subjects (Krupnick et al, 1986;Covi et al, 1979;Brauzer and Goldstein, 1973;Hersen et al, 1981;Thase et al, 1984). The few studies which looked at attrition and treatment response rates for the two groups found no differences between them (Last et al, 1984;Breckenridge et al, 1985;Krupnick et al, 1986;Covi et al, 1979;Hersen et al, 1981;Thase et al, 1984).…”

“…Concerns about the generalizability of findings from clinical trials include worry that trial results may be skewed due to design issues: the inflexibility of entry criteria, the limited length of evaluation and treatment (for most trials), the restrictive or manualized form that treatment usually takes, and the bias incurred during subject recruitment (Krupnick et al, 1986). This bias is of particular interest because the majority of patients who participate in clinical trials are recruited from advertisements in the media (symptomatic volunteers), while the majority of individuals treated in clinical practice come to practitioners by other means (Amori et al, 1989;Krupnick et al, 1986;Last et al, 1984;Breckenridge et al, 1985;Brauzer and Goldstein, 1973;Mitchell et al, 1988;Covi et al, 1979). There is concern that individuals who respond to advertisements may be different from patients who seek treatment from mental health professionals.…”

Declining Participation in Research Studies

“…Recruiting either professional volunteers (i.e. people who participate in multiple studies for the compensation) or symptomatic volunteers [4] can introduce bias.…”

“…In some countries, they can be recruited from general practitioners. Other countries have relied on volunteers recruited through advertisements [4] . With this latter approach and similar to our example of the online survey, the participation rate is totally unknown with corresponding unknown generalizability.…”

Lorazepam and Diazepam in Anxious Outpatients

“…Patients attended either the offices of several general practitioners (GP) or the Symptomatic Volunteer Clinic (SVC) of the Philadelphia General Hospital. The clinic consisted of patients recruited by newspaper advertisements and was initiated several years ago based on the Miami model of Brauzer and Goldstein (6). The practicality of participa tion by such patients in short-term drug trials has been reviewed elsewhere (7).…”