Innovating Clinical Trials

Liam Eves and Ted Trafford

Welcome to Innovating Clinical Trials, the podcast designed for clinical research professionals eager to deepen their understanding of clinical trials through concise, insightful segments. Join your hosts, Liam Eves and Ted Trafford, as they uncover the core issues in clinical research, reflect on the industry, and challenge conventional wisdom.Ted Trafford - https://probitymedical.com/With 30 years of experience in clinical research, Ted serves as the Director of Business Development, driving business growth and leading Feasibility and Site Relationship teams at Probity Medical Research, a clinical trial site administrative support company with a consortium of 75+ sites across four countries. As a writer and speaker, Ted contributes to thought leadership and strategic initiatives in the clinical trials industry, leveraging his extensive experience and creative approach to drive meaningful discussion and progress for Sponsors, CROs, Sites and Technology Vendors.Liam Eves - https://www.theendpointpodcast.com/Liam's held executive roles in SMOs and CROs, and led all major functions of trial delivery. His journey into the field began unexpectedly after an injury ended his career as a professional footballer.  Over the years Liam has optimized trial delivery methods / systems for effective enrollment and trial delivery. Currently, he focuses on building  and advising companies in the clinical trial space. Opinions expressed are those of the participants and not their employers. 

  1. 5h ago

    ICT Ep 2.46: Paul Ivsin on Deciding When to Fire Your Recruitment Vendor Before Patient One (Part 3/3)

    In the final part of this three-part conversation, Liam and Ted ask Paul Ivsin, Principal at First Patient In, a question that made everyone laugh: when should you fire a recruitment vendor? Paul's answer is that the decision belongs before the first patient is enrolled. Once a study is running, nobody agrees to change anything, so the only window is early. Agree a checkpoint, such as a hard look at 15% or 20% of target, and write down what "off track" means. Then treat it the way a trial treats an interim analysis: a planned moment to look at the data and make a go or no-go call on the operations. He admits the weakness too. Interim analyses often come back ambiguous, and so will this one. That leads to the theme of the episode: we run careful experiments on the drug and almost none on the enrollment. Paul uses pre-screeners as the example. Some have three questions, and he recently saw one with 21 that he couldn't finish himself. Which is better? After 25 years, he doesn't know, and says the honest answer is to put both versions on the same website, randomise, and count. When he has suggested this to larger pharma companies, nobody has liked it, because "we don't know" is hard to say out loud. Liam adds that no question count will ever be right for every patient, so segmenting by urgency and unmet need, even into eight rough buckets, beats pretending there is one answer. Ted closes with the big question: with all the tools we have now, are we getting better at recruitment or worse? Paul says both. The best digital programs are smarter and work better with sites than anything from ten years ago. But outreach has concentrated on Facebook, Instagram and Google, and anyone with a laptop and some overconfidence can now call themselves a recruitment company. He expects a reshuffle, because sites that understand what a screened patient is worth to them can run those ads themselves. Find Paul at firstpatientin.com and on the First Patient In on Substack.

  2. 5h ago

    ICT Ep 2.45: Paul Ivsin on the Text Reminder Every Dentist Sends and Some Sites Don't (Part 2/3)

    In Part 2 of this three-part conversation, Liam and Ted pick up with Paul Ivsin, Principal at First Patient In, at the point where most campaigns leak: the handoff between pre-screening and the site. It opens with an exercise the hosts ran on a number of central advertising campaigns. They took the pre-screening questions meant to qualify candidates and laid them against the protocol language. Every campaign had questions that either let the wrong patients through or turned the right ones away, and each had passed an ad agency and a sponsor review. Paul thinks this is getting worse. Turning a protocol criterion into a question a patient can answer always means choosing which errors you can live with, and some pre-screeners now look like they took under a minute to generate. From there the conversation turns to ownership. Liam has been reading CRO budgets with biotechs and keeps finding the same thing: the most senior recruitment person on the study is an associate director at around two hours a month, while the project manager and data manager have full seats at the table. Paul sees it from the vendor side. Some CROs still make money on change orders and have little reason to shorten a timeline. Many sponsors hand recruitment to a vendor and stop looking, so ask how enrollment is going overall, and someone starts digging through a spreadsheet. When a study is three months in and behind, the usual answer is "it'll catch up once more sites activate." Paul's point is that this is an answerable question: you have activation dates and patients in, so you have a rate. Ted raises no-shows, which he sees rising at sites. Paul's experience is that a persistent 20 to 30% of referrals never answer the phone once handed over, and the fixes that work are basic: send the text reminder every dentist sends, and hire someone for intake so study coordinators, who are often better with data than with people, aren't the ones phoning every referral.

  3. 5h ago

    ICT Ep 2.44: Paul Ivsin on the 80% Stat That Leads to a Missing Book (Part 1/3)

    In Part 1 of this three-part conversation, Liam and Ted sit down with Paul Ivsin, Principal at First Patient In, who has spent more than 20 years building enrollment programs with sponsors, sites and recruitment vendors. Paul studied philosophy, drifted into database work, and landed in recruitment through a client running radio and newspaper ads for a trial. The phones were ringing and leads were being faxed to sites, but nobody could prove a single call had turned into a patient. He was hired to build the tracking. Twenty-five years later, he says, the industry still struggles to connect recruitment activity to enrollment. That habit of asking "where did this number come from?" led him to the most quoted statistic in the industry: 80% of trials miss their enrollment timelines. The number has not moved in two decades, which made Paul wonder whether anyone was still measuring it. He followed the citations backwards and the trail ends at a source book from around 2000 that he has never been able to find. Worse, the question is broken anyway. Most studies have three timelines, the feasibility estimate, the CRO's bid and the date the CEO announced, so a trial can beat one and miss another. Paul's bigger worry is how the stat gets used: when everything is declared broken, any solution looks reasonable. The conversation then turns to what Paul's data shows about digital advertising. Ads built for retail are made to maximise clicks, and a trial needs the opposite: only the people who will qualify. When he has compared the best-performing ads by clicks with the ones that produced enrolled patients, the correlation has often been negative. Paul closes on where he would look first to improve any campaign: the handoff from pre-screening to the site. In a single campaign, with the same ads and the same pre-screener, he has seen one site consent 20% of its referrals while three others consented none.

About

Welcome to Innovating Clinical Trials, the podcast designed for clinical research professionals eager to deepen their understanding of clinical trials through concise, insightful segments. Join your hosts, Liam Eves and Ted Trafford, as they uncover the core issues in clinical research, reflect on the industry, and challenge conventional wisdom.Ted Trafford - https://probitymedical.com/With 30 years of experience in clinical research, Ted serves as the Director of Business Development, driving business growth and leading Feasibility and Site Relationship teams at Probity Medical Research, a clinical trial site administrative support company with a consortium of 75+ sites across four countries. As a writer and speaker, Ted contributes to thought leadership and strategic initiatives in the clinical trials industry, leveraging his extensive experience and creative approach to drive meaningful discussion and progress for Sponsors, CROs, Sites and Technology Vendors.Liam Eves - https://www.theendpointpodcast.com/Liam's held executive roles in SMOs and CROs, and led all major functions of trial delivery. His journey into the field began unexpectedly after an injury ended his career as a professional footballer.  Over the years Liam has optimized trial delivery methods / systems for effective enrollment and trial delivery. Currently, he focuses on building  and advising companies in the clinical trial space. Opinions expressed are those of the participants and not their employers. 

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