Celebrating the Pioneer of Clinical Trials: Captain James Lind's Enduring Legacy

Narrator: 0:00

Welcome to the MedEvidence Monday Minute radio show hosted by Kevin Geddings of WSOS St. Augustine Radio and powered by ENCORE Research Group. Each Monday morning, Dr. Michael Koren calls in to bring you the latest medical updates with insightful discussions. MedEvidence is where we help you navigate the real truth behind medical research, with both a clinical and research perspective. So sit back, relax and get ready to learn about the truth behind the data in medicine and healthcare. This is MedEvidence.

Kevin Geddings: 0:30

Happy Clinical Trials Day. That's right. Today, May 20th, is International Clinical Trials Day, to celebrate a very special day back in 1747. Dr Koren, you can probably help us understand why that date is so important.

Dr. Michael Koren: 0:46

Yeah, so thank you for bringing that up and happy International Clinical Trial Day to you. We celebrate it to recognize the first randomized clinical trial, which is related to Captain James Lind, who is trying to figure out how to treat or prevent scurvy, which I think a lot of people may know is a vitamin C deficiency and which is something that was affecting a lot of people on ships that were going across the Atlantic Ocean during those days. And if you recall the term limey, that's due to the fact that Captain Lind figured out that using citrus fruit was a way of getting vitamin C to his sailors and preventing scurvy. So these British sailors that were part of these trips across the ocean would suck down limes or any other citrus fruit they can get, and that would prevent this disease. And it's an important date in clinical research because it's the first randomized clinical trial and that's an important concept.

Dr. Michael Koren: 1:52

So when you randomize in a clinical trial. It means by random you assign people to one arm of a trial or another, and that's really the only way to figure things out. Obviously, if you were to treat everybody on that ship with lime, then people might have gotten better. But you're not sure if there's truly a difference between the people who got the lime and who did not get the lime. And it's also important that you pick those people based on just a completely random sequence so that you're not preferentially giving certain people the lime and other people are not getting it because you like them better or because they're more robust or whatever reason.

Dr. Michael Koren: 2:31

So this concept of a randomized clinical trial is extraordinarily important. The first one that's well documented is from 1747, as you mentioned. I keep on saying doctor, but he's a captain. I guess he was sort of a doctor in that clinical trial but Captain James Lind in 1747. So yes, thank you for bringing that up.

Kevin Geddings: 2:52

It's interesting because not only did he just do giving people fruit and then giving some sailors no fruit, but he actually did, I guess, six different treatments. One with just oranges, one with just lemons, one with cider vinegar, one with sulfuric acid, one with salt water and one with garlic. That's pretty complex.

Dr. Michael Koren: 3:11

Yeah, as a matter of fact, that's getting into more of the details, but we consider those multiple arms of a clinical trial and, quite frankly, we use that strategy even today. So there's a really neat study in my space called the Coronary Drug Project, where we were looking at ways of treating heart disease and dealing with cholesterol issues back in the 1970s. We didn't know exactly what worked, so we tried things like thyroid hormone. That didn't work. We were giving estrogen to men, which didn't work, but the thing that did work was treating their lipids, and in those days it was with niacin. So this concept of using a multi-arm clinical trial exists to this day. So good work, Dr. Captain Lind.

Kevin Geddings: 4:00

That was, I mean, really cutting edge. One of the big differences between participating in a clinical trial with you, Dr. Koren, and ENCORE Research Group versus Captain Lind's effort is, you know, his was more mandatory, right?

Dr. Michael Koren: 4:14

Well, that gets into a whole other discussion about the ethics of clinical research. And I don't recall offhand if he forced the sellers to be involved with it, Although, quite frankly, since he was the captain, chances are that they were coerced in it. So that's the difference between then and now. Obviously, nowadays we go through a very important informed consent process. We follow all the ethical rules. Clinical research is always voluntary for our patients.

Dr. Michael Koren: 4:41

So, that has changed over the years and we're very respectful of the autonomy and the rights of the patients before we get them involved. Having said that, there are tremendous benefits of participating in clinical research, and until you've done it it's hard to know what those benefits are. But my favorite statistic to report is if you ask people with no exposure to clinical research would they be interested in a clinical research project, only 40% say yes. But if you ask people after they've participated in a research project whether or not you do a second one, 97 to 99% of people say yes.

Kevin Geddings: 5:15

Wow.

Dr. Michael Koren: 5:15

So there's something about being involved in the clinical research project that people actually really love and that is valuable for folks, and the data bear that out, yeah.

Kevin Geddings: 5:25

Well, obviously you can participate and it is. It's fun. Number one, you're going to get some of the most intensive attention if you will. People are going to listen to your concerns and they're going to monitor your overall health as well. When you participate, and you might even learn, you know, might even earn a little compensation in the process. Learn more by going to ENCOREdocs. com. That's where's Dr. Michael Koren joining us here on Monday mornings around this time. We appreciate his time and he's going to be talking about cardiology because he is a cardiologist at an event at WJCT Studios, across from where the Jaguars play, right?

Dr. Michael Koren: 5:59

We are. We have a nice event coming up and we're going to be digging into some of the controversies in cardiovascular disease, particularly for people that have congestive heart failure, so we definitely encourage people to be part of the conversation. These have actually been sold out. I guess sold out is the wrong word because we don't charge for them, but they're filled to capacity, so I would ask people to sign up early so they don't miss a spot.

Kevin Geddings: 6:25

Yeah, go to WJCT.org. That's public radio up in Jacksonville and they host these events, do a great job and Dr. Koren has done a lot of these and, yes, they are very, very popular. So if you or someone you care about is dealing with congestive heart failure, you need to attend. This will be a good event and they always take good care of folks up there. Go to WJCT.org to sign up for the event, which I believe is May 29th, right doctor?

Dr. Michael Koren: 6:48

That is my understanding but, again. Sometimes I don't know my calendar until about an hour before.

Kevin Geddings: 6:59

No, I understand, hey, before we let you go, especially on this, you know it's actually International Clinical Trials Day. Talk to us about MedEvidence.com.

Dr. Michael Koren: 7:06

Sure, MedEvidence is our platform for discovering the truth. We call it the truth behind the data, and there's so many conflicting claims in health care that it's really hard for people to know what's right, what's wrong. And what we do in MedEvidence is we have conversations so that people can understand what we know about a particular area, what we don't know about a particular area and how we're going to learn about what we don't know. So it's a nice format for people to glean some very useful tips for their own problems or the problems of their family members or friends, problems with their family members or friends and it gives people this concept of why we do research, what questions are we addressing, what are we answering and how people can be part of that process. So, again, we're getting great feedback on it. People love it. It's entertaining. We have a good time while we're discussing these medical issues. We encourage everybody to give it a look for and hopefully enjoy it and give us your feedback.

Dr. Michael Koren: 8:03

Let us know if you think it's valuable or not.

Kevin Geddings: 8:05

Well, it's a real, trustworthy source, unlike just going on Google and just being thrown into the wide world of the internet. So we encourage you to check out MedEvidence.com. That's MedEvidence.com. Dr. Michael Koren. Thank you very much for being with us today. Have a safe day out there, okay.

Dr. Michael Koren: 8:21

You too. Happy clinical trial day, Kevin.

Narrator: 8:23

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