Clinical trial naming conventions

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Clinical trials are often assigned contrived acronyms. [1] [2] Some common themes include acronyms excluding words from the acronym and including letters taken from the middle of words. [3] It is suggested that the use of acronyms in titles is associated with a higher citation rate of research publications. [4]

Contents

Background

Acronyms were first used to identify clinical trials in the 1970s. [5] The first identified instance was "UGDP", an initialism for University Group Diabetes Program. The first trial title commonly pronounced as an English-language word or words came in 1982 with the publication of "MRFIT", referring to the Multiple Risk Factor Intervention Trial, and spoken as "Mr. Fit" or "the Mr. Fit trial". [5]

The term "acronymophilia" was coined in 1994 to refer to the overuse of acronyms in medicine. [6]

An article in the Annals of Internal Medicine classified clinical trial titles into five broad groups: un-abbreviated titles; initialisms that are not pronounced as English words; homonyms pronounced as a recognizable English word but spelled in a novel way; descriptive medical words relating to the study topic, such as CARDIAC and RALES; medical or health words that are not related to the topic of the study, such as ALIVE or RESCUE; and other English words not related to the topic, with a wide variety of subjects, including myths, places, musical terms, animals, and space, such as ISIS, CASANOVA, and APRICOT. [5]

Examples

A scientific study ranking acronyms was published in the British Medical Journal . Some of the negatively graded criteria include using letters that do not begin a word, and including letters in the acronym that are not found in the title. According to their metric, some of the worst names included "METGO: A 48-week, randomized, double-blind, double-observer, placebo-controlled multicenter trial of combination METhotrexate and intramuscular GOld therapy in rheumatoid arthritis", "PERFORM: Prevention of cerebrovascular and cardiovascular Events of ischaemic origin with teRutroban in patients with a history oF ischaemic strOke or tRansient ischaeMic attack", and "TYPHOON: Trial to assess the use of the cYPHer sirolimus-eluting coronary stent in acute myocardial infarction treated with BallOON angioplasty". Their ranking of acronyms shows a decrease in measured quality between 2000 and 2012. [4]

In a letter to the International Journal of Cardiology, Tsung O. Cheng called out his own field as prone to overuse of contrived acronyms, calling it a "persistent problem". He was spurred to write the letter after he reviewed nine articles about a study named "ZAHARA" without finding any explanation of what the acronym meant. [3] [7] [8]

Other clinical trials that have been noted in publications for their acronyms include: TORPEDO (Thrombus Obliteration by Rapid Percutaneous Endovenous Intervention (PEVI) in Deep Venous Occlusion) [9] and BATMAN (Bisphosphonate and Anastrozole Trial – Bone Maintenance Algorithm Assessment). [9]

See also

Related Research Articles

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Aspirin, also known as acetylsalicylic acid (ASA), is a nonsteroidal anti-inflammatory drug (NSAID) used to reduce pain, fever, and/or inflammation, and as an antithrombotic. Specific inflammatory conditions which aspirin is used to treat include Kawasaki disease, pericarditis, and rheumatic fever.

<span class="mw-page-title-main">Cardiology</span> Branch of medicine dealing with the heart

Cardiology is the study of the heart. Cardiology is a branch of medicine that deals with disorders of the heart and the cardiovascular system. The field includes medical diagnosis and treatment of congenital heart defects, coronary artery disease, heart failure, valvular heart disease and electrophysiology. Physicians who specialize in this field of medicine are called cardiologists, a speciality of internal medicine. Pediatric cardiologists are pediatricians who specialize in cardiology. Physicians who specialize in cardiac surgery are called cardiothoracic surgeons or cardiac surgeons, a speciality of general surgery.

<span class="mw-page-title-main">Coronary artery disease</span> Medical condition

Coronary artery disease (CAD), also called coronary heart disease (CHD), ischemic heart disease (IHD), myocardial ischemia, or simply heart disease, involves the reduction of blood flow to the heart muscle due to build-up of atherosclerotic plaque in the arteries of the heart. It is the most common of the cardiovascular diseases. Types include stable angina, unstable angina, myocardial infarction, and sudden cardiac death. A common symptom is chest pain or discomfort which may travel into the shoulder, arm, back, neck, or jaw. Occasionally it may feel like heartburn. Usually symptoms occur with exercise or emotional stress, last less than a few minutes, and improve with rest. Shortness of breath may also occur and sometimes no symptoms are present. In many cases, the first sign is a heart attack. Other complications include heart failure or an abnormal heartbeat.

A transient ischemic attack (TIA), commonly known as a mini-stroke, is a minor stroke whose noticeable symptoms usually end in less than an hour. TIA causes the same symptoms associated with strokes, such as weakness or numbness on one side of the body, sudden dimming or loss of vision, difficulty speaking or understanding language, slurred speech, or confusion.

<span class="mw-page-title-main">Angina</span> Chest discomfort due to not enough blood flow to heart muscle

Angina, also known as angina pectoris, is chest pain or pressure, usually caused by insufficient blood flow to the heart muscle (myocardium). It is most commonly a symptom of coronary artery disease.

<span class="mw-page-title-main">Statin</span> Class of drugs used to lower cholesterol levels

Statins, also known as HMG-CoA reductase inhibitors, are a class of lipid-lowering medications that reduce illness and mortality in those who are at high risk of cardiovascular disease. They are the most common cholesterol-lowering drugs.

<span class="mw-page-title-main">Aortic stenosis</span> Medical condition

Aortic stenosis is the narrowing of the exit of the left ventricle of the heart, such that problems result. It may occur at the aortic valve as well as above and below this level. It typically gets worse over time. Symptoms often come on gradually with a decreased ability to exercise often occurring first. If heart failure, loss of consciousness, or heart related chest pain occur due to AS the outcomes are worse. Loss of consciousness typically occurs with standing or exercising. Signs of heart failure include shortness of breath especially when lying down, at night, or with exercise, and swelling of the legs. Thickening of the valve without narrowing is known as aortic sclerosis.

<span class="mw-page-title-main">Cardiovascular disease</span> Class of diseases that involve the heart or blood vessels

Cardiovascular disease (CVD) is any disease involving the heart or blood vessels. CVDs constitute a class of diseases that includes: coronary artery diseases, stroke, heart failure, hypertensive heart disease, rheumatic heart disease, cardiomyopathy, abnormal heart rhythms, congenital heart disease, valvular heart disease, carditis, aortic aneurysms, peripheral artery disease, thromboembolic disease, and venous thrombosis.

<span class="mw-page-title-main">Stroke</span> Death of a region of brain cells due to poor blood flow

A stroke is a medical condition in which poor blood flow to the brain causes cell death. There are two main types of stroke: ischemic, due to lack of blood flow, and hemorrhagic, due to bleeding. Both cause parts of the brain to stop functioning properly.

<span class="mw-page-title-main">Acute coronary syndrome</span> Medical condition

Acute coronary syndrome (ACS) is a syndrome due to decreased blood flow in the coronary arteries such that part of the heart muscle is unable to function properly or dies. The most common symptom is centrally located pressure-like chest pain, often radiating to the left shoulder or angle of the jaw, and associated with nausea and sweating. Many people with acute coronary syndromes present with symptoms other than chest pain, particularly women, older people, and people with diabetes mellitus.

P2Y<sub>12</sub> Protein-coding gene in the species Homo sapiens

P2Y12 is a chemoreceptor for adenosine diphosphate (ADP) that belongs to the Gi class of a group of G protein-coupled (GPCR) purinergic receptors. This P2Y receptor family has several receptor subtypes with different pharmacological selectivity, which overlaps in some cases, for various adenosine and uridine nucleotides. The P2Y12 receptor is involved in platelet aggregation and is thus a biological target for the treatment of thromboembolisms and other clotting disorders. Two transcript variants encoding the same isoform have been identified for this gene.

Acronyms are very commonly used in healthcare settings. They are formed from the lead letters of words relating to medications, organisations, procedures and diagnoses. They come from both English and Latin roots. Acronyms have been described as jargon. and their use has been shown to impact the safety of patients in hospitals, owing to ambiguity and legibility.

<span class="mw-page-title-main">Myocardial infarction</span> Interruption of blood supply to a part of the heart

A myocardial infarction (MI), commonly known as a heart attack, occurs when blood flow decreases or stops in the coronary artery of the heart, causing damage to the heart muscle. The most common symptom is chest pain or discomfort which may travel into the shoulder, arm, back, neck or jaw. Often it occurs in the center or left side of the chest and lasts for more than a few minutes. The discomfort may occasionally feel like heartburn. Other symptoms may include shortness of breath, nausea, feeling faint, a cold sweat or feeling tired. About 30% of people have atypical symptoms. Women more often present without chest pain and instead have neck pain, arm pain or feel tired. Among those over 75 years old, about 5% have had an MI with little or no history of symptoms. An MI may cause heart failure, an irregular heartbeat, cardiogenic shock or cardiac arrest.

Jonathan L. Halperin is an American cardiologist and the author of Bypass (ISBN 0-89586-509-2), among the most comprehensive works on the subject of coronary artery bypass surgery. In addition, he is the Robert and Harriet Heilbrunn Professor of Medicine at The Mount Sinai School of Medicine as well as Director of Clinical Cardiology in the Zena and Michael A. Wierner Cardiovascular Institute at The Mount Sinai Medical Center, both in New York City. Halperin was the principal cardiologist responsible for both the design and execution of the multi-center Stroke Prevention in Atrial Fibrillation (SPAF) clinical trials, funded by the National Institutes of Health, which helped develop antithrombotic strategies to prevent stroke, and he subsequently directed the SPORTIF clinical trials, which evaluated the first oral direct thrombin inhibitor for prevention of stroke in patients with atrial fibrillation.

<span class="mw-page-title-main">Philip Poole-Wilson</span>

Philip Alexander Poole-Wilson FRCP, FESC, FACC, FMedSci was a British academic cardiologist of international reputation who had particular interest in the management of heart failure. His research helped to identify the cellular mechanisms behind heart failure and was also important in improving treatment for patients. He was instrumental in raising the profile of heart failure as a major public health problem.

<span class="mw-page-title-main">Caerphilly Heart Disease Study</span> Medical research project

The Caerphilly Heart Disease Study, also known as the Caerphilly Prospective Study (CaPS), is an epidemiological prospective cohort, set up in 1979 in a representative population sample drawn from Caerphilly, a typical small town in South Wales, UK.

Professor Peter Sleight M.D.(Cantab.), D.M. (Oxon.) FRCP FACC was a distinguished and internationally renowned research cardiologist and an Honorary Consultant Physician at the John Radcliffe Hospital in Oxford and the Oxford University Hospitals NHS Foundation Trust. Sleight was Emeritus Field Marshal Alexander Professor of Cardiovascular Medicine at the University of Oxford and an Emeritus Fellow of Exeter College, Oxford.

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Major adverse cardiovascular events is a composite endpoint frequently used in cardiovascular research. Despite widespread use of the term in clinical trials, the definitions of MACE can differ, which makes comparison of similar studies difficult.

References

  1. Lowe, Derek (18 July 2019). "Acronym Fever. We Need an Acronym For That". In the Pipeline. Retrieved 1 May 2020.
  2. Stanbrook, Matthew B.; Austin, Peter C.; Redelmeier, Donald A. (6 July 2006). "Acronym-Named Randomized Trials in Medicine — The ART in Medicine Study". New England Journal of Medicine. 355 (1): 101–102. doi:10.1056/NEJMc053420. PMID   16823008.
  3. 1 2 Fred, Herbert L.; Cheng, Tsung O. (2003). "Acronymesis". Texas Heart Institute Journal. 30 (4): 255–257. ISSN   0730-2347. PMC   307708 . PMID   14677733.
  4. 1 2 Pottegård, Anton; Haastrup, Maija Bruun; Stage, Tore Bjerregaard; Hansen, Morten Rix; Larsen, Kasper Søltoft; Meegaard, Peter Martin; Meegaard, Line Haugaard Vrdlovec; Horneberg, Henrik; Gils, Charlotte; Dideriksen, Dorthe; Aagaard, Lise; Almarsdottir, Anna Birna; Hallas, Jesper; Damkier, Per (16 December 2014). "SearCh for humourIstic and Extravagant acroNyms and Thoroughly Inappropriate names For Important Clinical trials (SCIENTIFIC): qualitative and quantitative systematic study". BMJ. 349: g7092. doi:10.1136/bmj.g7092. ISSN   1756-1833. PMC   4267482 . PMID   25516539.
  5. 1 2 3 Berkwits, Michael (7 November 2000). "CAPTURE! SHOCK! EXCITE! Clinical Trial Acronyms and the "Branding" of Clinical Research". Annals of Internal Medicine. 133 (9): 755–62. doi:10.7326/0003-4819-133-9-200011070-00039. PMID   11074930. S2CID   31188922.
  6. Isaacs, D.; Fitzgerald, D. (December 2000). "Acronymophilia: an update". Archives of Disease in Childhood. 83 (6): 517–518. doi:10.1136/adc.83.6.517. ISSN   0003-9888. PMC   1718581 . PMID   11087292.
  7. Cheng, Tsung O. (1 November 2009). "What is the ZAHARA study? Acronymania is an incurable Disease Afflicting MAiNly the cardiologisTs (ADAMANT)". International Journal of Cardiology. 137 (3): 289. doi:10.1016/j.ijcard.2008.05.056. PMID   18692260 . Retrieved 1 May 2020.
  8. Cheng, Tsung O. (5 April 2000). "PASTA is good, but SUSHI is better". Catheterization and Cardiovascular Interventions. 49 (4): 478–479a. doi:10.1002/(SICI)1522-726X(200004)49:4<478::AID-CCD29>3.0.CO;2-P. PMID   10751783.
  9. 1 2 "Clinical trial names can be quite AMUSING, but they don't include unicorns : Spoonful of Medicine". blogs.nature.com. Retrieved 1 May 2020.