A rapid increase in the globalization of clinical trials is being driven by a need for lower cost, greater speed, and higher quality. Increasing costs—approximately 20% per year—account for much of this effort. Trials in developing countries—done with rigorous controls and safeguards—can lower the cost of drugs, distribute modern science and medicine, and enhance the health of patients around the world. Lesser developed countries offer a large pool of willing, treatment-naïve patients. Globalization of clinical trials introduces potential issues: for example, ethical concerns, harmonization, logistical challenges. Researchers must take into account potential ethnic, genetic, and other differences which can make extrapolation from one geographical region to another problematic. Differences between populations and geographies are divided into intrinsic and extrinsic differences. Historically, these differences have not resulted in changes to the risk–benefit ratio of outsourcing clinical trials.
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This practical guide thoroughly discusses both well-established and new interventions that are applied to the spine for the purpose of pain relief.
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