How clinical trials shape patient care

The medications people take, and the guidelines doctors follow are built on evidence gathered through clinical trials. For more than 25 years, Dr. Thomas Ransom has contributed to that evidence as an endocrinologist and clinical trial investigator in Nova Scotia.

Dr. Ransom has been involved in more than 200 trials over the years and says for him clinical research has never been about testing the next promising medication. It's about improving patient care.

"The results of the trials impact clinical practice and clinical practice guidelines," he says. "They have significant impact on patient care and what we do."

In addition to a busy clinical practice, Dr. Ransom is affiliated with the Dalhousie University medical school, where he teaches medical students, residents, fellows, and practicing physicians, while also contributing to the training of future endocrinologists.

Clinical trials are a critical step in the development of new treatments. Before a medication reaches pharmacy shelves, it must undergo rigorous testing to ensure it is safe and effective. Researchers examine not only whether a drug works, but also how it affects patients over time and whether it offers benefits beyond its original purpose.

"You might have a cholesterol drug that lowers cholesterol," he explains. "But does it reduce heart attacks? That's what these larger studies are designed to answer."

He’s witnessed firsthand how trials transform medical practice. Some of the most influential studies he’s been involved with looked at diabetes medications and the impact on cardiovascular health. Researchers initially set out to determine whether the medications were safe for the heart but discovered something even more significant.

"Not only did this drug lower sugar and was safe, but the people who took it had fewer heart attacks," says Ransom. "Big breakthrough."

The findings changed how physicians around the world treat patients. Today, some medications originally developed to lower blood sugar are also prescribed to help protect the heart and kidneys.

"Cardiologists are giving this diabetes drug to their patients who don’t have diabetes because it's good for the heart," says Ransom. "Nephrologists are giving it to their patients with kidney disease because it's good for the kidney."

Not every trial leads to a new treatment. Some therapies fail to demonstrate benefit, while others reveal unexpected side effects. Ransom says those trial outcomes are equally important.

"A number of medications never made it," he says. "You don't know until you do the study."

That process of careful evaluation is what makes clinical trials such a valuable part of healthcare research. 

Participants join studies for a variety of reasons, Ransom says.

"There are some people who think it's noble. I may not benefit, but the next generation will."

Some want to learn more about their condition, while others appreciate the increased interaction.

"While you're in a trial, someone's checking in on you a lot more frequently and you get seen a lot more often than otherwise."

Participant safety remains the highest priority. Teams closely monitor every aspect of a participant's health, and studies are subject to extensive oversight.

"We evaluate every scratch, sneeze, or headache." says Ransom. "Is this related or not? We monitor them exceedingly closely."

As opportunities expand for people to participate in research through Nova Scotia’s new research consent framework, Ransom hopes more people will take part. The new framework gives residents 19-year-old and up a range of ways to become involved in research. Whether a study confirms a treatment's effectiveness, uncovers a new benefit, or determines that a therapy shouldn’t move forward, Ranson says the value of the research is impact on patients and ultimately, better care. It’s what continues to motivate him.

“Someone has to teach about the drugs that might be coming to market next year,” he says. “And someone has to help generate the evidence that tells us what works.”

Clinical trials do so much more than test new treatments. They help shape the future of healthcare, one study, and one patient, at a time.

Photo of Dr. Thomas Ransom.