经济学人423:临床实验 测试测试

 　　Clinical trials

　　临床实验

　　Testing, testing

　　测试，测试

　　The nation is losing its grip on a valuable industry

　　我国正失去一项重要行业的优势。

　　THE British have long been experimenting on each other: in 1747 a Scottish doctor first fed oranges to a group of scurvy-ridden sailors. But clinical trials have been moving overseas for years. The number of trials approved in Britain dropped by 14% between 2005 and 2013; at the same time, the country's share of the global market fell. This is a big problem—but one with a solution.

　　不列颠人对自己人进行实验由来已久：1747年，一名苏格兰医生首次让一群饱受坏血病折磨的水手进食橘子。不过临床试验搬移海外已有数年之久。在2005年至2013年间，在不列颠进行的实验数量已经下降14%；与此同时，我国医药领域在全球市场的份额下降。这是个大问题——好在还有挽救的余地。

　　临床实验.jpg

　　The process of testing new treatments is unusually slow in Britain. It is held up at every stage—from getting formal approval to finding the right hospital. But the biggest challenge is the time it takes to round up subjects. At present trial designers often recruit by phoning doctors they know, who will try and remember to mention the trial to their patients. It is “all quite ad hoc,” says Shaun Treweek, a researcher at Dundee University. Indeed, recruitment has not moved on much since the tuberculosis¹ trials of the 1940s, where ten to 20 subjects were thought sufficient, and could be gathered locally and at random².

　　在不列颠推进新治疗方案的过程异常缓慢。在所有阶段都会有阻碍—从获得正式许可到找到合适的医院。不过最大的问题在于招募被试时费时过长。目前实验设计者常通过打电话给他们熟知的医生进行招募。这些医生会试着在记起来的情况下向他们的病人提及此事。此乃“便宜之举，”Dundee大学的研究员Shaun Treweek道。实际上，招募自从上世纪40年代的肺结核实验之后便无改观。彼时认为10至20名被试足矣，而且可以在当地就近随机选取。

　　For drugs companies the delays that result are costly³. The life of a patent starts as soon as a drug is discovered, and a single day's delay getting it to market costs up to $10m. Trials have been moving to eastern Europe and China, where hurdles⁴ are fewer. Britain is thus losing its grasp on a valuable industry: the global clinical trials industry is worth ￡30 billion ($51 billion) a year. It is also in danger of losing research and development investment. Trials are the habitat of R&D's most valuable workers: skilled researchers and clinicians.

　　对医药公司而言，结果的耽搁意味着代价高昂。药物专利的时限在发现之日起就开始计算，而每多一日的延迟将使药物投放市场的成本上升1000万美元。目前实验已经迁至东欧和中国，那些地区阻碍较少。自此不列颠正对这一有价值产业的影响正在下降：每年全世界临床实验产业价值300亿英镑。在研发领域的投资也存在上述危险。实验是研发产业最有价值职工—熟练研究者和临床医生的聚集地。

　　And as trials move away from Britain, more subtle damage is being done. Martin Landray, a researcher at Oxford⁵ University, points out that clinical standards go up when doctors are involved in research, as their hospital keeps pace with evolving knowledge. And, as in many other industries, innovation happens in clusters.

　　而且，随着实验从不列颠迁走，小损失产生不断。牛津大学的研究员Martin Landray指出，临床标准会随着医生研究的进行而提高，同时他们所在的医院也会随着知识的演进紧随步伐。而这如同许多其他产业一样，在聚集中产生创新。

　　Yet in recent years some of the biggest and most smoothly-conducted trials have taken place in Britain. One is UK Biobank, which, with half a million subjects, has become one of the largest ever studies into the importance of nature versus⁶ nurture⁷. Then there is the vast REVEAL heart disease trial, which recruited 19,000 Britons in record time.

　　当然最近这些年，一些大型和进展顺利的实验还是在不列颠进行了，其中一个是联合王国生物银行计划，大约有50万被试参与其中。这项计划已经成为天性与教养孰轻孰重的研究中规模最大的一个。然后还有规模庞大的“揭示”心脏病发病机制的实验，这项计划创纪录地招募了19000名不列颠人。

　　These studies have something in common: researchers were able to trawl NHS data to find appropriate subjects and contact them directly. Data-protection laws usually make this tricky⁸, but they were granted an exemption⁹ by the confidentiality¹⁰ advisory¹¹ group. Unfortunately, such exemptions¹² are rare, and are now under threat from a proposed EU directive. Mr Landray, who helped arrange the REVEAL study, reckons the bar is set too high. “We wrote to a third of a million people. 19,000 took part; 30 complained,” he says.

　　这些研究具有一些共性：研究者得以查阅英伦国民健康档案，并依此寻找合适的被试，直接与之联系。信息保护法经常让事情变得棘手，不过这些研究者获得保密咨询小组的保证得以豁免。不幸的是，这种豁免少之又少，而现在又面临一项欧盟指令的威胁。Landray,曾帮助筹备安排“揭示”计划。他认为门槛设得太高了。“我们曾写给30万人请求加入计划。19000人加入；30人投诉。”他说。

　　Allowing more studies to recruit patients in this way would give Britain a unique advantage. After all, it is the only country with a centralised patient data system. And there are ways to protect patients from abuses—Ben Goldacre, a doctor and science writer, has suggested making the penalties for breaching¹³ medical privacy stiffer. Minimise the risks, and Britain could lead the world in clinical testing. Politicians panicked when it looked as though Pfizer, an American drugs company, might end up buying AstraZeneca, a British one, and shred¹⁴ the country's research base. They should consider Britain's hidden strengths.

　　允诺更多实验以此途径招募被试将给不列颠带来独特优势。不管怎么说，我国是世界上仅有的具有一个集中病例系统的国家。并且，避免病人受到虐待也方法颇多—医生与科学作家Ben Goldacre已经建议立法者对违反医疗隐私法例的人处以更严厉的惩罚。以最大的努力降低这些风险，不列颠可以引领世界临床测试。政客们面对辉瑞公司时惊慌失措。这个美国公司最终将购买不列颠的AstraZeneca公司。他们认为这将毁掉我国的研究根基。政客们应该注意到不列颠隐藏的能量。

1 tuberculosis   

n.结核病，肺结核

参考例句：

• People used to go to special health spring to recover from tuberculosis.人们常去温泉疗养胜地治疗肺结核。
• Tuberculosis is a curable disease.肺结核是一种可治愈的病。

2 random   

adj.随机的；任意的；n.偶然的(或随便的)行动

参考例句：

• The list is arranged in a random order.名单排列不分先后。
• On random inspection the meat was found to be bad.经抽查，发现肉变质了。

3 costly   

adj.昂贵的，价值高的，豪华的

参考例句：

• It must be very costly to keep up a house like this.维修这么一幢房子一定很昂贵。
• This dictionary is very useful,only it is a bit costly.这本词典很有用，左不过贵了些。

4 hurdles   

n.障碍( hurdle的名词复数 )；跳栏；（供人或马跳跃的）栏架；跨栏赛

参考例句：

• In starting a new company, many hurdles must be crossed. 刚开办一个公司时，必须克服许多障碍。 来自《简明英汉词典》
• There are several hurdles to be got over in this project. 在这项工程中有一些困难要克服。 来自辞典例句

5 Oxford   

n.牛津（英国城市）

参考例句：

• At present he has become a Professor of Chemistry at Oxford.他现在已是牛津大学的化学教授了。
• This is where the road to Oxford joins the road to London.这是去牛津的路与去伦敦的路的汇合处。

6 versus   

prep.以…为对手，对；与…相比之下

参考例句：

• The big match tonight is England versus Spain.今晚的大赛是英格兰对西班牙。
• The most exciting game was Harvard versus Yale.最富紧张刺激的球赛是哈佛队对耶鲁队。

7 nurture   

n.养育，照顾，教育；滋养，营养品；vt.养育，给与营养物，教养，扶持

参考例句：

• The tree grows well in his nurture.在他的培育下这棵树长得很好。
• The two sisters had received very different nurture.这俩个姊妹接受过极不同的教育。

8 tricky   

adj.狡猾的，奸诈的；(工作等)棘手的，微妙的

参考例句：

• I'm in a rather tricky position.Can you help me out?我的处境很棘手，你能帮我吗？
• He avoided this tricky question and talked in generalities.他回避了这个非常微妙的问题，只做了个笼统的表述。

9 exemption   

n.豁免，免税额，免除

参考例句：

• You may be able to apply for exemption from local taxes.你可能符合资格申请免除地方税。
• These goods are subject to exemption from tax.这些货物可以免税。

10 confidentiality   

n.秘而不宣，保密

参考例句：

• They signed a confidentiality agreement. 他们签署了一份保守机密的协议。
• Cryptography is the foundation of supporting authentication, integrality and confidentiality. 而密码学是支持认证、完整性和机密性机制的基础。

11 advisory   

adj.劝告的，忠告的，顾问的，提供咨询

参考例句：

• I have worked in an advisory capacity with many hospitals.我曾在多家医院做过顾问工作。
• He was appointed to the advisory committee last month.他上个月获任命为顾问委员会委员。

12 exemptions   

n.（义务等的）免除( exemption的名词复数 )；免（税）；（收入中的）免税额

参考例句：

• The exemptions for interpretive rules, policy statements, and procedural rules have just been discussed. 有关解释性规则、政策说明和程序规则的免责我们刚刚讨论过。 来自英汉非文学 - 行政法
• A: The regulation outlines specific exemptions for some WPM. 答：该规定概述了某些木质包装材料的特定的例外情形。 来自互联网

13 breaching   

攻破( breach的过去式 )； 破坏，违反

参考例句：

• The company was prosecuted for breaching the Health and Safety Act. 这家公司被控违反《卫生安全条例》。
• Third, an agency can abuse its discretion by breaching certain principles of judge-made law. 第三，行政机关会因违反某些法官制定的法律原则而构成滥用自由裁量权。

14 shred   

v.撕成碎片，变成碎片；n.碎布条，细片，些少

参考例句：

• There is not a shred of truth in what he says.他说的全是骗人的鬼话。
• The food processor can shred all kinds of vegetables.这架食品加工机可将各种蔬菜切丝切条。