* Means that does not reach statistical significance
Table 1
Characteristics of healthcare providers that responded to the survey.
| CHARACTERISTICS OF RESPONDENTS | NUMBER | PERCENTAGE |
|---|---|---|
| Age category (years) | ||
| <30 | 45 | 17.60% |
| 31–45 | 137 | 53.70% |
| 46–55 | 54 | 21.20% |
| 56–65 | 16 | 6.30% |
| >66 | 3 | 1.20% |
| Female sex | 51 | 20% |
| Specialty | ||
| Interventional cardiology | 114 | 44.70% |
| Clinical cardiology | 26 | 10.19% |
| Cardiac imaging/Echocardiography | 25 | 9.80% |
| Electrophysiology | 1 | 0.39% |
| Clinical researcher/Physician scientist | 17 | 6.67% |
| Allied healthcare professional | 48 | 18.82% |
| Cardiac-cardiothoracic surgery/vascular intervention | 4 | 1.57% |
| Other medical specialties | 19 | 7.45% |
| Medical student | 1 | 0.39% |
| Designation/Role | ||
| Cardiology consultant | 74 | 29.01% |
| Non-cardiology consultant | 17 | 6.67% |
| Cardiology fellow in training | 79 | 30.98% |
| Non-cardiology fellow in training | 19 | 7.45% |
| Allied healthcare professional | 48 | 18.82% |
| Others | 18 | 7.07% |
| Teaching/academic hospital | 234 | 91.80% |
| Actively functioning ethical committee (authority) in the respondent facility | ||
| Yes | 152 | 59.60% |
| No | 46 | 18% |
| The respondent did not know | 57 | 22.40% |
Figure 1
Insights of respondents toward conducting clinical trials in Iraq.
Figure 2
Perceived barriers to establishing clinical trials in Iraq.
Figure 3
Barriers that might prevent cardiovascular healthcare professionals from participating in clinical trials if invited to participate as co-investigators.
Figure 4
Perceived motivators for establishing clinical trials in Iraq.
*We mean allocation of credits by Medical Board/Council for physicians or fellows that participate in clinical trials.
Table 2
Previous participation of respondents in clinical trials according to baseline characteristics.
| FACTORS | YES | NO | |
|---|---|---|---|
| Age | % | % | |
| <30 | 15.6 | 84.4 | 0.033 |
| 31–45 | 29.2 | 70.8 | |
| 46–55 | 35.2 | 64.8 | |
| 56–65 | 56.3 | 43.8 | |
| >66 | 33.3 | 66.7 | |
| Gender | |||
| Male | 29.4 | 70.6 | 0.784 |
| Female | 31.4 | 68.6 | |
| Type of Hospital | |||
| Teaching/academic | 29.9 | 70.1 | 0.897 |
| non-teaching | 28.6 | 71.4 | |
| Presence of institutional active ethical committee | |||
| Yes | 31.6 | 68.4 | 0.42 |
| No | 32.6 | 67.4 | |
| Respondent did not know | 22.8 | 77.2 | |
| Specialty | |||
| Interventional cardiology | 29.8 | 70.2 | 0.294 |
| Clinical cardiology | 30.8 | 69.2 | |
| Cardiac imaging/Echocardiography | 45.8 | 54.2 | |
| Electrophysiology | 100 | 0 | |
| Clinical researcher/Physician scientist | 41.2 | 58.8 | |
| Allied health care professional | 20.8 | 79.2 | |
| Cardiac-cardiothoracic surgery/vascular intervention | 25 | 75 | |
| Other medical specialties | 20 | 80 | |
| Medical student | / | 100 |
Figure 5
Previous role of respondents in clinical trials.
Three respondents mentioned in the free text that their role in the clinical trial was published research, study-thesis, and head of department; these responses were not included in this figure.
*One respondent mentioned in the free text that he was the device implanter of a clinical trial.
**Some respondents chose (No) when they were asked if they had prior participation in clinical trials, yet they chose one of the roles when they were asked what your role in clinical trials was, we think that those respondents misinterpreted their participation in certain roles (mostly data collection) for research or interventional studies as participation in trials despite such studies are not necessarily were clinical trials.
Table 3
Respondents willing to participate in cardiovascular clinical trials in Iraq if invited.
| FACTORS | WILLING TO PARTICIPATE | |||
|---|---|---|---|---|
| YES | NO | CANNOT DETERMINE | p VALUE | |
| Age | % | % | % | |
| <30 | 44.4 | 4.4 | 51.1 | 0.072 |
| 31–45 | 56.9 | 2.2 | 40.9 | |
| 46–55 | 72.2 | 7.4 | 20.4 | |
| 56–65 | 68.8 | 0 | 31.3 | |
| >66 | 66.7 | 0 | 33.3 | |
| Gender | ||||
| Male | 61.3 | 4.4 | 34.3 | 0.043 |
| Female | 49 | 0 | 51 | |
| Type of Hospital | ||||
| Teaching/academic | 60.3 | 3.8 | 35.9 | 0.128 |
| non-teaching | 42.9 | 0 | 57.1 | |
| Presence of institutional active ethical committee | ||||
| Yes | 65.8 | 2 | 32.2 | 0.024 |
| No | 56.5 | 6.5 | 37 | |
| Respondent did not know | 42.1 | 5.3 | 52.6 | |
| Specialty | ||||
| Interventional cardiology | 62.3 | 3.5 | 34.2 | 0.012 |
| Clinical cardiology | 73.1 | 3.8 | 23.1 | |
| Cardiac imaging/Echocardiography | 33.3 | 4.2 | 62.5 | |
| Electrophysiology | 0 | 0 | 100 | |
| Clinical researcher/ Physician scientist | 88.2 | 0 | 11.8 | |
| Allied health care professional | 54.2 | 0 | 45.8 | |
| Cardiac-cardiothoracic surgery/vascular intervention | 75 | 0 | 25 | |
| Other medical specialties | 35 | 15 | 50 | |
| Medical student | 100 | 0 | 0 | |
Table 4
Multiple regression analysis of predictors of respondents willing to participate in future clinical trials in Iraq*.
| PREDICTOR | UNSTANDARDIZED COEFFICIENT B | STANDARD ERROR | 95% CI LOWER BOUND | 95% CI UPPER BOUND | p VALUE |
|---|---|---|---|---|---|
| Age | –0.124 | 0.078 | –0.277 | 0.03 | 0.115 |
| Gender | 0.176 | 0.159 | –0.137 | 0.488 | 0.269 |
| Specialty | 0.002 | 0.025 | –0.048 | 0.052 | 0.951 |
| Teaching/academic institution | 0.0343 | 0.216 | –0.081 | 0.768 | 0.112 |
| Active institutional ethical committee | 0.171 | 0.072 | 0.03 | 0.313 | 0.018 |
| Prior participation in clinical trials | 0.235 | 0.131 | –0.022 | 0.492 | 0.073 |
[i] *p = 0.002 for the regression model.
Figure 6
Qualitative data from the survey regarding cardiovascular healthcare providers opinions about clinical trials in cardiology in Iraq.
Figure 7
Action plan to establish clinical trials ecosystem in Iraq.