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Is it possible to paint an overly bleak picture of university based clinical research?

Recently I was reminiscing with an old colleague about  how our publications from almost 30 years ago that tried to encourage better conduct and reporting of clinical research seemed to have had so little impact. This one for instance.

Recently, they suggested there is some reason to hope for better, pointing to a website reporting on failures to enable open science by failure to share trial results.  If reason has little impact maybe some wider public awareness might work? So I checked the data on the list from the link they gave for some of the universities I was associated with in the past – [edit – sorted by percent missing] they were at the 11th, 32nd, 49th and 72nd percentile (higher being better). I was hoping they would in the 80th or higher.  Perhaps surprisingly, the higher percentiles seem to be occupied mostly by pharma for profit companies.

Then by distraction I happened across this. They focus on pharma for profit companies’ sharing of their trial results in a particular setting. It’s complicated, but better and improving.

I am sure there are some good reasons for the deficiencies being reported in universities (e.g. lack of resources, career pressures, inappropriate incentives, etc.) but this does need to change. Will  wider public awareness work in a university setting?

8 Comments

  1. Dale Lehman says:

    Interesting data in the links which I hope to look into further. Just casually looking at the rankings regarding sharing of results, it looks like there may be many potential contributing factors. It appears to me that you have to go to the 46th place before finding an American university or company while the bottom 10 spots appear to be all American companies. I’ll be interested to see if your observations about for-profit pharma companies or universities is robust versus my initial look at the country of location (of course, both may be true, or neither). Also of interest is my inability (not so interesting if it is just my failure) to access the data from the BMJ open access journal (your last link). In fact, I could not even open the supplementary files. The article says that the data can all be obtained from Bioethicsinternational.org when the article is published – but I could not find it there. Again, not very interesting if I just failed due to my own incompetence – but more interesting (at least ironic) if the data is actually not there.

  2. I had read some Chalmers & Sackett back in 90’s. It explains my intrigue with measurement.

  3. Things might be changing (slowly), due to increased outside scrutiny.
    Examples:

    1. Transparency International yesterday called for governments to ensure that all trials fully report their results. Their study documents in detail the immense costs of not doing so:
    http://ti-health.org/content/opacity-clinical-trials-medical-treatments-putting-patients-risk/
    (Disclosure: I was the lead author of that study.)

    2. TranspariMED recently published a study highlighting the (very weak) performance of UK universities:
    https://www.transparimed.org/single-post/2017/08/17/Top-medical-universities-in-the-UK-routinely-fail-to-post-clinical-trial-results-TranspariMED-study-finds

    3. A coalition of health groups has called on the UK govt to centrally monitor whether trials report their results:
    https://www.transparimed.org/single-post/2017/11/09/How-to-get-all-UK-clinical-trials-registered-and-reported

    In the US, CRIT at Yale University are doing excellent work on the topic.

    There are no technical or financial barriers to solving this problem, just political attention and political will.

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