Researchers say government efforts to focus NHS resources on fewer well-designed clinical trials could inadvertently contribute to a delay in stopped medical research and lead to the elimination of some important trials.
His warning comes when a report describes the scale of “research waste” that has occurred during the pandemic, with rampant duplication of scientific efforts and poorly designed clinical trials exposing millions of patients to untested treatments. , with few scientific benefits.
About 1 billion pounds of money from the Department of Health and Social Care (DHSC) is spent on funding medical research each year through the National Institute for Health and Care Research (NIHR), which also supports those conducting clinical trials by providing additional staff, such as nurses, facilities, and equipment.
When Covid was hit, these staff and resources were largely diverted to vaccine research or treatments, while scientists working in other areas suspended existing trials or struggled to recruit patients because of Covid’s restrictions or people’s fears about catching the coronavirus.
Now that some of these trials are being resumed, the DHSC has instructed NHS hospitals and universities to conduct a review of sponsored clinical trials and eliminate those that appear unlikely to be conducted, such as studies that they have difficulty recruiting enough patients or little practice due to staff availability.
“To ensure that the NHS research system continues to recover from the pandemic, we have asked sponsors and funders to conduct a review of their research, focusing on the most viable studies, which will yield as much as possible. the chance to succeed, “he said. DHSC said.
But some have warned that the DHSC revision risks creating more delays and could lead to some major studies being left out.
Nikola Sprigg, a professor of stroke medicine at the University of Nottingham, said: “It’s a good idea at first, but the process is taking so long that it is leaving people in limbo and causing further delays.”
He is concerned that some studies that have failed to recruit enough participants may be judged unfeasible for review and that their funding may be withdrawn, but could have been more successful if they had not been delayed.
“Often some of the most important trials are the hardest to do,” Sprigg added. “I think there needs to be some kind of process to make sure that the really important questions or the potentially beneficial treatments are not misdirected.”
Dr Simon Kolstoe, a bioethicist at the University of Portsmouth who studies research waste, said: “This is a pragmatic decision, but it will be sad for many fields of research, such as cancer research, where it seems funding will be withdrawn, perhaps rightly so, because they have stopped for so long that they will never gather all the data they need to produce meaningful results.
“The concern is that if they are not nuanced enough in how they do it, they can force the studios to close, which, if given a little more, would be fine.”
However, Till Bruckner, the founder of TranspariMED, which campaigns for greater transparency in medical research, described it as a bold move that “will greatly benefit patients and taxpayers,” citing the pandemic as an example of the waste it can be medical research.
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According to a report released by TranspariMED and Health Action International last week, most clinical trials of potential Covid drugs focused on only a handful of treatment options, while inconsistencies in their design made it difficult to group data from similar studies to calculate a global effect. As of October 2020, nearly a third of the 516 trials recorded during the first hundred days of the pandemic had not recruited any patients, according to the report.
The UK recovery trial, the world’s largest randomized controlled trial of drugs against Covid-19, was a rare example of a study that provided useful information through its flexible design, which allowed it to evolve. as knowledge about the pandemic grew.
Bruckner said: “The UK’s excellent Covid research program has clearly demonstrated the benefits of focusing NHS resources on a limited number of well-designed, well-resourced studies that quickly show what treatments work. “But the uncoordinated chaos of research in most other countries yielded virtually no useful evidence.”
The DHSC said each study should have a procedure in place to ensure the well-being of participants if it is to be closed soon, as this is necessary as part of its authorization by the Health Research Authority.