Medical research has stalled as the NHS focuses on a small number of trials, experts say Medical research

Government efforts to focus NHS resources on a smaller number of well-designed clinical trials could inadvertently contribute to a delay in halted medical research, and result in some major trials being phased out, researchers say.

Their warning comes as a report outlines the scale of “research waste” that occurred during the pandemic, with rampant duplication of scientific efforts and poorly designed clinical trials exposing millions of patients to unproven treatments, with little scientific benefit.

About £ 1 billion from the Department of Health and Social Care (DHSC) is spent 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 researching vaccines or treatments for it, while scientists working in other areas either stopped existing trials or struggled to recruit patients because of Covid restrictions or people’s fears of catching coronavirus.

Now that some of those attempts are starting again, the DHSC taught NHS hospitals and universities are conducting a review of the clinical trials they sponsor and eliminating those that seem unlikely to deliver, e.g. studies that struggle to recruit enough patients, or are impractical due to the availability of staff.

“To ensure that the NHS research system continues to recover from the pandemic, we have asked sponsors and funders to review their research – focusing on studies that are most feasible that will give as many opportunities as possible to succeed,” the DHSC said. said.

But some have warned that the DHSC review risks creating further delays, and could result in some major studies falling apart.

Nikola Sprigg, a professor of stroke at the University of Nottingham, said: “It’s a good idea in principle, but the process takes so long that it leaves people in limbo and causes extra delays.”

She is concerned that some studies that failed to recruit enough participants could be judged as unfeasible by the review and have their funding withdrawn, however they may have been more successful if they had not been delayed.

“Often, some of the most important tests are the hardest to do,” Sprigg added. “I think a process is needed to make sure that really important issues, or perhaps useful treatments, are not improperly dismissed.”

Dr Simon Kolstoe, a bioethicist at the University of Portsmouth who studies research waste, said: funding drawn, perhaps rightly so, because they have been paused for so long that they will never collect all the data they need to produce meaningful results.

“The concern is that if they’re not nuanced enough about how they do that, they might force studies to close, which in fact, if given a little longer, 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 would “greatly benefit patients and taxpayers,” citing the pandemic as an example of how wasteful medical research can be.

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According to a report published by TranspariMED and Health Action International last week, most clinical trials of potential Covid drugs focused on just a few treatments, while inconsistencies in their design made it difficult to combine data from similar studies to calculate overall effect. As of October 2020, almost a third of the 516 trials recorded during the first hundred days of the pandemic had not recruited a single patient, said the report.

The UK rehearsal – the largest randomized controlled trial of drugs against Covid-19 in the world – was a rare example of a study that provided useful information with its flexible design that allowed it to evolve as knowledge of the pandemic grew.

Bruckner said: “Britain’s outstanding Covid research program has clearly demonstrated the benefits of concentrating NHS resources on a limited number of well-designed and well-resourced studies that quickly show which treatments work and which don’t. In contrast, the uncoordinated research chaos in most other countries it has produced 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 close early, as this is required as part of their authorization from the Health Research Authority.

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