Dr. Penny Reynolds presented “Why academic clinical trials fail: Trial cemetery demographics and a case study” at the 2017 Evidence Live conference at the University of Oxford. A survey of trials registered in ClinicalTrials.gov suggested that academic trial failures had little to do with the efficacy of the intervention. Instead, more than two-thirds of trial failures resulted from management issues: inadequate staffing, loss of key personnel, administrative burden, and unaccounted logistic and operational constraints. Investigators should be aware of these pitfalls, because failed clinical trials are a major cost burden, waste resources, and can pose significant risks to patients without providing benefit.
Evidence Live is hosted jointly by the British Medical Journal (BMJ) and the Centre for Evidence-Based Medicine (CEBM) at the Nuffield Department of Primary Care Health Sciences, University of Oxford. The theme of this year’s conference was Better Evidence For Better Health Care. Keynote speakers included Dr Carl Heneghan, Director, CEBM; Dr Fiona Godlee, Editor in Chief, BMJ; Sir Iain Chalmers, founder of the Cochrane Collaboration and Director UK Cochrane Centre; Professor Doug Altman, Director, Centre for Statistics in Medicine, and UK EQUATOR Centre; and Dr Ben Goldacre, author of Bad Science and Bad Pharma.
Problems with the current state of clinical research highlighted during the conference included the persistence of bad (not ‘poor’) trial methodology and reporting; lack of shared decision-making; high trial costs and regulatory burden; conflicts of interest, publication bias and selective reporting; and research conducted to further clinical careers rather than to benefit the public good. Talks, posters, hands-on workshops, and informal discussion groups generated strategies for development, dissemination, and implementation of better evidence for a variety of healthcare practices. A practical initiative to facilitate change was The Evidence-Based Medicine Manifesto For Better Healthcare BMJ 2017; 357 https://doi.org/10.1136/bmj.j2973