Journal articles highlight need for central coordination of trials
Australia has failed to develop a centralised system for running medical trials to combat the Covid-19 pandemic, a professor of infectious diseases has said, while a study has shown that many Covid-19 trials in Australia have been ineffective.
In an article published in the Medical Journal of Australia, Asha Bowen, head of the vaccines and infectious disease programme at the Telethon Kids Institute, writes that a lack of coordination on randomised controlled trials has weakened Australia’s pandemic response.
Whereas the UK and some parts of the United States have had a well-organised response, “there has been little central coordination in Australia for the prioritisation and funding of trials. Nor was there a nationally resourced and coordinated trials infrastructure in existence before the Covid-19 pandemic,” Bowen writes.
It has been “extremely challenging” to run trials of Covid-19 therapeutics in Australia, partly because of the relatively small number of patients in the country.
Bowen is also a specialist in paediatric infectious diseases at Perth Children’s Hospital. The article, which was co-written with other medical researchers, recommends the creation of a small number of national platforms to run publicly funded trials, according to the stage of disease.
Coalitions of groups of researchers should be created to “facilitate sharing of expertise and infrastructure, thus reducing the duplication of efforts”.
Bowen says there should be rapid mobilisation of government funds, and more help from chief health officers for local health providers to take part in trials.
“Furthermore, we recommend that a national pandemic clinical trials prioritisation panel be formed to advise the National Health and Medical Research Council, the Medical Research Future Fund, chief health officers and the national cabinet,” the article says.
Duplication of effort
In a separate study released on 19 July, researchers from the National Health and Medical Research Council’s clinical trials centre at the University of Sydney and from Westmead Hospital found that in Australian Covid-19 trials, “duplication of effort is a risk, and many trials alone are underpowered to find statistically significant effects for clinically important outcomes, including mortality”.
“Recruitment has been a particular issue in Australia due to low case numbers compared with other countries. Furthermore, funds in Australia were rapidly made available to support research addressing the pandemic, but little is known about how effectively these funds have been used to drive the global agenda of preventing, diagnosing and treating Covid‐19,” the researchers, led by Anna Seidler, a research fellow at the clinical trials centre, wrote.
The study also found that researchers in Australia were unlikely to share their Covid-19 trial data, with 80 per cent of clinical trials in the study “not planning to share data” despite international calls for better data sharing around the disease.