Lack of Adherence to Best Practices in Canadian Clinical Trials: Improving the Implementation Gap
Evidence-based medicine minimizes harmful practices and standardizes patient care.
According to the World Health Organization and the World Medical Association, all clinical trials must adhere to the following best practices: register their studies before enrolling patients, report their results, and publish their findings within a few years, regardless of the clinical trial outcome.
These best practices are the cornerstone of evidence-based medical research as ultimately, they aim to prevent the publication of biased results.
Read this open access paper on the FACETS website.
In our study, we identified 6,720 interventional Canadian clinical trials conducted between 2009 and 2019. Hundreds of thousands of patients were involved in these trials. Of all these trials, only 59% researchers registered the study prior to patient recruitment and 32% had neither their results reported nor their findings published.
When only 59% of clinical trials are registered prior to patient recruitment, it creates room for selective reporting, thereby skewing the results and by extension the evidence that healthcare professionals rely on when treating patients.
Merely 3% of all these trials met all three criteria: prospective registration, reporting results, and publishing findings. In other words, hundreds of thousands of patients likely unknowingly were enrolled in clinical trials that could have had skewed or biased results.
Furthermore, the odds of adhering to all three practices concurrently in Canadian trials decreased by 95% compared with international trials. The lack of adherence to these best practices calls into question the overall integrity of Canadian medical research.
Knowledge of this widespread non-compliance should motivate stakeholders in the Canadian clinical trial ecosystem to address and continue to monitor this problem.
Read the paper — Evaluating prospective study registration and result reporting of trials conducted in Canada from 2009 to 2019 by Mohsen Alayche, Kelly D. Cobey, Jeremy Y. Ng, Clare L. Ardern, Karim M. Khan, An-Wen Chan, Ryan Chow, Mouayad Masalkhi, Ana Patricia Ayala, Sanam Ebrahimzadeh, Jason Ghossein, Ibrahim Alayche, Jessie V. Willis, and David Moher.
