What Would a More Efficient Clinical Trial System Look Like?

What might a more-efficient trial system look like? One collaboration in Chicago offers a possible way forward.
Working together, several of the city’s academic medical centers have established a joint network for conducting clinical trials. Participating institutions now routinely interview all of their hospitalized patients, regardless of diagnosis, to keep detailed records on their health status. With permission, those records are made available to researchers.
Over 15 years, the process has enrolled 100,000 patients, many of whom are then recruited for clinical trials, said David O. Meltzer, a professor of medicine and director of the Center for Health and the Social Sciences at the University of Chicago. Much of the data is collected by undergraduates, and the team has grown large enough that newcomers can be trained without the need to constantly rebuild for each new trial, Dr. Meltzer said. “It’s wildly cost-effective,” he said, “and it’s incredibly good for the students.”
Even more savings could be realized by reconsidering when trial participants are even needed. A dozen years ago, Benjamin A. Olken, a professor of economics at the Massachusetts Institute of Technology, wanted to study corruption in Indonesia, to learn which of two strategies—threatening audits of government officials or giving community members a more direct role in monitoring—would do a better job of keeping road builders from “cheating.”