Mitigating the Impact of COVID-19 on Funded Clinical Research: Crucial Next Steps

New reporting items and recommendations for randomized trials impacted by COVID-19 and force majeure events: a targeted approach

Background

Appropriate analyses and reporting are essential to the reproducibility and interpretation of clinical trials. However, the coronavirus disease 19 (COVID-19) pandemic and other force majeure events, like the war in Ukraine, have impacted the conduct of clinical trials.

Methods

The number of clinical trials potentially impacted were estimated from clinicaltrials.gov. To identify reporting items considered vital for assessing the impact of COVID-19, we reviewed 35 randomized phase III trials from three top oncology journals published between July and December 2020. For validation, we reviewed 29 phase III trials published between January and December 2021.

Results

Our results show that the number of clinical trials being potentially impacted in cancer, cardiovascular diseases, and diabetes is at least 1,484, 535, and 145, respectively. The magnitude of disruption is most significant in oncology trials. Based on the review of 35 trials, a modified checklist with ten new and four modified items covering pandemic's impact on trial conduct, protocol changes, delays, data capture, analysis and interpretation was developed to ensure comprehensive and transparent reporting. Our validation shows that six out of seven applicable reporting items were reported in less than 21% of the articles.

Conclusions

Our recommendations were proposed to improve the reporting of randomized clinical trials impacted by COVID-19 and force majeure events that are broadly applicable to different areas of medical research.

The COVID-19 Citizen Science Study: Protocol for a Longitudinal Digital Health Cohort Study

BACKGROUND

The COVID-19 pandemic has catalyzed a global public response and innovation in clinical study methods.

OBJECTIVE

The COVID-19 Citizen Science study was designed to generate knowledge about participant-reported COVID-19 symptoms, behaviors, and disease occurrence.

METHODS

COVID-19 Citizen Science is a longitudinal cohort study launched on March 26, 2020, on the Eureka Research Platform. This study illustrates important advances in digital clinical studies, including entirely digital study participation, targeted recruitment strategies, electronic consent, recurrent and time-updated assessments, integration with smartphone-based measurements, analytics for recruitment and engagement, connection with partner studies, novel engagement strategies such as participant-proposed questions, and feedback in the form of real-time results to participants.

RESULTS

As of February 2021, the study has enrolled over 50,000 participants. Study enrollment and participation are ongoing. Over the lifetime of the study, an average of 59% of participants have completed at least one survey in the past 4 weeks.

CONCLUSIONS

Insights about COVID-19 symptoms, behaviors, and disease occurrence can be drawn through digital clinical studies. Continued innovation in digital clinical study methods represents the future of clinical research.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/28169.

The hidden influence of communities in collaborative funding of clinical science

Every year the National Institutes of Health allocates $10.7 billion (one-third of its funds) for clinical science research while the pharmaceutical companies spend $52.9 billion (90% of its annual budget). However, we know little about funder collaborations and the impact of collaboratively funded projects. As an initial effort towards this, we examine the co-funding network, where a funder represents a node and an edge signifies collaboration. Our core data include all papers that cite and receive citations by the Cochrane Database of Systemic Reviews, a prominent clinical review journal. We find that 65% of clinical papers have multiple funders and discover communities of funders that are formed by national boundaries and funding objectives. To quantify success in funding, we use a g-index metric that indicates efficiency of funders in supporting clinically relevant research. After controlling for authorship, we find that funders generally achieve higher success when collaborating than when solo-funding. We also find that as a funder, seeking multiple, direct connections with various disconnected funders may be more beneficial than being part of a densely interconnected network of co-funders. The results of this paper indicate that collaborations can potentially accelerate innovation, not only among authors but also funders.