Effect of a US National Institutes of Health programme of clinical trials on public health and costs

  title={Effect of a US National Institutes of Health programme of clinical trials on public health and costs},
  author={S. Claiborne Johnston and J D Rootenberg and Shereen Katrak and Wade S. Smith and Jacob S. Elkins},
  journal={The Lancet},

Translating Research Findings Into Practice—The Unfulfilled and Unclear Mission of Observational Data

Randomized clinical trials (RCTs) are rightfully valued as the primary source of research data that drives changes in practice and directs evidence-based care. However, the time and associated costs

The value proposition of investigator‐initiated clinical trials conducted by networks

  • Medicine
    The Medical journal of Australia
  • 2021
This study finds that while the proportion of funding for nonindustry-sponsored investigator-initiated clinical trials (IITs) is relatively small, these studies account for more than half of Australia’s clinical trial activity.

Conducting clinical trials—costs, impacts, and the value of clinical trials networks: A scoping review

Key findings from the review are: 1) delayed trial activation has costs to budgets and research; 2) poor accrual leads to low-value trials and wasted resources; 3) the pharmaceutical industry can be a pragmatic, if problematic, partner in clinical research; and there are spillover benefits of clinical trials to healthcare systems.

Lessons Learned and Future Directions

  • J. Lee
  • Medicine, Psychology
  • 2009
The stroke research community can take pride in the solid base of evidence that has been built over the past 2 decades, and if the authors continue to follow the discoveries of science, create new trial methodology, and increase participation in clinical trials, significant advances in the treatment of cerebrovascular disease will continue.

Publicly funded practice-oriented clinical trials: of importance for healthcare payers.

Government should see public funding of pragmatic practice-oriented clinical trials as a good opportunity to improve the selection and quality of treatments and stimulate efficient use of limited resources.

Closing the cycle of innovation in healthcare in Europe

It would appear reasonable that decision makers should get more involved in priority setting and funding also in the field of clinical research in order to provide further evidence needed for assessments, reassessments, and subsequent qualified decisions and resource allocations in health care.

The Economic Case for New Stroke

Better thrombolytics for stroke that extended the time window or improved efficacy could generate greater revenue if priced at an accepted level of cost-effectiveness and potential returns to developers would appear to justify greater investment in new candidates.

NIH Disease Funding Levels and Burden of Disease

Current levels of NIH disease-specific research funding correlate modestly with US disease burden, and correlation has not improved in the last decade.

Does health intervention research have real world policy and practice impacts: testing a new impact assessment tool

A modified impact assessment process that builds on best practice to 5 years of intervention research funded by Australia's National Health and Medical Research Council to determine if these studies had post-research real-world policy and practice impacts was applied.

Genetics in clinical trials.

New tools including microarray technology, high-throughput screening and bioinformatics, when combined with large simple trial infrastructure, allow a better understanding of pharmacogenetics.



Can Medical Cost-Effectiveness Analysis Identify the Value of Research?

The prospects for harnessing the tools of medical cost-effectiveness to assess the expected value of research using a value of information framework are examined and it is suggested that value-of- information calculations may help assess the value ofResearch in a range of clinical contexts, including clinical trial design.

Quality of systematic reviews of economic evaluations in health care.

The reviews found consistent evidence of serious methodological flaws in a significant number of economic evaluations, and editorial teams and regulatory bodies should perform quality assurance based on a single widely accepted and validated standard instrument.

Estimating the economic value to societies of the impact of health research: a critical review.

The review did not identify any consistency of methodology, but the fourth approach has most promise as a measure of social value.

Measuring the Gains from Medical Research: An Economic Approach

In this book, leading health economists ask whether the authors are getting their money's worth on medical research; from an economic perspective, they find, the answer is a resounding "yes"; in fact considering the extraordinary value of improvements to health, they may even be spending "too little".

Payback arising from research funding: evaluation of the Arthritis Research Campaign.

A structured evaluation framework was applied to 16 case studies of research grants funded by the Arthritis Research Campaign in the early 1990s and a range of research paybacks was identified.

Relation between prepublication release of clinical trial results and the practice of carotid endarterectomy.

Pre prepublication dissemination of CEA trial results with clinical alerts was associated with prompt and substantial changes in medical practice, but the observed changes suggest that the results were extrapolated to patients and settings not directly supported by the trials.

Making economic evaluations respectable.

The underutilization of cardiac medications of proven benefit, 1990 to 2002.

Multistate utilization, processes, and outcomes of carotid endarterectomy.

All surgeons performing CEA should participate in outcome assessment and adopt protocols that include the routine administration of antiplatelet agents preoperative, the use of heparin intraoperatively, and patch angioplasty of the endarterectomy site.

Revisiting the Appropriateness of Carotid Endarterectomy

A major shift has occurred toward operating on asymptomatic patients, and rates of overuse appear to have fallen considerably, although they are still significant.