Georgia Salanti

Evidence-based planning of future clinical trials

When existing evidence about the risks and benefits of the available medical treatment options is inconclusive, scarce or unreliable, there is public interest in designing and undertaking new studies to address evidence gaps with the minimum monetary and human cost involved.

To date, clinical trials that evaluate the efficacy and acceptability of medical interventions are primarily designed as stand-alone experiments ignoring previous evidence. Consequent, researchers potentially experiment with an unnecessarily large number of patients or try to address a question to which the answer is already known.

This presentation will outline a theoretical framework of efficient research planning that has the potential to direct resource allocation by optimally desinging future clinical studies after considering the existing evidence. The main methodological vehicle of the suggested framework is the circular updating of a network meta-analysis. Before planning a trial, the existing network of all competing treatments is considered and its conclusiveness is statistically evaluated. If further trials are needed these are designed with an aim to render the existing evidence conclusive after considering patient’s preferences. The results from the new trial are used to update the existing systematic review.