This following all research on stroke should be the minimum that our fucking failures of stroke associations should do for us. I don't have enough brainpower or minions to know about research that is registered but not published. As an example, what are
the 1000+ failed neuroprotective research trials that Dr. Michael Tymianski, of the Toronto Western Hospital Research Institute
in Canada talks about? I'm sure that with a minute amount of brainpower someone could figure out where to go from those failures. But we have to publicly know about them.
http://www.alphagalileo.org/ViewItem.aspx?ItemId=163549&CultureCode=en
Although the publication of results of clinical trials carried out in
the US within 12 months of their completion has been mandatory since
2007, an astoundingly high number of Phase III radiotherapy trials did
not do so, according to new research to be presented at the ESTRO 35
conference today (Saturday). An analysis of 802 trials with a primary
completion date of before 1 January 2013 showed that 655, or 81.7%, did
not publish even a summary result.
Jaime Pérez-Alija and his colleague Pedro Gallego, medical physicists
from the radiotherapy and oncology department, Hospital Plató,
Barcelona, Spain, also looked at radiotherapy trials that began before
the 2007 Act was passed, and found little difference; 422 out of 552, or
76.4%, did not deposit their results with the ClinicalTrials.gov
database.
“These findings came as a surprise for many reasons, not least of
which was that many of the trials had been funded by the US National
Institutes of Health. Since we know that clinical trials produce the
best data for decision-making in modern evidenced-based medicine, it is
particularly worrying that the law is being ignored on such a wide
scale,” Mr Pérez-Alija will tell the conference.
One possible reason for non-publication, say the researchers, is that
some of the trials may have been granted a deadline extension. But, if
this is the case, it is not publicly known. “Therefore, our first
problem is that we do not know with any certainty whether a trial is
truly overdue. The registry says clearly that all dates must be updated
if an extension has been allowed, but it seems likely that this is not
happening in many cases,” says Mr Pérez-Alija.
The researchers are investigating the issue further to see, for
example, how many of the trials registered in ClinicalTrials.gov or in
other databases are being published in medical journals. They will also
analyse bias, in the knowledge that it is easier and more usual to
publish positive rather than negative findings. They intend to email
principal investigators to ask why the mandatory deposition of results
did not take place, and to enquire about the reasons for non-publication
in medical journals of those trials where there is a published
deposition.
“Interestingly, we found that company-funded trials are far better at
complying with the rules than academic trials – 55% and 30%
respectively. However, only one-third of all the trials we studied were
company trials,” Mr Pérez-Alija will say.
The researchers broke down their results further by cancer sub-type.
The only sub-type where more than half the trial results were published
was eye cancer, with 47% unpublished, whereas in testicular and anal
cancer the percentage of unpublished trial results was 100% for both
categories. Even common cancers such as breast and lung fared badly,
with 78% and 73.7% of results unpublished respectively.
“We have shown that a large number of study participants are
routinely exposed to the risks of trial participation without the
benefits that sharing and publishing results would have for patients in
the future. This ethical issue should be at the heart of our current
medical practice, and our leaders should be made aware that withholding
these data poses a significant threat to public health. Both the US and,
more recently, EU laws have made important steps to correct this
situation. But if most trials – even those funded by public institutions
– do not comply with these requirements, further measures need to be
taken,” says Mr Pérez-Alija.
The US Act allows for economic sanctions to be taken against trial
sponsors who do not comply with regulations. But the danger here, the
researchers say, is that some investigators might decide not to begin a
new trial if sanctions are a possibility. Having fewer trials could be
damaging to the health system as a whole as well as to future patients.
A potential solution would be to institute a system whereby if
clinical investigators apply for public funding, they would have to
disclose results of all previously-conducted trials. And for
privately-funded trials, results from all previous studies would have to
be made available before the new trial could be registered.
“Millions of volunteers have participated in clinical trials to help
find out more about the effects of treatments on disease, yet the
important ethical issue of reporting results has been ignored widely.
Information about what was done, and what was found in these trials
could be lost forever, leading to bad treatment decisions, missed
opportunities for good medicine, and trials being repeated
unnecessarily. This situation should not be allowed to continue,” Mr
Pérez-Alija will conclude.
ESTRO President Professor Philip Poortmans commented: “Patients who
agree to participate in trials do so for the unselfish reason that they
want to help others to have the best possible treatment in the future.
Not to publish results is unfair to them, to future patients, and to
medicine as a whole.”
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