On the other hand, as federal research budgets have decreased in the U.S. and Canada, more industry sponsorship could allow trials to be conducted that would not otherwise have been possible, and new treatments made available, Kavanagh tells Reuters Health by phone. An overall increase in registration of trials is positive, he said.
“Before trial registration became a requirement for publication in journals, trials were started and negative results or unfavorable results were in many cases simply not published,” so as registration has increased, so has transparency, he says.
There are two ways to increase the number of NIH-funded trials, Ehrhardt says: increase the NIH budget, which seems unlikely, or specify focus areas for the NIH research budget, for example, on studies with implications for the largest number of people.
The National Cancer Institute Molecular Analysis for Therapy Choice (MATCH) trial includes 10 arms, or substudies, and new treatments can be added or dropped from the trial over time. This “umbrella trial” design helps maximize efficient use of funds, Denicoff tells Reuters Health by phone.
Clinical trial registration is not internationally mandated, so it is hard to know if this trend of decreasing federally funded trial research is happening elsewhere, says Dr. Vojtech Huser of the NIH, National Library of Medicine.