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Excerpt re the difference between G Britain and US research style.
"Maybe the most important factor is an attitudinal difference: British clinical researchers have a longstanding commitment to large, simple and rapid randomized trials. American researchers prefer smaller, selective and complex trials with many restrictions on patients who can enroll.
Martin Landray, the British epidemiologist who is one of the leaders of Britain’s effort, identified six other factors that contributed to its success in an interview with us. They should be applied in the United States to produce more rapid, large-scale clinical trials of Covid-19 therapeutics.
First, the Recovery trials are designed to be easy to take part in, with paperwork that is short and simple for health care providers — doctors, nurses, even medical students — to handle.
Second, the Recovery protocol was quickly approved at the national level and adopted by all hospitals in Britain.
Third, background patient data provided by the National Health Service helped to simplify the research process. Information like age, race and other health problems is already built into the hospital systems for all patients, so providers didn’t have to collect it. Follow-up data is more comprehensive because post-discharge mortality can be tracked through the N.H.S. database.
Fourth, support from leaders in government health care ensured widespread cooperation by hospitals. The four chief medical officers of England, Scotland, Wales and Northern Ireland wrote to every hospital executive in their country that participating in the Recovery trial was a priority.
Fifth, Britain has a national system of research nurses who were rapidly redeployed to work on Covid-19 research at the beginning of the pandemic.
And last, the British effort was incorporated as part of everyday clinical care in hospitals. The alternative, of haphazardly trying anything and everything, which seems to have been the American way, was rejected in Britain because it neither optimizes patient care nor generates useful data. The philosophy that clinical research is the standard of care — a philosophy common in cancer treatment — was the right and ethical approach for Covid-19.
An additional feature worth noting about the Recovery effort is that it has been relatively inexpensive to conduct. Oxford’s grant for the study was roughly $2.8 million. N.H.S. clinician
Excerpt re the difference between G Britain and US research style.
"Maybe the most important factor is an attitudinal difference: British clinical researchers have a longstanding commitment to large, simple and rapid randomized trials. American researchers prefer smaller, selective and complex trials with many restrictions on patients who can enroll.
Martin Landray, the British epidemiologist who is one of the leaders of Britain’s effort, identified six other factors that contributed to its success in an interview with us. They should be applied in the United States to produce more rapid, large-scale clinical trials of Covid-19 therapeutics.
First, the Recovery trials are designed to be easy to take part in, with paperwork that is short and simple for health care providers — doctors, nurses, even medical students — to handle.
Second, the Recovery protocol was quickly approved at the national level and adopted by all hospitals in Britain.
Third, background patient data provided by the National Health Service helped to simplify the research process. Information like age, race and other health problems is already built into the hospital systems for all patients, so providers didn’t have to collect it. Follow-up data is more comprehensive because post-discharge mortality can be tracked through the N.H.S. database.
Fourth, support from leaders in government health care ensured widespread cooperation by hospitals. The four chief medical officers of England, Scotland, Wales and Northern Ireland wrote to every hospital executive in their country that participating in the Recovery trial was a priority.
Fifth, Britain has a national system of research nurses who were rapidly redeployed to work on Covid-19 research at the beginning of the pandemic.
And last, the British effort was incorporated as part of everyday clinical care in hospitals. The alternative, of haphazardly trying anything and everything, which seems to have been the American way, was rejected in Britain because it neither optimizes patient care nor generates useful data. The philosophy that clinical research is the standard of care — a philosophy common in cancer treatment — was the right and ethical approach for Covid-19.
An additional feature worth noting about the Recovery effort is that it has been relatively inexpensive to conduct. Oxford’s grant for the study was roughly $2.8 million. N.H.S. clinician
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