The value of participating in clinical trials: the whole is greater than the sum of its parts

Engaging clinicians in the process of trial design, and the ensuing dialogue about best practice, can improve routine care

Evidence-based medicine remains the Holy Grail for clinicians and policy makers, and is dependent on the results of large randomised phase 3 clinical trials and on meta-analyses of all related phase 3 trials of treatment in a specific patient population.1 Irrespective of whether clinical trials test a new intervention or a drug or are comparative effectiveness studies, the findings have the potential to not only affect routine clinical practice but to inform the evidence base to lay a solid foundation for optimal care in the future as well as raise new research questions. The cost of these large trials and the resources required to mount such studies are considerable, which inevitably raises questions about whether the study is essential to answer a clinical question. Indeed, it is not uncommon to be asked by grant reviewers “do we need to do these studies in Australia?”