2020 Submission: Topic 5: Health Strategy

Another chunk of my 2020 gabfest submissions, to Topic 5 (Health Strategy).  Other submissions and discussion via the 2020 Gabfest category filter

A: Supporting an international registry of all pharmaceutical trials

More efficient and efficacious delivery of the most suitable medication is currently prevented worldwide because of poor governance of data relating to the results from clinical trials.

Often, companies hide unfavorable results, while publishing numerous papers from favorable results. Some experts have advocated that all drug research is registered beforehand, and publications are linked to the registry, allowing better assessment of both published and unpublished results, and thus more appropriate supply of drugs to patients.

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Notes/See Also

• Yes, it is a minor point, but because it can save big bucks, it can free cash for other issues.
   
• More appropriate implies cheaper-in-the-long-run, lower costs from iatrogenic problems, especially if newer drugs with barely marginal increases in efficacy (and worse economics) are not put onto the PBS.
   
• Getting document management (metadata and privileges) in medical records allowing better policy analysis would also be important (see OMG’s Clinical Observation Access Service, and – but such issues are in large part covered by the general document management suggestions covered here.  For epidemiology and health economic geeks, the following items may be of interest (with proper labelling by ICD and ICHI funding priorities can be assessed, and COAS helps make medical records interchange between clinicians efficient while maintaining privacy).
  • WHO ICD (International Classification of Diseases)
  • WHO ICHI (International Classification of Health Interventions
  • COAS (Clinical Observations Access Service) 1.0 from the OMG Healthcare Domain Task Force as well as related work from the OMG Life Sciences Research DTF
• "Are drug trials stopped too early to exaggerate benefits?" : New Scientist/Health (2008-08-09) based, among other things, on : Annals of Oncology DOI:10.1093/annonc/mdn042 "Stopping a trial early in oncology: for patients or for industry?"
   
• ToDo: I’ll add more pointers to articles in PLoS and other journals about these issues, in particular the call by scientists and health economists for such a registry, at a later stage.  Of course, feel free to add a comment with a useful link!

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