Systematically synthesised evidence already informs funding decisions for new clinical trials and is set to become an important part of future models of peer review. Within existing systems of peer review, information on the volume and quality of evidence underpinning a proposed trial is largely supplied by applicants and reviewers. In future, peer review will need to take on board independent systematic evidence as to the need for new trials and the appropriateness of their design.

The role of systematic reviews in providing quality information on which to base funding decisions is becoming increasingly important. At the MRC we have already introduced a standard question that applicants for trials funding must answer - "Has a systematic review been done and what were its findings". Those involved in generating the systematic evidence are also increasingly used as referees.

However, high quality systematic review of completed trials is only part of the picture. As trials become larger and increasingly multinational, it will become ever more important for funders to have access to reliable information on trials that other bodies have already started or are planning to start. Such information can prevent limited resources being expended on unnecessary trials and allow other trials to go ahead on the basis that they will contribute to the available power, rather than answering the question on their own. The challenge for the future is to encourage prospective registration of all new trials in easily accessible trials registers and to ensure that this information becomes part and parcel of the normal peer review system. More challenging still is ensuring access to reliable information on trials that other funding bodies may have 'in the pipeline'. The MRC is currently running a pilot project through the Cochrane Cancer Network to assess the feasibility and evaluate the usefulness of establishing this type of link in the peer review process.