Article type
Year
Abstract
Background:
The output of randomized controlled trials (RCTs) is an important indicator of research priorities. Whether an association exists between the number of published RCTs and the global burden of disease has yet to be examined systematically.
Objective:
To assess the association between the quantity of RCTs and the global burden of disease, as determined in the 2010 Global Burden of Disease (GBD) study [Lancet 2012;380:2197–223].
Methods:
We identified and reviewed all primary reports of RCTs published in December 2012 and indexed in PubMed by 17 November 2013. Review of abstracts, review of full text papers and extraction of trial characteristics was performed in duplicate. No language restrictions were applied. The disease examined by each RCT was classified using the GBD criteria. Multivariable regression was used to examine the relationship between number of RCTs and total DALYs (Disability Adjusted Life Years), proportion of DALYs in middle-income (pDALYs-MICs) and proportion of DALYs in low-income countries (pDALYs-LICs).
Results:
4190 abstracts were reviewed and 1370 primary RCTs were identified, of which 1112 could be classified using the GBD taxonomy. 892 RCTs (82%) examined non-communicable diseases whereas 69 (6.2%), 14 (1.3%), 23 (2.1%), 23 (2.1%) and 91 (8.2%) examined communicable, maternal, neonatal and nutritional diseases and injuries, respectively. Total DALYs was poorly associated with number of RCTs in univariable analysis (R2 = 0.25), although it was a significant predictor in the univariable and multivariable models (p<0.01). pDALYs-LICs was inversely associated with number of RCTs (p<0.01) and pDALYs-MICs was not a significant predictor. Relative to total DALYs, neonatal sepsis was the most underrepresented disease, while female infertility was the most overrepresented (Table 1).
Conclusions:
Overall, there was a poor association between global burden of disease and number of published RCTs. Additionally, diseases with a high proportion of DALYs in LICs were associated with significantly fewer RCTs.
The output of randomized controlled trials (RCTs) is an important indicator of research priorities. Whether an association exists between the number of published RCTs and the global burden of disease has yet to be examined systematically.
Objective:
To assess the association between the quantity of RCTs and the global burden of disease, as determined in the 2010 Global Burden of Disease (GBD) study [Lancet 2012;380:2197–223].
Methods:
We identified and reviewed all primary reports of RCTs published in December 2012 and indexed in PubMed by 17 November 2013. Review of abstracts, review of full text papers and extraction of trial characteristics was performed in duplicate. No language restrictions were applied. The disease examined by each RCT was classified using the GBD criteria. Multivariable regression was used to examine the relationship between number of RCTs and total DALYs (Disability Adjusted Life Years), proportion of DALYs in middle-income (pDALYs-MICs) and proportion of DALYs in low-income countries (pDALYs-LICs).
Results:
4190 abstracts were reviewed and 1370 primary RCTs were identified, of which 1112 could be classified using the GBD taxonomy. 892 RCTs (82%) examined non-communicable diseases whereas 69 (6.2%), 14 (1.3%), 23 (2.1%), 23 (2.1%) and 91 (8.2%) examined communicable, maternal, neonatal and nutritional diseases and injuries, respectively. Total DALYs was poorly associated with number of RCTs in univariable analysis (R2 = 0.25), although it was a significant predictor in the univariable and multivariable models (p<0.01). pDALYs-LICs was inversely associated with number of RCTs (p<0.01) and pDALYs-MICs was not a significant predictor. Relative to total DALYs, neonatal sepsis was the most underrepresented disease, while female infertility was the most overrepresented (Table 1).
Conclusions:
Overall, there was a poor association between global burden of disease and number of published RCTs. Additionally, diseases with a high proportion of DALYs in LICs were associated with significantly fewer RCTs.