Study debunks idea that Covid trials cut clinical corners

Fears that clinical trials for Covid treatments cut corners are not supported by evidence which suggests many drug studies were better designed than those in other medical fields, a new study has claimed.

With researchers racing to find reliable vaccines and treatments for coronavirus in 2020, amid ongoing lockdowns and soaring death rates, there were concerns that the acceleration of many drug trials – which had typically taken years to complete, rather than months – may have led to a fall in quality control.

According to one paper in the Journal of Medical Ethics, some 4,000 studies had been placed on preprint servers throughout the year, while a further 1,221 clinical trials related to Covid had been registered by May 2020. Although efforts to ensure quality had been made, “no location is exempt from the pressures and speed at which Covid-19 research is occurring”, it remarked.

However, a new study by University of Oxford academics published in the journal Royal Society Open Science, which compared Covid drug trials to pre-pandemic trials, suggests that “pandemic research design may not be worse than usual and, based on some outcomes, may be improved”.

The study compared about 800 clinical trials for Covid with roughly 800 trials for respiratory, cardiovascular and infectious diseases similar to coronaviruses undertaken in 2018 and 2019.

It found that Covid trials demonstrated increased use of control groups and also randomisation – in which patients within a study group are randomly assigned different treatments, such as standard therapies or the drug being analysed.

There was also a greater prevalence of blinding of studies and the use of preregistered reports within Covid studies, which could reflect a “broader trend of improved research quality since the start of the pandemic”, the study says.

Overall, the study challenges the narrative which claims that “Covid-19 studies are of poor quality and that there is substantial room for improvement”.

“There was extensive evidence of poor-quality medical research before the pandemic and relatively few studies have compared Covid-19 trials to pre-pandemic trials,” it continues, adding that the current study “suggests that pandemic research design may not be worse than usual and, based on some outcomes, may be improved”.

However, the paper, published on 11 January, observes that “certain low-quality Covid-19 trials” which may not have been registered and therefore not part of the dataset may have had “an undue influence on global clinical care” and that the “influence of such trials would not be captured in this study”.

jack.grove@timeshighereducation.com