Limited resources for research into potential COVID-19 interventions make it critical to prioritize clinical trials, a group of research experts and bioethicists said. But because this important prioritization generally is not occurring upstream of individual institutions, the institutions themselves need to perform it, the experts wrote in Clinical Trials.
The institutions also must make certain to conduct their reviews in ways that ensure the most promising research moves forward first, and also that the research benefits everyone, said lead Michelle Meyer, assistant professor and associate director of research ethics at Geisinger Health System’s Center for Translational Bioethics and Health Care Policy.
“Happily, there are a lot of pharmaceutical—and nonpharmaceutical—interventions to be trialed in the fight against COVID-19,” Meyer said in an interview with RRC.
The paper lays out a framework for considering and prioritizing proposed clinical trials to determine ethically which proposals would best make use of scarce resources.
“The paper came about because most of the authors served on the committees that their respective institutions quickly stood up to do this prioritization work early in the pandemic,” Meyer said, noting that trial prioritization is uncommon outside of oncology. “What began as trading challenges and crowdsourcing solutions ended up with this article and, we hope, more work to come.”
The 12 co-authors also heard from other institutions with similar committees, Meyer said. However, she said, “I’m not sure to what extent most institutions that have done this work have appreciated the ethical aspects of it and, in particular, the importance of ensuring not only that scientifically strong trials testing promising interventions are trialed, but also in ensuring that trials collectively ‘cover’ research questions important to patients at different life stages (children, pregnant people), different disease stages (mild, moderate, and severe COVID-19, as well as preventive interventions), and different kinds of patients (e.g., those with and without a variety of comorbidities).”