Clinical Trials Networks are collaborative groups of practicing clinician researchers (often several hundred per network) that come together to identify important clinical questions and design large multi-centre clinical trials to answer them. Some also conduct trials in collaboration with industry but the majority have a strong focus on investigator-initiated trials that can provide unbiased, high-quality scientific evidence of the effectiveness or cost effectiveness of interventions.
Most of Australia’s Clinical Trials Networks are predominantly national or bi-national groups (some smaller groups are state-based) but all are as broadly inclusive as possible of any clinician researcher (medical, nursing and allied health practitioners + career clinical researchers) wanting to be part of the group and contribute to trials in their field.
Unlike academic health science centres or other geographically focused academic/health research partnerships, clinical trials networks extend across state borders and well into regional – and in some cases rural – Australia. For example, the ANZICS Clinical Trials Group has 90 intensive care units that contribute to the design and conduct of the group’s trials.
This horizontal distribution across the health system ensures that trials conducted by networks have strong external validity (the trial results are more likely to be broadly representative of real world practice); provides training and mentoring for clinical trial sites and the clinical trials workforce outside of the major metro teaching hospitals/centres; and maximises access for eligible patients.
One of their primary functions is the collective peer review and endorsement of trial proposals. This ensures that trials conducted by networks are investigating an important clinical question, that the trial is scientifically rigorous, that there is sufficient engagement, capacity and feasibility to conduct the trial.
Networks predominantly conduct phase 2,3 and 4 trials. They tend to have the capacity to recruit larger numbers of patients or complete trials in smaller sub-groups of patients through broad national and international collaboration. They also develop group “brand” or “track record” for excellence that supports greater funding success.
Networks all vary slightly in the way they’re structured and how they operate but in general, they can be categorised into two groups: Facilitating Networks and Coordinating Networks (to find out more about these models check out the Profiling Networks Report link below).
It is widely considered that one of the key benefits of clinical trial networks is that they facilitate more rapid translation of trial results into practice because they have the engagement or “buy-in” of a large and broadly distributed group of practicing clinicians; those that participate in the trial being more likely to translate the results of the trial into practice.
ACTA’s recent national study of Australia’s Clinical Trials Networks completed for the NHMRC found that over the last decade, Australian networks have completed or initiated more than 1,000 clinical studies involving more than 1 million participants and representing at least $1 billion in total research funding (possibly much more).