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The Cooperative Landscape of Multinational Clinical Trials.

Hsiehchen D, Espinoza M, Hsieh A - PLoS ONE (2015)

Bottom Line: The scale and nature of cooperative efforts spanning geopolitical borders in clinical research have not been elucidated to date.In a cross-sectional study of 110,428 interventional trials registered in Clinicaltrials.gov, we characterized the evolution, trial demographics, and network properties of multinational clinical research.Performances in network centrality measures also highlight the differential contribution of nations in the global research network.

View Article: PubMed Central - PubMed

Affiliation: Mount Auburn Hospital, Cambridge, Massachusetts 02138, United States of America.

ABSTRACT
The scale and nature of cooperative efforts spanning geopolitical borders in clinical research have not been elucidated to date. In a cross-sectional study of 110,428 interventional trials registered in Clinicaltrials.gov, we characterized the evolution, trial demographics, and network properties of multinational clinical research. We reveal that the relative growth of international collaboratives has remained stagnant in the last two decades, although clinical trials have evolved to become much larger in scale. Multinational clinical trials are also characterized by higher patient enrollments, industry funding, and specific clinical disciplines including oncology and infectious disease. Network analyses demonstrate temporal shifts in collaboration patterns between countries and world regions, with developing nations now collaborating more within themselves, although Europe remains the dominant contributor to multinational clinical trials worldwide. Performances in network centrality measures also highlight the differential contribution of nations in the global research network. A city-level clinical trial network analysis further demonstrates how collaborative ties decline with physical distance. This study clarifies evolving themes and highlights potential growth mechanisms and barriers in multinational clinical trials, which may be useful in evaluating the role of national and local policies in organizing transborder efforts in clinical endeavors.

No MeSH data available.


Related in: MedlinePlus

Circular plots of collaborations in trials among geopolitical regions.(A) A circular plot portrays absolute levels of collaborations in trials among geopolitical regions across the globe from 1999 to 2003. The size of each regional segment corresponds to the relative contribution of each region to all collaborations produced worldwide. Tie widths at each end portray the relative contribution of collaborations between two regions to all collaborations associated with each individual region. (B) A circular plot of the same data from (A) except after normalization so that the collaborative output of each world region is the same. (C) A circular plot formatted in a similar manner to the plot in (A) except with data from 2009 to 2013. (D) A circular plot of the same data from (C) except after normalization so that the collaborative output of each region is the same. Regions are labeled as follows: Western Europe, WEu; Eastern Europe, EEu; Latin America, LAm; North America, NAm; Eastern Asia, EA; North Africa and Middle East, NAf&ME; South East Asia, SEA; Sub-Sahara, SS; South Asia, SA; Carribean, Ca.
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pone.0130930.g007: Circular plots of collaborations in trials among geopolitical regions.(A) A circular plot portrays absolute levels of collaborations in trials among geopolitical regions across the globe from 1999 to 2003. The size of each regional segment corresponds to the relative contribution of each region to all collaborations produced worldwide. Tie widths at each end portray the relative contribution of collaborations between two regions to all collaborations associated with each individual region. (B) A circular plot of the same data from (A) except after normalization so that the collaborative output of each world region is the same. (C) A circular plot formatted in a similar manner to the plot in (A) except with data from 2009 to 2013. (D) A circular plot of the same data from (C) except after normalization so that the collaborative output of each region is the same. Regions are labeled as follows: Western Europe, WEu; Eastern Europe, EEu; Latin America, LAm; North America, NAm; Eastern Asia, EA; North Africa and Middle East, NAf&ME; South East Asia, SEA; Sub-Sahara, SS; South Asia, SA; Carribean, Ca.

Mentions: Grouping nations by the UN human development (HD) index revealed that low HD countries have increased collaboration with medium HD countries over time at the expense of ties with high and very high HD countries. Moreover, internal collaborations increased and decreased for low HD and very high HD countries, respectively, while remaining minuscule in high and medium HD countries (Fig 6C and 6D). Tie formation organized by geopolitical regions also demonstrated the considerable and relatively uniform involvement of Western Europe in clinical research with other world regions (Fig 7). On the other hand, ties between either North America or East Asia (which includes research intensive countries such as China, Japan, and Korea) with non-European regions were diminutive. Notably, there was also a perceptible decline in the absolute and relative number of internal collaborations within Western Europe over the last decade.


The Cooperative Landscape of Multinational Clinical Trials.

Hsiehchen D, Espinoza M, Hsieh A - PLoS ONE (2015)

Circular plots of collaborations in trials among geopolitical regions.(A) A circular plot portrays absolute levels of collaborations in trials among geopolitical regions across the globe from 1999 to 2003. The size of each regional segment corresponds to the relative contribution of each region to all collaborations produced worldwide. Tie widths at each end portray the relative contribution of collaborations between two regions to all collaborations associated with each individual region. (B) A circular plot of the same data from (A) except after normalization so that the collaborative output of each world region is the same. (C) A circular plot formatted in a similar manner to the plot in (A) except with data from 2009 to 2013. (D) A circular plot of the same data from (C) except after normalization so that the collaborative output of each region is the same. Regions are labeled as follows: Western Europe, WEu; Eastern Europe, EEu; Latin America, LAm; North America, NAm; Eastern Asia, EA; North Africa and Middle East, NAf&ME; South East Asia, SEA; Sub-Sahara, SS; South Asia, SA; Carribean, Ca.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4478022&req=5

pone.0130930.g007: Circular plots of collaborations in trials among geopolitical regions.(A) A circular plot portrays absolute levels of collaborations in trials among geopolitical regions across the globe from 1999 to 2003. The size of each regional segment corresponds to the relative contribution of each region to all collaborations produced worldwide. Tie widths at each end portray the relative contribution of collaborations between two regions to all collaborations associated with each individual region. (B) A circular plot of the same data from (A) except after normalization so that the collaborative output of each world region is the same. (C) A circular plot formatted in a similar manner to the plot in (A) except with data from 2009 to 2013. (D) A circular plot of the same data from (C) except after normalization so that the collaborative output of each region is the same. Regions are labeled as follows: Western Europe, WEu; Eastern Europe, EEu; Latin America, LAm; North America, NAm; Eastern Asia, EA; North Africa and Middle East, NAf&ME; South East Asia, SEA; Sub-Sahara, SS; South Asia, SA; Carribean, Ca.
Mentions: Grouping nations by the UN human development (HD) index revealed that low HD countries have increased collaboration with medium HD countries over time at the expense of ties with high and very high HD countries. Moreover, internal collaborations increased and decreased for low HD and very high HD countries, respectively, while remaining minuscule in high and medium HD countries (Fig 6C and 6D). Tie formation organized by geopolitical regions also demonstrated the considerable and relatively uniform involvement of Western Europe in clinical research with other world regions (Fig 7). On the other hand, ties between either North America or East Asia (which includes research intensive countries such as China, Japan, and Korea) with non-European regions were diminutive. Notably, there was also a perceptible decline in the absolute and relative number of internal collaborations within Western Europe over the last decade.

Bottom Line: The scale and nature of cooperative efforts spanning geopolitical borders in clinical research have not been elucidated to date.In a cross-sectional study of 110,428 interventional trials registered in Clinicaltrials.gov, we characterized the evolution, trial demographics, and network properties of multinational clinical research.Performances in network centrality measures also highlight the differential contribution of nations in the global research network.

View Article: PubMed Central - PubMed

Affiliation: Mount Auburn Hospital, Cambridge, Massachusetts 02138, United States of America.

ABSTRACT
The scale and nature of cooperative efforts spanning geopolitical borders in clinical research have not been elucidated to date. In a cross-sectional study of 110,428 interventional trials registered in Clinicaltrials.gov, we characterized the evolution, trial demographics, and network properties of multinational clinical research. We reveal that the relative growth of international collaboratives has remained stagnant in the last two decades, although clinical trials have evolved to become much larger in scale. Multinational clinical trials are also characterized by higher patient enrollments, industry funding, and specific clinical disciplines including oncology and infectious disease. Network analyses demonstrate temporal shifts in collaboration patterns between countries and world regions, with developing nations now collaborating more within themselves, although Europe remains the dominant contributor to multinational clinical trials worldwide. Performances in network centrality measures also highlight the differential contribution of nations in the global research network. A city-level clinical trial network analysis further demonstrates how collaborative ties decline with physical distance. This study clarifies evolving themes and highlights potential growth mechanisms and barriers in multinational clinical trials, which may be useful in evaluating the role of national and local policies in organizing transborder efforts in clinical endeavors.

No MeSH data available.


Related in: MedlinePlus